Document Type

Doctoral Project

Publication Date

2016

Abstract

Trauma assessment is a core skill for all United States Air Force nurses. However, with the recent withdrawals from Iraq and Afghanistan, there are serious concerns about how Air Force nurses can maintain high-level trauma skills without the frequent exposure and opportunities in which to perform them. Although training affiliation agreements with local civilian trauma centers exist, it is difficult to routinely send nurses to receive training in these facilities due to time constraints. Simulation is a feasible way to provide essential training and allows participants to practice critical skills during reproducible scenarios in a realistic but non-threatening environment. Providing relevant and targeted didactics prior to the simulation experience follows the principles of problem-based learning of allowing participants to use prior knowledge to critically think through a situation. This evidence-based practice project was designed to answer the following question: In nurses required to perform trauma assessments, how does interval training using the Hybrid Educational Method (HEM) (combination of didactics and simulation) affect knowledge and skill retention compared to current skill acquisition? An extensive literature review demonstrated both didactics and simulation, when used together, increase knowledge and/or skill retention. A pilot project was conducted at a local military medical center and a validated and reliable data evaluation tool was used to measure trauma skill and knowledge at specified time periods. Outcome data was analyzed and inserted in the Predictive Performance Optimizer (PPO) model to evaluate skill decay rates and establish the right “dose” of training to ensure skill retention. Results demonstrated the HEM is effective in delivering trauma assessment training and maintaining knowledge and skill retention over time. This is further bolstered when training is accomplished during the right interval, providing the right “dose” of training to maintain a set competency level. Although this project exhibited the HEM can be used with both novice and experienced nurses to obtain and maintain trauma assessment skills and the PPO could effectively predict the appropriate time a small sample of participants returned to maintain proficiency, further studies are warranted on a large scale to truly measure the HEM and PPO’s effectiveness and generalizability.

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