Battlefield Trauma Training: A Pilot Study Comparing the Effects of Live Tissue vs. High-Fidelity Patient Simulator on Stress, Cognitive Function, and Performance

Abstract

Within the Canadian Armed Forces (CAF), the Tactical Medicine (TACMED) course is used to train medical technicians (i.e., medics) in battlefield trauma care. Although training is administered using both simulators (SIM) and live tissue (LT), little is known about their relative effects on stress and cognitive function in this context. To address this shortcoming, we conducted a pilot study and collected self-report (State-Trait Anxiety Inventory [STAI]) and biological measures of stress (salivary cortisol and dehydroepiandrosterone [DHEA]), as well as working memory (WM) and short-term memory (STM) data from medics (N = 20) assigned randomly to training and skill assessment using either SIM or LT. Skill assessment resulted in the elevation of STAI scores and salivary cortisol and DHEA levels. WM and STM performance were better at the time of skill assessment, and WM performance exhibited a positive correlation with salivary cortisol level. Salivary cortisol and DHEA levels, STAI scores, and memory performance did not predict pass/fail rates on combat casualty care skills. Although the TACMED course was associated with elevated stress and improved memory performance, those effects were not affected by the training modality. We end by discussing lessons learned from our pilot study and highlight outstanding questions that remain to be addressed in future studies on this topic.