Training for a Mass Casualty Incident: Conception, Development and Implementation of a Crew-Resource Management Course for Forward Surgical Teams.

Abstract

The purpose of this article is to describe the development of a crew resource management (CRM) training course dedicated for the forward surgical teams (FSTs) of the French Military Health Service. Since 2021, the predeployment training of French FSTs has included a simulation-based curriculum consisting of organizational and human factors. It combines lectures, laboratory exercises, and situational training exercises to consider four fundamental "nontechnical" (cognitive and social) skills for effective and safe combat casualty care: (a) leadership, (b) decision-making, (c) coordination, and (d) situational awareness. The approach was based on three steps: (1) establishment of a conceptual framework of FSTs deployment; (2) development and implementation of an aircrew-like CRM training dedicated to combat casualty care; and (3) assessment of FSTs' CRM skills using an audio/video recording of a simulated mass-casualty incident. To ensure complete and high-quality predeployment training, French FSTs undergo a high-quality training that takes into account both technical and non-technical skills to maintain quality of combat care during mass-casualty incidents.