Human Patient Simulator Research Articles

Developing clinical skills in paediatric dysphagia management using human patient simulation (HPS)

Purpose: The use of simulated learning environments to develop clinical skills is gaining momentum in speech-language pathology training programs. The aim of the current study was to examine the benefits of adding Human Patient Simulation (HPS) into the university curriculum in the area of paediatric dysphagia.Method: University students enrolled in a mandatory dysphagia course (n = 29) completed two, 2-hour HPS scenarios: (a) performing a clinical feeding assessment with a medically complex infant; and (b) conducting a clinical swallow examination (CSE) with a child with a tracheostomy. Scenarios covered technical and non-technical skills in paediatric dysphagia management. Surveys relating to students’ perceived knowledge, skills, confidence and levels of anxiety were conducted: (a) pre-lectures; (b) post-lectures, but pre-HPS; and (c) post-HPS. A fourth survey was completed following clinical placements with real clients.Result: Results demonstrate significant additive value in knowledge, skills and confidence obtained through HPS. Anxiety about working clinically reduced following HPS. Students rated simulation as very useful in preparing for clinical practice. Post-clinic, students indicated that HPS was an important component in their preparation to work as a clinician.Conclusion: This trial supports the benefits of incorporating HPS as part of clinical preparation for paediatric dysphagia management.

Strategies To Teach Physiology in An Era of Declining Lecture Attendance

Lecture simulcasts and web‐based archiving have reduced class attendance among preclinical medical students, even as labs and demos decline. Thus while the basic science years of MD education have historically been the primary arena for physiology instruction, its content experts increasingly face empty seats. In 16 years of running a Respiratory Module for MD‐2 students (175/yr), we have resisted this trend via a menu of opportunities to engage students. Of these, four draw more students than the 30‐40% at lectures. By attendance and student evaluations, the most popular are two where groups of <18 perform: 1) a Pulmonary Function Test (PFT) for basic spirometry and plethysmography and then join pulmonologists to discuss new PFT cases (>95% attend); 2) a 7‐stage Human Patient Simulation (HPS) to diagnose and treat a ‘penetrating chest wound of unknown etiology’ (>90% attend). While voluntary, many students attend twice; enthusiastic evaluations lead later classes to arrive with positive expectations. Then all lectures, labs, PFT, and HPS are revisited at weekly Structured Speed Reviews (SSR) summarizing each hour of content in 10 min and are recorded like lectures by Tegrity; >65% attend. Finally, we hold 2‐3 Facilitated Peer‐to‐Peer (FPTP) lunch hours per week. Attended by 15‐20% of students, FPTPs are guided by faculty but students identify concepts to review, complete practice problems, and explore tangential topics of mutual interest. Costs (personnel, facilities, time) and benefits of the PFT, HPS, SSR, and FPTP are evaluated yearly.

High-fidelity simulation of transcutaneous cardiac pacing: characteristics and limitations of available high-fidelity simulators, and description of an alternative two-mannequin model.

Transcutaneous cardiac pacing (TCP) is a potentially lifesaving technique that is part of the recommended treatment for symptomatic bradycardia. Transcutaneous cardiac pacing however is used uncommonly, and its successful application is not straightforward. Simulation could, therefore, play an important role in the teaching and assessment of TCP competence. However, even the highest-fidelity mannequins available on the market have important shortcomings, which limit the potential of simulation. Six criteria defining clinical competency in TCP were established and used as a starting point in the creation of an improved TCP simulator. The goal was a model that could be used to assess experienced clinicians, an objective that justifies the additional effort required by the increased fidelity. The proposed 2-mannequin model (TMM) combines a highly modified Human Patient Simulator with a SimMan 3G, the latter being used solely to provide the electrocardiography (ECG) tracing. The TMM improves the potential of simulation to assess experienced clinicians (1) by reproducing key features of TCP, like using the same multifunctional pacing electrodes used clinically, allowing dual ECG monitoring, and responding with upper body twitching when stimulated, but equally importantly (2) by reproducing key pitfalls of the technique, like allowing pacing electrode misplacement and reproducing false signs of ventricular capture, commonly, but erroneously, used clinically to establish that effective pacing has been achieved (like body twitching, electrical artifact on the ECG, and electrical capture without ventricular capture). The proposed TMM uses a novel combination of 2 high-fidelity mannequins to improve TCP simulation until upgraded mannequins become commercially available.

The use of a novel technology to study dynamics of pathogen transmission in the operating room.

Pathogenic organisms have been found in the intraoperative environment, potentially posing a risk of infection that could cause morbidity and mortality. In an effort to understand how a patient's bacteria can be spread throughout the operating room with the anesthesia provider as a vector, we conducted a study using recently developed experimental technology in a simulated operating room environment with a high-fidelity human patient simulator.

The impact of exposure to liver transplantation anesthesia on the ability to treat intraoperative hyperkalemia: a simulation experience.

The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify and treat a simulated hyperkalemic crisis after reperfusion more appropriately than residents who have not been involved in liver transplantation anesthesia care. Participation in liver transplantation anesthesia is not a mandatory component of the curriculum of anesthesiology training programs in the United States. It is unclear whether exposure to liver transplantation anesthesia is beneficial for skill set development. A high-fidelity human patient simulation scenario was developed. Times for administration of epinephrine, calcium chloride, and secondary hyperkalemia treatment were recorded. A total of 25 residents with similar training levels participated: 13 residents had previous liver transplantation experience (OLT), whereas 12 residents had not been previously exposed to liver transplantations (non-OLT). The OLT group performed better in recognizing and treating the hyperkalemic crisis than the non-OLT group. Pharmacologic therapy for hyperkalemia was given earlier (OLT 53.3 ± 27.0 seconds versus non-OLT 148 ± 104.1 seconds; P < 0.01) and hemodynamics restored quicker (OLT 87.9 ± 24.9 seconds versus non-OLT 219.9 ± 87.1 seconds; P < 0.01). Simulation-based assessment of clinical skills is a useful tool for evaluating anesthesia resident performance during an intraoperative crisis situation related to liver transplantations. Previous liver transplantation experience improves the anesthesia resident's ability to recognize and treat hyperkalemic cardiac arrest.

Asthma Exacerbation: An Emergency Medicine Simulation Scenario.

In the practice of emergency medicine, simulation is a valuable tool that allows medical students and postgraduate residents to develop skills in a safe environment at no risk to patients. In this report, we present a case simulation of an acute asthma exacerbation utilizing a human patient simulator. The case is designed such that it can be easily modified to accommodate the trainee’s level of expertise, allowing instructors to challenge both the novice and advanced learner alike.

Simulation in the intensive care setting.

About 10 years ago, the first human patient simulators were introduced to intensive care units (ICUs). Since then, there has been a rapid development of both technical and non-technical aspects in medical education. The aim of this review is to elaborate how simulation training is already used in the intensive care setting, the role of different types of commercially available mannequins and which benefits can be achieved for participants by using this teaching method. Furthermore, a practical example describes how a simulation curriculum can be designed, which challenges might need to be faced and which steps need to be taken to make the most out of the training. Human patient simulation is an effective tool in the education of health-care professionals and will surely become an important part in the training of ICU physicians as well.

Human patient simulation to improve the attitude of the nursing students

Attitude is an essential attribute of a nurse. Nursing education has an important role to shape the attitude of the nursing students, as a foundation of their attitude as nurses. The aim of this study was to evaluate the effect of the human patient simulation learning method on the attitude of the nursing students. Quasi-experimental, two group pre/post-test design was used. A total of 95 nursing students of the second year were given intervention and 37 students from another institution were assigned as control group. Second year students were selected as they were about to have clinical practice at the hospital. After the human patient simulation the attitude score statistically significantly increased in the intervention group ( p < .01). The attitude score in the intervention group rose by 18.7 points (scale 37-185) and decreased by 8.2 point in the control group. The findings showed that the human patient simulation improved the attitude of the nursing students before having the actual learning experience with the patients at the hospital. Clinical learning environment in Indonesia is generally far from ideal to shape good attitude of the nursing students. Thus, human patient simulation is recommended to prepare the nursing students prior to clinical internship.

SimTCM: A human patient simulator with application to diagnostic accuracy studies of Chinese medicine

ObjectiveThe aim of this work is to develop and implement the SimTCM, an advanced computational model that incorporates relevant aspects from traditional Chinese medicine (TCM) theory as well as advanced statistical and epidemiological techniques for simulation and analysis of human patients. MethodsSimTCM presents five major attributes for simulation: representation of true and false profiles for any single pattern; variable count of manifestations for each manifestation profile; empirical distributions of patterns and manifestations in a disease-specific population; incorporation of uncertainty in clinical data; and the combination of the four examinations. The proposed model is strengthened by following international standards for reporting diagnostic accuracy studies, and incorporates these standards in its treatment of study population, sample size calculation, data collection of manifestation profiles, exclusion criteria and missing data handling, reference standards, randomization and blinding, and test reproducibility. ResultsSimulations using data from patients diagnosed with hypertension and post-stroke sensory-motor impairments yielded no significant differences between expected and simulated frequencies of patterns (P = 0.22 or higher). Time for convergence of simulations varied from 9.90 s (9.80, 10.27) to 28.31 s (26.33, 29.52). The ratio iteration profile necessary for convergence varied between 1:1 and 5:1. ConclusionThis model is directly connected to forthcoming models in a large project to design and implement the SuiteTCM: ProntTCM, SciTCM, DiagTCM, StudentTCM, ResearchTCM, HerbsTCM, AcuTCM, and DataTCM. It is expected that the continuity of the SuiteTCM project enhances the evidence-based practice of Chinese medicine. The software is freely available for download at: http://suitetcm.unisuam.edu.br.

Caring Behaviors Among Student Nurses Interacting in Scenario-Based High Fidelity Human Patient Simulation

Important questions remain around the increased use of simulation in nursing education and the development of caring competencies. An observational study of 105 nursing students was conducted to explore the caring behaviors demonstrated during simulations and to examine the affordances and limitations of the simulation milieu to support development of caring competencies. The McDaniel (1990) instrument was adapted for scoring caring behaviors. A majority of participants exhibited passive caring behaviors. Self-initiated and transpersonal caring behaviors occurred in low frequency. Caring is important to patient health, satisfaction, and quality healthcare. Recommendations to support development of caring behaviors in simulation are offered.

Cross-Cultural Validation and Psychometric Testing of the Questionnaire: Debriefing Experience Scale

BackgroundIn the use of human patient simulation, there is a need for standardized and validated instruments across both national boundaries and cultural conditions. The aim of the present study was to translate and validate the Debriefing Experience Scale in a Norwegian context. MethodThe study was conducted as a survey of 146 bachelor's nursing undergraduates. An expert group, conventional content analysis, the known-group technique, and psychometric testing were all used. ResultsThe scale seemed to hold good potential for evaluating debriefing but would also benefit from reducing the subscales. ConclusionsBecause of testing for validity being an ongoing process, there is a need for more studies to draw conclusions about the properties of questionnaire.

Student and educator experiences of maternal-child simulation-based learning: a systematic review of qualitative evidence protocol.

Review question/objective The overall aim of this systematic review is to identify the appropriateness and meaningfulness of maternal-child simulation-based learning for undergraduate or pre-registration nursing students in educational settings to inform curriculum decision-making. 1. What are the experiences of nursing or health professional students participating in undergraduate or pre-licensure maternal-child simulation-based learning in educational settings? 2. What are the experiences of educators participating in undergraduate or pre-licensure maternal-child simulation-based learning in educational settings? 3. What teaching and learning practices in maternal-child simulation-based learning are considered appropriate and meaningful by students and educators? Inclusion criteria Types of participants Participants will include undergraduate or pre-registration or pre-licensure nursing or midwifery or health professional students and educators participating in maternal-child simulation-based learning. Midwifery or undergraduate medical students are included as participants as their clinical learning experiences are similar to undergraduate nursing students. However students in graduate, postgraduate, or specialty education programs and practising nurses or other health care professionals (continuing education) will be excluded from this review because the purpose is to identify the implications for undergraduate or pre-registration nursing programs. Undergraduate or pre-registration education differs from continuing professional education as students are more likely to be learning this way of thinking or clinical reasoning for the first time. The pedagogical approaches used also differ from continuing professional development. Phenomena of interest This review will consider studies that investigate simulation-based learning experiences that are relevant to maternal-child nursing. Our primary interest in this review is in preparing nursing students for senior level maternal-child practice placements and transition to working as an Registered Nurse. However, we will include all qualitative studies and case reports of simulation-based learning that involve pre-registration nursing or health professional students. Context The purpose of this review is to identify the implications of this body of knowledge for undergraduate or pre-registration nursing programs in Canada This review will include qualitative research that may be applicable to the Canadian context for nursing education, such as reports from North America, Europe, Australia and New Zealand.

Designing a disaster.

A mass casualty simulation was developed and implemented for senior-level nursing students in a large baccalaureate program. This simulation was developed to introduce students to rapid triage in an interactive and immersive experience. The purpose of the simulation was to provide students with a realistic, hands-on experience in a safe environment. Unlike other similar exercises, all students participated in the health care provider role rather than as observers or victims. Didactic content regarding triage and a short video preceded the surprise simulated "bus crash." The element of surprise was used to create the chaos and confusion that often accompanies these incidents. Fifteen victims were comprised of static manikins, high-fidelity human patient simulators, and live actors with various injuries. The students worked in small groups and assigned each victim an appropriate Simple Triage and Rapid Treatment triage category on the basis of what they learned in lecture. Participating students performed well on their final examinations on questions covering the triage content they learned in this unit and feedback regarding the simulated experience was overwhelmingly positive. This simulation could be adapted for the education of other health care providers who may be involved in a future mass casualty incident.

A study to evaluate the introduction of simulation as a teaching strategy for the mental health and learning disability fields of nursing in an undergraduate nursing curriculum within one higher education institution in the UK

High Fidelity Simulation or Human Patient Simulation is an educational strategy embedded within nursing curricula throughout many healthcare educational institutions. This paper reports on an evaluative study that investigated the views of a group of Year 2 undergraduate nursing students from the mental health and the learning disability fields of nursing (n = 75) in relation to simulation as a teaching pedagogy. The study took place in the simulation suite within a School of Nursing and Midwifery in the UK. Two patient scenarios were used for the session and participants completed a 22-item questionnaire consisting of three biographical information questions and a 19-item Likert scale. Descriptive statistics were employed to illustrate the data and non-parametric testing (Mann-Whitney U test) was employed to test a number of hypotheses. Overall students were positive about the introduction of patient scenarios using the human patient simulator into the undergraduate nursing curriculum. This study used a small, convenience sample in one institution and therefore the results obtained cannot be generalised to nursing education before further research can be conducted with larger samples and a mixed-method research approach. However these results provide encouraging evidence to support the use of simulation within the mental health and the learning disability fields of nursing, and the development and implementation of further simulations to complement the students’ practicum.

The centricity of presence in scenario-based high fidelity human patient simulation: a model.

Enhancing immersive presence has been shown to have influence on learning outcomes in virtual types of simulation. Scenario-based human patient simulation, a mixed reality form, may pose unique challenges for inducing the centricity of presence among participants in simulation. A model for enhancing the centricity of presence in scenario-based human patient simulation is presented here. The model represents a theoretical linkage among the interaction of pedagogical, individual, and group factors that influence the centricity of presence among participants in simulation. Presence may have an important influence on the learning experiences and learning outcomes in scenario-based high fidelity human patient simulation. This report is a follow-up to an article published in 2014 by the author where connections were made to the theoretical basis of presence as articulated by nurse scholars.

The effects of mobile applications in cardiopulmonary assessment education

BackgroundMobile applications can be used as effective simulations for nursing education. However, little is known regarding the effects of mobile application-mediated training on nursing. The aim of this study was to determine the effectiveness of mobile applications by comparing the effectiveness of a high-fidelity human patient simulator to that of a mobile application on student learning. MethodsFollowing lectures on the lungs and the heart, twenty-two students were separated into two groups to perform a simulation exercise. Then, the students' education effects were evaluated based on their knowledge of lung and heart assessments, their clinical assessment skill, and satisfaction with their education. ResultsAfter four weeks, the mobile application group maintained their knowledge, whereas the high-fidelity human patient simulator group exhibited significantly decreased knowledge of the lung assessment. Knowledge of the heart assessment was significantly increased in both groups. There was no significant difference in clinical assessment skill or educational satisfaction between the groups. ConclusionsWe found that mobile applications provide educational tools similarly effective to a high-fidelity human patient simulator to maintain memory and to teach cardiopulmonary assessment skills.

Board #134 - Research AbstractThe Effect of Hybrid Learning with Nuring Students’ Clinical Competency

Hypothesis In most nursing curricula, simulation and PBL (problem-based learning) are used solely and separately as teaching and learning tools. Nurse educators should facilitate complex clinical experiences and utilize more complex and mixed education strategies to enhance nursing students’ clinical reasoning in order to improve the comprehensiveness and accuracy of nursing students’ clinical judgment. In the present study, simulation is combined with PBL as a hybrid framework or a learning strategy including lectures, discussion using problem-based learning modules, self-directed learning, and real situation practice with human patient simulators [HPS] (Lee et al., 2009). Moreover, there is no research in pediatric nursing literature that examines the effect of hybrid learning with combined simulation and problem-based learning. Hence, the purpose of this study is to test students’ clinical competency to assess the effectiveness of the combined teaching method. Methods The bronchiolitis module in the present study was designed based on the PBL and Simulation Model Framework (Barrows and Tamblyn, 1980; Jeffries, 2005). The Hybrid learning combining simulation with PBL was used to assess clinical competency including knowledge, confidence, and students’ satisfaction. This is a comparison study with three education modalities: PBL group (experimental group 1, E1), simulation with PBL group (experimental group 2, E2), and control group (C). We used descriptive, paired t-test statistics, one-way ANOVA, and post-hoc test (Duncan test) for data analysis using SPSS version 18.0 program. A convenient sample of 195 senior nursing students from three nursing schools located in Seoul and Chuncheon, South Korea participated in this study from Sep 1st to Dec 10th, 2013. Results There were no statistically significant differences between the groups in prior simulation experiences (χ2=.396, p=.529), and baseline knowledge (7.80±1.11 versus 7.79±1.99, t=.020, p=.984). There were significant difference in the mean score of knowledge difference (post-pre) among E1 (1.42±2.49), E2 (1.77±2.11), and C (0.44±2.74) (F=14.718, p<.001). There were significant difference in the mean score of confidence among E1 (3.69±0.30), E2 (3.57±0.33), and C (3.38±0.44) (F=12.693, p<.001). There were significant differences in the mean satisfaction total score among E1 (4.67±0.39), E2 (4.17±0.53), and C (3.48±0.62) (F=93.471, p<.001). Conclusion This result could provide a much-need template or starting point for educators who desire to introduce simulation combined with PBL as a teaching-learning strategy in pediatric nursing courses. It is also necessary to monitor the effectiveness of combined simulation with PBL education. New approaches and strategies combined simulation with PBL for teaching critical thinking, clinical assessment, effective communication, and technical skills will be required to meet the demands of the new roles and responsibilities faced by nurse educators and their students.

Board #227 - Program Innovation A pilot investigation of deliberate practice and Safe Nursing Skills-Competency Testing in a BSN program (Submission #10024)

Objectives At Dominican University of California’s nursing program (DUC), a typical pattern would arise where students began each semester with little ability to perform the skills taught in the previous semester. The scale and duration of this problem were significant enough to warrant an intervention. To resolve this problem, the DUC nursing program initiated a large scale semi-annual testing event designed to ensure ongoing competency of appropriate skills each semester. This program change was initiated with the understanding that scheduled tests create great motivation for study and practice. In the process of preparing for testing, the authors also hoped to provide a stimulus for students to perform deliberate practice at regular intervals. While deliberate practice is not a direct requirement of the testing process, as word of mouth from successful students has spread, greater than 95% of the students choose to spend time in the clinical simulation center performing deliberate practice to obtain mastery of the required skills. The objectives of the testing process were to ensure the students were held accountable for maintaining ongoing competency in previously acquired skills. Description The Safe Nursing Skills-Competency Test (SNS-CT) process occurs at the beginning of each semester. Students in all med-surg and preceptorship courses are tested. Four unique testing stations with rich personal narratives provided context. On test day students are randomly assigned a station. SNS-CT rubrics were developed and numerically rated. Students are provided rubrics in advance, allowing for deliberate practice. Students are encouraged to attend open lab in pairs to grade each other during practice. Students voluntarily practice skills at each station. The labs are open for practice sessions extensively during the week prior to testing. The stations use low-fidelity human patient simulators (HPS). Students who do not “pass” are encouraged to attend additional open lab hours until they achieve competency. The goal of the testing process was to have students review previously taught clinical skills ultimately demonstrating competency. After three semesters of competency testing, the program is deemed a success based upon both testing pass rates (> 97%) and extensive student contact hours logged during open lab sessions. The labs in which practice/testing occur were near full capacity for many hours preceding testing. Lab hours were extended to support student demand. Conclusion DUC has experienced success in nursing students’ ongoing competency with clinical skills through implementation of SNS-CT. Requiring students to test at only one of four possible stations has been effective at prompting students to deliberately practice all the required skills. Students demonstrate a strong desire for practice time, and use it effectively. Working in pairs has been particularly popular as an active study technique. Students voluntary preparation for testing has been extensive, requiring the addition of resources in both lab time and materials to meet the needs. This is viewed as a highly positive response by the authors. Testing stations in which rich personal narratives and clinical scenarios encompassing multiple skills have been an effective method for providing context for student decision making and skill recall. Providing extensive open lab hours is resource intensive, but appreciated by the students. Providing additional payment for clinical faculty to be available has been an effective method of ensuring appropriate staffing on test day. Testing of non-senior nursing students has been effective with senior or graduated students resulting in cost savings. Results of surveys are being used for continuous quality improvement.

Board #224 - Program Innovation Integration of Simulation Training throughout Undergraduate Medical Education (Submission #10053)

Objectives For more than 20 years, medical literature has increasingly documented the need for students to learn, practice, and demonstrate competence in basic clinical knowledge, assessment skills, and procedural skills. In 2001, the LSUHSC School of Medicine New Orleans replaced its traditional Introduction to the Clinical Medicine (ICM) course with the Science and Practice of Medicine (SPM) course. Curriculum innovations included changes to the lecture format, reduction in lecture hours, changes to the lab structure, additional small group instruction, and the incorporation of computer-based learning. One of the key adaptations to the new curriculum was the addition of simulation (role play, anatomical models, low-high fidelity simulators) in the Clinical Skills Lab and Human Patient Simulation Lab (HPS). Description The Clinical Skills Lab (CSL) is designed as an active learning approach that focuses on small group instruction, hands-on training, peer-to-peer observation, and immediate feedback in a non-stressful controlled environment. Procedural skill instruction at the level of first and second-year medical students permits reinforcement of basic science principles in clinical case scenarios. The CSL allows the preclinical students to learn, practice, and demonstrate competence in 40 basic skills over the 15 sessions. Third year students participate in the HPS Lab, and are required to manage patients that relate to their clerkship curriculum. Over the course of the year, students manage and treat eight simulated patients with a variety of illnesses which are listed below. In 2011, LSUHSC extended the use of simulation into the fourth year with a new course called Critical Concepts. This course was developed to ensure that students can recognize and manage core conditions that clinical departments believed necessary for all interns. This course currently has eight participating departments: Emergency Medicine, Pulmonary Critical Care, Pediatrics/NICU, Anesthesia, Obstetrics/Gynecology, Orthopedics, Psychiatry and Surgery. The table below shows the department and areas of instruction.Conclusion The SPM course allows freshman medical students the opportunity to supplement their history-taking skills with rudimentary physical assessment and procedure/skill acquisition. Second-year medical students are encouraged to solve more complex medical cases involving lab and physical exam abnormalities that require integration of previously acquired CSL skills. The Critical Concept course prepares students to enter residency with a more sophisticated understanding of the complexity of diseases and patient management. While all of these courses use various types of simulation training, they are not designed to replace real clinical patient experiences. They are designed to provide early exposure to clinical medicine, challenge students to apply their medial knowledge, enhance patient management skills, and provide the opportunity to practice skills/procedures in a patient-free environment. Disclosures None

Use of Human Patient Simulation and Validation of the Team Situation Awareness Global Assessment Technique (TSAGAT): A Multidisciplinary Team Assessment Tool in Trauma Education

Situation awareness (SA) is a vital construct for decision making in intense, dynamic environments such as trauma resuscitation. Human patient simulation (HPS) allows for a safe environment where individuals can develop these skills. Trauma resuscitation is performed by multidisciplinary teams that are traditionally difficult to globally assess. Our objective was to create and validate a novel tool to measure SA in multidisciplinary trauma teams using a HPS--the Team Situation Awareness Global Assessment Technique (TSAGAT). Memorial University Simulation Centre. Using HPS, 4 trauma teams completed 2 separate trauma scenarios. Student, junior resident, senior resident, and attending staff teams each had 3 members (trauma team leader, nurse, and airway manager). Individual SAGATs were developed by experts in each respective field and contained shared and complimentary knowledge questions. Teams were assessed with SAGAT in real time and with traditional checklists using video review. TSAGAT was calculated as the sum of individual SAGAT scores and was compared with the traditional checklist scores. Shared, complimentary, and TSAGAT scores improved with increasing team experience. Differences between teams for TSAGAT and complimentary knowledge were statistically significant (p < 0.05). Mean checklist differences between teams also reached statistical significance (p < 0.05). TSAGAT scores correlated strongly with traditional checklist scores (Pearson correlation r = 0.996). Interrater reliability for the checklist tool was high (Pearson correlation r = 0.937). TSAGAT is the first valid and reliable assessment tool incorporating SA and HPS for multidisciplinary team performance in trauma resuscitation. TSAGAT could compliment or improve on current assessment methods and curricula in trauma and critical care and provides a template for team assessment in other areas of surgical education.