Improvement of Teamwork Nontechnical Skills Through Polytrauma Simulation Cases Using the Communication and Teamwork Skills (CATS) Assessment Tool

OBJECTIVE: To assess acquisition of nontechnical skills (NTS) through clinical simulation cases by healthcare personnel who participated in a Crisis Resource Manage-ment (CRM) training program for the initial care of polytraumatisms. DESIGN: Pre-and postintervention study. SETTING: Acute-care teaching hospital in Sabadell, Bar-celona (Spain). PARTICIPANTS: Healthcare personnel that composed teamworks providing initial care to polytraumatized patients attended 12-hour simulation training using a SimMan 3G manikin and performed exercises corre-sponding to 3 clinical scenarios. All simulations lasted 15 to 25 min and were video recorded. The CATS Assess-ment tool was used for analysis of teamwork NTS, which included 21 behaviors clustered into the categories of coordination, situational awareness, cooperation, com-munication, and crisis situation. RESULTS: Three editions of the CRM training course were carried out with 12 trauma team groups composed by team leader, anesthesiologist, general surgeon, trau-matologist, registered nurses, nursing assistant, and stretcher bearer. There were statistically significant (p <0.001) improvements in the speed of key times of total duration of case resolution, transfusion of hemoder-ivatives, Focused Assessment Sonography for Trauma, and chest and pelvic X-rays. The percentage of cases cor-rectly resolved improved from 75% to 91.7% but differ-ences were not statistically significant (p = 0.625). Precourse and postcourse results of CATS scores showed a statistically significant increase in the weighted total score as well as in all behavioral categories of coordina-tion, situational awareness, cooperation, communica-tion, and crisis situation. CONCLUSIONS: Simulation-based training of NTS was associated with significant improvements in teamwork behaviors in the setting of the initial care of patients with polytraumatisms. (J Surg Ed 80:706-713. (c) 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)