Monday May 15, 2023

Pamela B. Andreatta, EdD, PhD - Managing Upper Extremity Vascular Injuries: Training and Readiness for Military Surgeons

Military Medicine & WarDocs present: "A Ready Medical Force Special Collection"

MILMED-D-21-00643: “Upper Extremity Vascular Exposures for Trauma: Comparative Performance Outcomes for General Surgeons and Orthopedic Surgeons”

EPISODE SUMMARY

Discover the critical skills Military General and Orthopedic Surgeons need to confidently diagnose and manage upper extremity vascular injuries on and off the battlefield. Our conversation with Dr. Pamela Andreatta, Director of Surgical Skills Assessment at the Uniformed Services University of Health Sciences and the Walter Reed National Military Medical Center, reveals the importance of courses like ASSET+ and the Combat Orthopedic Trauma Surgical Course in training and assessing readiness.

We dive deep into the factors influencing the performance of military surgeons and assess the pre-training scores of Military General Surgeons and Orthopedic Surgeons. Listen in as Dr. Andreatta breaks down how experience and the volume of operative practice impact success in managing these complex injuries. We also discuss the challenges military teams face when integrating into operational teams, and how pre-deployment and post-deployment rehearsals ensure the maintenance of critical capabilities.

Join us in this thought-provoking episode as we emphasize the importance of good research in Military Medicine and explore the complexities of maintaining preparedness and readiness in the field.

EPISODE CHAPTERS

(0:00:01) - Preparing Surgeons for Battlefield Vascular Injuries

(0:12:12) - Assessing Surgical Training and Performance

(0:24:25) - Maintaining Critical Medical Team Capabilities

EPISODE CHAPTER SUMMARIES

(0:00:01) - Preparing Surgeons for Battlefield Vascular Injuries (12 Minutes)

We explore the preparedness of Military General Surgeons and Orthopedic Surgeons to confidently deal with upper extremity vascular injuries in battlefield settings. To assess readiness and train critical expeditionary procedural skills, we discuss the importance of courses like ASSET+ and the Combat Orthopedic Trauma Surgical Course. Dr. Andreatta discusses her Military Medicine paper, “Upper Extremity Vascular Exposures for Trauma: Comparative Performance Outcomes for General Surgeons and Orthopedic Surgeons”. We look back at the recent high op tempo time in OIF and OEF and consider the likelihood of encountering extremity vascular injuries in Role II MTFs and below. We discuss the importance of preparedness to recognize and control peripheral vascular bleeds to save lives and limbs.

(0:12:12) - Assessing Surgical Training and Performance (12 Minutes)

We investigate the pre-training scores of Military General Surgeons and Orthopedic Surgeons, exploring the factors that could influence the performance of these medical professionals. The sample was largely homogeneous and consisted of junior personnel with limited deployment experience, though it was found that the more experienced surgeons with a higher volume of operative practice tended to perform better. We also discuss the determination of the benchmark score, and how it is rooted in measurement science and clinical medicine. Lastly, we learn that although the Orthopedic Surgeons did not reach the benchmark at baseline, the quality of the surgeons and the fact that they are able to recognize performance gaps allows them to work on improving their skills.

(0:24:25) - Maintaining Critical Medical Team Capabilities (6 Minutes)

We discuss the challenges military teams face when integrating into operational teams and the necessity of individual professional role capabilities. We also discuss the need for pre-deployment and post-deployment rehearsals, and the importance of providing resources for military surgeons to maintain their abilities. Finally, we explore the potential of pre-planning through videos and reading to reduce the "Walker dip" between deployments.

EPISODE KEYWORDS

Military Medicine, Battlefield Vascular Injuries, Surgical Training, Performance, Medical Team Capabilities, Pre-Deployment Rehearsals, Post-Deployment Rehearsals, Dr. Pamela Andreatta, Asset Plus, Combat Orthopedic Trauma Surgical Course, Operative Practice, Junior Personnel, Deployment Experience, Benchmark Score, Measurement Science, Clinical Medicine, Walker Dip, Journal of Military Medicine, WarDocs

#Military #Medical #Podcast #WarDocs #Orthopedics #Surgeon #GeneralSurgeon #Vascular #Injuries #MilitaryMedicine #Readiness #Training #Knowledge #Skills #Abilities #KSAs

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Pamela B. Andreatta, EdD, PhD - Managing Upper Extremity Vascular Injuries: Training and Readiness for Military Surgeons

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