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J Surg Educ. 2018 Aug 4. pii: S1931-7204(18)30162-4. doi: 10.1016/j.jsurg.2018.06.007. [Epub ahead of print]

Hemorrhage Control Training Promotes Resilience-Associated Traits in Medical Students.

Author information

1
Division of Medical Psychiatry, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: NLevy-Carrick@bwh.harvard.edu.
2
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: jmccarty@bwh.harvard.edu.
3
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: mchaudhary@bwh.harvard.edu.
4
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: ecaterson@bwh.harvard.edu.
5
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: ahhaider@bwh.harvard.edu.
6
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: aeyre@bwh.harvard.edu.
7
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: pmahon@bwh.harvard.edu.
8
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: egoralnick@bwh.harvard.edu.

Abstract

OBJECTIVE:

Given rising rates of physician burnout, the potential for clinical skills training programs to develop and reinforce resilience-associated traits in medical students warrants investigation. The primary objective of this study was to examine the impact of a hemorrhage control training program on resilience-associated traits (role-clarity, self-efficacy, and empowerment) in medical students. A secondary objective was to examine the differential impact of additional hands-on skills training.

DESIGN:

This was a prospective study of medical students participating in an established hemorrhage control training program, utilizing pre-, mid-, and post-training questionnaires. The program included both an in-person lecture and hands-on skills training. Primary endpoints were self-reported increases in role clarity (when the hemorrhage control skills would and would not be applicable), self-efficacy (confidence in ability to use the skill), and empowerment (to act in a situation where the skill was needed).

SETTING:

Harvard Medical School, Boston, Massachusetts.

PARTICIPANTS:

One hundred and twenty-six Harvard Medical School students participated.

RESULTS:

There was a significant increase at each stage of training in self-reported role clarity about when to apply hemorrhage control skills (p < 0.01) and when not to apply them (p < 0.01); confidence in application of the skill (p < 0.01); as well as empowerment to apply the skill when appropriate (p < 0.01).

CONCLUSIONS:

Hemorrhage control training, a first response-related clinical skills program, is a promising domain for development and reinforcement of resilience-associated traits in medical students, particularly when the program includes hands-on skills training. Providing experiential learning opportunities that are designed not only for skills-specific outcomes, but also to reinforce such resilience-associated traits as role-clarity, self-efficacy, and empowerment provides an essential integrated perspective.

KEYWORDS:

Burnout; First Response; Hemorrhage control; Medical Knowledge; Medical education; Patient Care and Procedural Skills; Practice-Based Learning and Improvement; Resilience; Systems-Based Practice

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