Community of trauma care partnering with stakeholders to improve injury outcomes: survey analysis and panel development.

Background: In June 2021, the Injury Research Engagement Project (I-REP) was established. In 2022, we preformed focus group analysis with patients/caregiver and researchers that resulted in themes in preferences, motivations, and best practices to increase participation in trauma research. The importance of trust and well-established relationships was common across all groups.

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study.

Background: Secondary traumatic stress and compassion fatigue have been studied among trauma clinicians yet have not been explored in trauma registry professionals (TRPs).

Objective: The purpose of this study is to describe the secondary traumatic stress component of compassion fatigue among TRPs.

Methods: A qualitative, phenomenological study was conducted to examine TRPs' experiences with the secondary traumatic stress component of compassion fatigue.

Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis.

Introduction: Engaging trauma survivors/caregivers results in research findings that are more relevant to patients' needs and priorities. Although their perspectives increase research significance, there is a lack of understanding about how best to incorporate their insights. We aimed to capture stakeholder perspectives to ensure research is meaningful, respectful, and relevant to the injured patient and their caregivers.

How to say "I don't know": development and evaluation of workshops for medical students and surgical residents on communicating uncertainty using the ADAPT framework.

Purpose: Uncertainty, or the conscious awareness of having doubts, is pervasive in medicine, from differential diagnoses and the sensitivity of diagnostic tests, to the absence of a single known recovery path. While openness about uncertainty is necessary for shared decision-making and is a pillar of patient-centered care, it is a challenge to do so while preserving patient confidence. The authors' aim was to develop, pilot, and evaluate an uncertainty communication curriculum to prepare medical students and residents to confidently navigate such conversations.

Expediting Treatment of Trauma Patients in the Emergency Department: Rapid Trauma Evaluation (RTE).

Background: Criteria for trauma determination evolves. We developed/evaluated a Rapid Trauma Evaluation (RTE) process for a trauma patient subset not meeting preestablished trauma criteria.

Methods: Retrospective study (July 2019 - May 2020) for patients either > 65 years with ground level fall within 24 hours or in a motorcycle collision (MCC) arriving by EMS not meeting ACS trauma-criteria.

Efficacy of Animal-Assisted Therapy in Treatment of Patients With Traumatic Brain Injury: A Randomized Trial.

Background: Severe traumatic brain injury carries major public health consequences, with patients suffering long-term disability with physiological, cognitive, and behavioral changes. Animal-assisted therapy, the use of human and animal bonds in goal-directed interventions, has been a suggested therapy, but its efficacy in acute brain injury outcomes remains unknown.

Objective: This study aimed to assess animal-assisted therapy's effects on cognitive outcome scores of hospitalized severe traumatic brain-injured patients.

Virtual Communication Across Differences: Development of a Workshop on Managing Patient Bias.

Problem: Despite the prevalence and detrimental effects of racial discrimination in American society and its health care systems, few medical schools have designed and implemented curricula to prepare medical students to respond to patient bias and racism.

Approach: During the summer of 2020, a virtual communication class was designed that focused on training medical students in how to respond to patient bias and racism. Following brief didactics at the start of the session, students practiced scenarios with actors in small groups and received direct feedback from faculty.

Acceptability of Deimplementing High-Flow Nasal Cannula in Pediatric Bronchiolitis.

Background And Objectives: High-flow nasal cannula (HFNC) in children hospitalized with bronchiolitis does not significantly improve clinical outcomes but can increase costs and intensive care unit use. Given widespread HFNC use, it is imperative to reduce use. However, there is limited information on key factors that affect deimplementation.

Developing a National Trauma Research Action Plan: Results from the long-term outcomes research gap Delphi survey.

Background: In the National Academies of Sciences, Engineering, and Medicine 2016 report on trauma care, the establishment of a National Trauma Research Action Plan to strengthen and guide future trauma research was recommended. To address this recommendation, the Department of Defense funded the Coalition for National Trauma Research to generate a comprehensive research agenda spanning the continuum of trauma and burn care. We describe the gap analysis and high-priority research questions generated from the National Trauma Research Action Plan panel on long-term outcomes.

Implementation of a skills-based virtual communication curriculum for medical students interested in surgery.

Background: Communication skills are essential to providing patient-centered care. The need for standardized communication skills training is at the forefront of medical school and residency education. We aimed to design and implement a curriculum teaching virtual communications skills to medical students.

Managing Patient Bias: Teaching Residents to Navigate Racism and Bias in the Workplace.

Background: Racial inequities are infused within American society and healthcare systems; notable events in 2020 highlighted an urgent need for change. Many organizations were inspired to examine the impacts of systemic racism. The impact of physician bias on patient experiences and outcomes has been well documented; biased patient behavior is now becoming more openly discussed.

Predictive Value of the Methicillin-Resistant Nasal Swab for Methicillin-Resistant Ventilator-Associated Pneumonia in the Trauma Patient.

Many trauma centers have empiric treatment algorithms for ventilator-associated pneumonia (VAP) treatment prior to culture results that include antibiotic agents for methicillin-resistant (MRSA) coverage that can have adverse effects. This is the only study to evaluate risk factors and MRSA nasal swabs to risk-stratify trauma patients for MRSA VAP, thereby potentially limiting the need for empiric vancomycin. This was a single institution retrospective cohort study.

Protocol Use in Surgical Intensive Care Units.

Background: Protocols are common in intensive care, however the association between protocol prevalence and outcomes in surgical ICU patients is unclear. We hypothesized that ICUs in a multicenter database using more protocols had better outcomes.

Material And Methods: This is a retrospective analysis of prospectively collected data from a 2-d prevalence study with 30-d follow up, on surgical and trauma patients in ICUs at 42 trauma centers.

Effect of Obesity on Early, In-Hospital Amputation Risk Following Popliteal Artery Injury Using an Analysis of the National Trauma Data Bank.

Background: Popliteal artery injury is associated with a high risk of limb loss; identifying factors associated with increased morbidity and mortality is hampered by its rare occurrence and confounding factors. Anecdotal observations suggest delay in diagnosis of obese patients may be associated with amputation. We aimed to determine whether there is an increased risk of early amputation and if diagnosis is delayed in obese patients with popliteal artery injuries.

Barriers and Facilitators to the Implementation of Injury Prevention Programs: A Qualitative Exploration and Model Development.

Background: In 2006, the American College of Surgeons Committee on Trauma mandated implementation of injury prevention programs as a requirement for Level I and II trauma center designation. Little is known about the factors that facilitate or create barriers to establishing evidence-based injury prevention program implementation. The purpose of this research is to generate hypotheses regarding processes used to implement injury prevention programs at trauma centers, identify the factors that facilitate and serve as a barrier to implementation, and develop a model reflecting these factors and relationships.

Training Surgical Residents to Communicate with Their Patients: A Scoping Review of the Literature.

Objective: Effective communication is critical in surgical practice and the Accreditation Council on Graduate Medical Education requires a focus on interpersonal and communication skills. Absent a national communication skills curriculum for surgical residents, individual programs have designed and implemented their own curricula. This scoping review explores communication training in North American surgical residency programs.

Family Survey of Understanding and Communication of Patient Prognosis in the Intensive Care Unit: Identifying Training Opportunities.

Objective: Family members making medical decisions for critically ill patients depend on surgeons' high-quality communication. We aimed to assess family experience of communication in the trauma intensive care unit (TICU), identify opportunities for improvement, and tailor resident communication training to address deficiencies.

Design: We designed surveys based on our Conceptual Model of Surgeon Communication and Family Understanding, using items from previously validated tools to assess (1) family well-being, experiences of care, access to information, and assessment of patient condition and prognosis; and (2) surgeon and nursing assessment of patient condition and prognosis.

Building Rapport and Earning the Surgical Patient's Trust in the Era of Social Distancing: Teaching Patient-Centered Communication During Video Conference Encounters to Medical Students.

Background: Effective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely.

Range of Motion Testing of a Novel 3D-Printed Synthetic Spine Model.

Study Design: Biomechanical model study.

Objective: The Barrow Biomimetic Spine (BBS) project is a resident-driven effort to manufacture a synthetic spine model with high biomechanical fidelity to human tissue. The purpose of this study was to investigate the performance of the current generation of BBS models on biomechanical testing of range of motion (ROM) and axial compression and to compare the performance of these models to historical cadaveric data acquired using the same testing protocol.

Dimensional Characterization of the Human Cervical Interlaminar Space as a Guide for Safe Application of Minimally Invasive Dilators.

Background: The risk of interlaminar passage of a dilator into the cervical spinal canal in minimally invasive approaches is currently unknown. Among the various anthropometric data reported in the literature, there is no report of the interlaminar dimensions in the cervical spine.

Objective: To report the cervical interlaminar dimensions in neutral, flexion, and extension.

Evaluation of abnormal styloid anatomy as a cause of internal jugular vein compression using a 3D-printed model: a laboratory investigation.

This study used a 3-dimensional (3D) craniocervical junction model of styloidogenic jugular venous compression (SJVC) syndrome to simulate and evaluate intracranial pressure (ICP) after internal jugular vein (IJV) compression by an elongated styloid process during axial rotation. The 3D-printed model created using data from an SJVC-syndrome patient included an articulating occipital-cervical junction, simplified arteriovenous system, gauge to measure simulated ICP, fixed obstruction simulating left-sided venous occlusion, and right-sided vascular tubing to simulate IJV compression. The model was rotated axially to its extreme right and left; maximum degree of motion and pressure were recorded for 3 cycles.

Optimizing biomechanics of anterior column realignment for minimally invasive deformity correction.

Background Context: Anterior column realignment (ACR) is a powerful but destabilizing minimally invasive technique for sagittal deformity correction. Optimal biomechanical design of the ACR construct is unknown.

Purpose: Evaluate the effect of ACR design on radiographic lordosis, range of motion (ROM) stability, and rod strain (RS) in a cadaveric model.

Surgeon Communication and Family Understanding of Patient Prognosis in Critically Ill Surgical Patients: A Qualitative Investigation Informs Resident Training.

Purpose: Surgeons treating critically ill patients must work with family members making medical decisions for the patient. These surrogate decision makers depend on providers' high-quality communication and empathy to facilitate medical decisions. There is growing evidence of poor quality of communication and delayed family engagement in the intensive care unit, and of a decline in empathy over the course of a surgeon's clinical training.