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Non-technical skills impact trauma resuscitation time. Crisis resource management teaches non-technical skills required for effective teamwork in a crisis. We developed a simulation-based multidisciplinary trauma team training, with an emphasis on crisis resource management and a goal of improving residents' non-technical skills. Twenty-five post-graduate year-1 general surgery and emergency medicine residents were divided into multidisciplinary teams with embedded nurse participants. Teams underwent 3 trauma resuscitation scenarios followed by a crisis resource management debrief. Additionally, a Just-In-Time crisis resource management didactic was delivered before 1 scenario. Teams' non-technical skills in each scenario were assessed by expert raters using non-technical skills scale for trauma and scenario scores before and after the Just-In-Time didactic were compared. Multiple linear-regression calculating the impact of clinical scenario, case order, and timing relative to the Just-In-Time didactic on a teams' non-technical skills scale for trauma score was performed. Seventy-four team T-NOTECHS ratings were completed. T-NOTECHS total score was significantly higher on the third training case regardless of clinical scenario or timing relative to the Just-In-Time didactic (pre = 15.58 vs post = 18.11, P =.117). Teams scored an average of 15.44 on the first scenario of the day, 16.63 on the second, and 19.04 on the last (P <.001). Crisis resource management-focused multidisciplinary team training significantly improves residents' non-technical skills in the simulated environment. Case repetition followed by crisis resource management focused debriefings outweighed the effect of a single Just-In-Time crisis resource management didactic. [ABSTRACT FROM AUTHOR]

Excessive stress negatively impacts surgical residents' technical performance. The effect of stress on trainee nontechnical skills, however, is less well studied. Given that nontechnical skills are known to impact clinical performance, the purpose of this study was to assess the relationship between residents' perceived stress and nontechnical skills during multidisciplinary trauma simulations. First-year surgery and emergency medicine residents voluntarily participated in this study. Residents participated in 3 trauma simulations across 2 training sessions in randomly assigned teams. Each team's nontechnical skills were evaluated by faculty using the Trauma Nontechnical Skills scale. The Trauma Nontechnical Skills scale consists of 5 items: leadership, cooperation, communication, assessment, and situation awareness/coping with stress. After each scenario, residents completed the 6-item version of the State-Trait Anxiety Inventory and the Surgery Task Load Index to detail their perceived stress and workload during scenarios. Linear regressions were run to assess relationships between stress, workload, and nontechnical skills. Twenty-five residents participated in the first simulation day, and 24 residents participated in the second simulation day. Results from regressions revealed that heightened stress and workload predicted significantly lower nontechnical skills performance during trauma scenarios. In regard to specific aspects of nontechnical skills, residents' heightened stress and workload predicted statistically significant lower situation awareness and decision-making during trauma scenarios. Residents' perceived stress and workload significantly impaired their nontechnical skills during trauma simulations. This finding highlights the need to offer stress management and performance-optimizing mental skills training to trainees to lower their stress and optimize nontechnical skills performance during challenging situations. [ABSTRACT FROM AUTHOR]

Acceptance and commitment therapy (ACT) emphasizes values and behavioral commitments to help individuals achieve goals and manage emotions. This study evaluated the preliminary psychometric properties of the ACTive Values Wheel, a smartphone application-based psychometric instrument. ACTive provides a weighted and idiographic index of individuals' self-reported values-directed behavior. One hundred sixty adults participated on an individual basis to complete the ACTive Values Wheel and questionnaire measures of well-being, psychological distress, psychological flexibility, and valued living to assess the convergent, incremental, discriminant, and criterion-related validity of the ACTive Values Wheel. The ACTive Values Wheel showed evidence of convergent and criterion-related validity through significant positive correlations with existing measures of valued living, emotional well-being, and openness to experience, respectively. Likewise, discriminant validity was evidenced by a nonsignificant correlation with age. However, evidence of incremental validity over and above existing measures of valued living was not found. These findings provide preliminary support for the psychometric properties of the ACTive Values Wheel. Accounting for the methodological limitations of the study, the ACTive Values Wheel shows potential as an accessible and interactive measure of self-reported values-directed behavior that could be extended to other languages and cultural contexts. [ABSTRACT FROM AUTHOR]