Advanced Modular Manikin and Surgical Team Experience During a Trauma Simulation: Results of a Single-Blinded Randomized Trial


Dimitrios Stefanidis, Rajesh Aggarwal, Robert M Rush, Gyusung Lee, Patrice G Blair, David Hananel, Yoon Soo Park, Robert M Sweet, Gordon G Wisbach, and Ajit K Sachdeva. 2021. “Advanced Modular Manikin and Surgical Team Experience During a Trauma Simulation: Results of a Single-Blinded Randomized Trial.” J Am Coll Surg.


OBJECTIVE: To assess whether an integrated Advanced Modular Manikin (AMM) provides improved participant experience compared to use of peripheral simulators alone, during a standardized trauma team scenario. BACKGROUND: Simulation-based team training has been shown to improve team performance. To address limitations of existing manikin simulators the AMM platform was created, that enables interconnectedness, interoperability and integration of multiple simulators ("peripherals") into an adaptable, comprehensive training system. METHODS: A randomized single-blinded, cross-over study with two conditions was employed to assess learner experience differences when using the integrated AMM platform versus peripheral simulators. First responders, anesthesiologists, and surgeons rated their experience and workload with the conditions in a 3-scene standardized trauma scenario. Participant ratings were compared and focus groups conducted to obtain insight into participant experience. RESULTS: Fourteen teams (n=42) participated. Team experience ratings were higher for the integrated AMM condition compared with peripherals (Cohen's d = .25, p = .016). Participant experience varied by background with surgeons and first responders rating their experience significantly higher compared with anesthesiologists (p < .001). Higher workload ratings were observed with the integrated AMM condition (Cohen's d = .35, p = .014) driven primarily by anesthesiologist ratings. Focus groups revealed that participants preferred the integrated AMM condition based upon its increased realism, physiologic responsiveness, and feedback provided on their interventions. CONCLUSION: This first comprehensive evaluation suggests that integration with the AMM platform provides benefits over individual peripheral simulators and has the potential to expand simulation-based learning opportunities and enhance learner experience, especially for surgeons.