Medical Event Management on Deep Space Exploration Missions

Developing and validating specific medical event management training protocols for flight crews on deep space, long-duration space exploration missions

NASA-NSBRI grant: HPF04501

Research team: Steven Yule PhD, David Musson MD PhD, Thomas Doyle PhD PEng, Stuart Lipsitz ScD, Chuck Pozner MD, Douglas Smink MD MPH, Roger Dias MD MBA PhD, Jamie Robertson MPH PhD, Avni Gupta BDS MPH.

Timeline: June 2016 - July 2017 (Phase 1) July 2018 - June 2019 (Phase 2)

Project background: In-flight medical emergencies represent a significant risk for mission failure. The potential for these to compromise crew health and capacity is heightened when considering the unique nature of deep space, long duration missions. Effective medical emergency management training can ameliorate this risk, and is vital for building crew resilience in order to achieve mission goals. Current training approaches in both medical and non-medical contexts focus on specific non-technical skills (e.g. situation awareness, leadership, crew coordination) for successful management of non-routine medical events. Training curricula have been developed targeted at individual and team management of medical events in terrestrial settings; however, a valid training framework and a set of objective measures of non-technical skills is currently lacking for space crews. In line with the NASA research priorities to "Operationalize Customized Refresher and Just-In-Time Training Products for Deep Space, Long Duration Spaceflight Crews": we are working on two specific aims that will address the risk of team performance errors resulting from a lack of medical focused non-technical skills, as follows.

Specific aim 1: Identify objective measures of non-technical skills that enhance crew management of in-flight medical emergencies. We are developing an objective measurement tool based on the essential astronaut behaviors for effective medical emergency management and according to a set of design criteria. Primary data collection is by a Delphi consensus process with an international expert advisory panel comprising astronauts, surgeons, emergency medicine physicians, human factors engineers, applied psychologists, health services researchers, patient safety scientists, and space flight human resource management experts.

Specific aim 2: Develop a simulated spacecraft medical bay, and run a series of simulation scenarios to measure crew behavior during high acuity, low frequency medical emergencies. This physical simulator prototype will provide crews with valid medical emergency scenarios on which to gain experience of dealing with rare but highly consequential events in space. The platform is being designed for deployment in both ground-based and in-flight training situations, as recurrent and deliberate practice in non-technical skills is required to enhance proficiency, reduce performance errors, and realize optimal patient outcomes. Once developed we will use the simulator to measure astronaut behavior during spaceflight emergencies.