Effectiveness of Army military-civilian trauma team training in generating surgical readiness

Abstract: BACKGROUND: The Military Health System uses a readiness program that identifies the knowledge, skills, and abilities (KSAs) necessary for surgeons to provide combat casualty care. Recent studies highlight the importance of surgical experience outside of military hospitals to maintain clinical readiness. The Army Military-Civilian Trauma Team Training (AMCT3) program embeds Army surgeons in civilian trauma centers to provide greater patient acuity and higher case volume. We quantified the current state of this program and the overall readiness generated. STUDY DESIGN: Monthly self-reported clinical care and procedural logs from surgeons assigned to AMCT3 programs in 2022 were collected. Clinical work was assigned CPT codes and processed through the joint knowledge, skills, and abilities calculator. Training and deployment calendars were used to identify time away from clinical practice. RESULTS: Thirteen surgeons were assigned to AMCT3s in 2022 for a combined 87 clinical months (average 6.7 ± 3.7 clinical months). Average monthly workload included 19.3 ± 7.9 operative cases, 3.3 ± 1.6 chest tubes, 3.4 ± 3.2 central venous catheters, 13.1 ± 11.7 extended focused assessment with sonography in trauma, 28.5 ± 12.1 trauma resuscitations, and 39.4 ± 36.8 episodes of critical care. Surgeons accumulated 5,016.9 ± 2,315 KSA points per month with 2,917.1 ± 1,877 (58.1%) coming from resuscitations and critical care episodes. Using the Military Health System threshold of 16,500 KSA points for trauma surgeons, the average surgeon would require 3.3 clinical months to meet the annual readiness threshold. CONCLUSIONS: AMCT3 platforms provide significant opportunities for critical care experience and procedures relevant to combat casualty care. The readiness generated through the use of this program suggests that it should be fostered and expanded.