Page 72 - JSOM Summer 2018

medical losses could be decreased. Surgical team members stress-related factors that could be implemented in future stud-
were aware of craft motion, used compensatory measures, re- ies include incorporating combat fatigue and sleep deprivation
ported higher perceived workload, and exhibited some physi- within the research model. By establishing the maximum en-
ological response. Despite these, their overall performance and vironment in which members can operate, we can assemble
ability to perform these procedures in the simulator was not teams and resources around those parameters. It is import-
negatively affected. ant to know what environments are most optimal for surgi-
cal success, as well as understanding the conditions that make
Given the many factors assessed, the observed trends are com- surgery impossible or that create greater risks with lower out-
pelling and warrant further exploration. The next step is to comes of success.
take aspects of this training environment aboard actual non-
traditional Navy vessels such as the LCS (USS Freedom) and Finally, future research could investigate performing more
the EPF 1 (USNS Spearhead) in live sea states. In this setting, complicated surgical procedures aboard nontraditional ves-
many of the variables would remain the same, including, but sels. With the goal of expanding our shipboard resources
not limited to, number of participants, procedures performed, while minimizing costs, investigators should consider multi-
and blood simulation modalities. From here, comparison of system trauma procedures that can be performed on these ves-
the true effectiveness of a health-care team in a setting modi- sels to expand the resourcefulness and utility of various naval
fied for surgical procedures can be assessed. platforms.

Additional studies could include increasing the severity of the Disclosures
training environment with the goal of establishing the up- The authors have indicated they have no financial relation-
per-limit of health-care providers’ abilities. The LCS 1 and ships relevant to this article to disclose.Author Contributions
EPF 1 can approach speeds of 40 knots, and subjecting par-
ticipants to more strenuous environments could offer insight Author Contributions
as to what motion conditions lead to skill atrophy. 11,12 Other EP served as the principal investigator, project manager, and
lead systems engineer for this project. AL and TH served as
the surgical subject matter experts. JK and JB served as the
test directors. AC served as project safety representative and
vital sign and motion platform operator throughout the exper-
iment. RR took the lead in writing and editing the manuscript.
PAH contributed to the manuscript. MP served as a consultant
for the project.
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