Page 29 - JSOM Fall 2018

TABLE 2 Hypothesis Topics Generated for Future Scholarly Works References
User’s preference for a metric may vary by their level of skill from 1. Berwick D, Downey A, Cornett E, eds. Committee on Military
novice to expert. Trauma Care’s Learning Health System and Its Translation to
Metric utility varies by user’s level of skill from novice to expert. the Civilian Sector; Board on Health Sciences Policy; Board on
the Health of Select Populations; Health and Medicine Division;
Learners demonstrating the step order of the skill may suffice in ini­ National Academies of Sciences, Engineering, and Medicine. A
tial training of novices. National Trauma Care System: Integrating Military and Civilian
A mechanical metric of effectiveness like pulse stoppage may aid in Trauma Systems to Achieve Zero Preventable Deaths After Injury.
later training of novices. http://www.nap.edu/catalog/23511/a­national­trauma­care­
The proportion of errors varies by user’s level of skill ranging from system­integrating­military­and­civilian­trauma accessed 6/17/2016.
novice to expert. 2. Schreckengaust R, Littlejohn L, Zarow GJ. Effects of training and
Readiness of public caregivers can be shaped by knowing how to simulated combat stress on leg tourniquet application accuracy,
time, and effectiveness. Mil Med. 2014;179(2):114–120.
assess performance. 3. Kragh JF, Lunati MP, Kharod CU, et al. Assessment of groin ap­
Performance assessment science may aid leader development in first plication of junctional tourniquets in a manikin model. Prehosp
aid and casualty care. Disaster Med. 2016;31(4):1–6.
Training users how to self­assess and practice on their own may aid 4. Department of Homeland Security. Stop the Bleed. http://www
their self­development. .dhs.gov/stopthebleed. Accessed 1 February 2016.
Do midlevel users risk misjudging strategy (e.g., prioritizing speed 5. Pons PT, Jerome J, McMullen J, et al. The Hartford Consensus
over effectiveness)? on Active Shooters: Implementing the continuum of prehospital
Investigators may relook at existing sequential data for learning trauma response. J Emerg Med. 2015;49(6):878–885.
curve analyses. 6. Kragh JF Jr, Geracci JJ, Parsons DL, et al. Junctional tourniquet
training experience. J Spec Oper Med. 2015;15(3):20–30.
Given these LC­CUSUM parameters, users starting with six passes 7. Kragh JF Jr, Mabry RL, Parsons DL, et al. Learning curves of
can go on to another task. emergency tourniquet use exploring for utility in training. J Spec
Given these LC­CUSUM parameters, users starting with five failures Oper Med. 2016;16(4):7–14.
can stop and remediate. 8. Kragh JF Jr, Aden JK 3rd, Shackelford S, Dubick MA. Prelimi­
If educators teach to the center of mass of a class, how well do the nary measures of instructor learning in teaching junctional tour­
neediest learners achieve? niquet users. J Spec Oper Med. 2016;16(2):13–15.
If the skill of learners is not validated in class, do they sink or swim 9. Clumpner BR, Polston RW, Kragh JF Jr, et al. Single versus dou­
later as providers? ble routing of the band in the Combat Application Tourniquet.
J Spec Oper Med. 2013;13(1):34–41.
LC­CUSUM, learning curve cumulative sum.
10. Kragh JF Jr, Dubick MA. Skill decay or maintenance between
tourniquet uses among first aid caregivers: Exploration in a man­
Disclaimer ikin model. Am J Emerg Med. 2016;34(9):1897–1899.
The opinions or assertions contained herein are the private 11. US Government. Soldier’s Manual of Common Tasks, Warrior
Skill Level 1 Soldier Training Publication 21­1­SMCT. Headquar­
views of the authors and are not to be construed as official or ters, Department of the Army, 2017.
reflecting the views of the Department of Defense or US Gov­ 12. Kragh JF Jr, Moore VK 3rd, Aden JK 3rd, et al. Short report
ernment. The authors are employees of the US Government. comparing generation 6 versus prototype generation 7 Combat
®
This work was prepared as part of their official duties and, as Application Tourniquet in a manikin hemorrhage model. J Spec
such, there is no copyright to be transferred. Oper Med. 2016;16(1):14–17.
13. Kak N, Burkhalter B, Cooper M. Measuring the Competence
of Healthcare Providers. U.S. Agency for International Develop­
Disclosure ment (USAID). Quality Assurance (QA) Project. 2001;2(1):1–28.
The authors declare no conflicts of interest. https://www.usaidassist.org/sites/assist/files/measuring_the_
competence_of_hc_providers_qap_2001.pdf, accessed 2/28/2018.
Author Contributions 14. Zhang Q, Zhang Q, Guo W, et al. The learning curve for minimally
NOZ, JFK, JKA, and MAD conceived the study; all made a invasive Oxford phase 3 unicompartmental knee arthroplasty:
contribution to its design; JFK resourced, managed, and over­ cumulative summation test for learning curve (LC­CUSUM). J
Orthop Surg Res. 2014;9:81.
saw the study; JFK, BSJ, and DLP collected data in the source 15. Idris AH, Guffey D, Aufderheide TP, et al. The relationship be­
sample; NOZ, JFK, and JKA analyzed data; and all partici­ tween chest compression rates and outcomes from cardiac arrest.
pated in writing the manuscript. All authors approved the fi­ Circulation. 2012;125(24):3004–3012.
nal version of the manuscript. 16. Goodloe JM, Idris AH. Metrics save lives: value and hurdles
faced. Curr Opin Crit Care. 2017;23(3):204–208.
17. Yannopoulos D, Aufderheide TP, Abella BS, et al. Quality of
CPR: An important effect modifier in cardiac arrest clinical out­
comes and intervention effectiveness trials. Resuscitation. 2015;
94:106–113.

Your Metric Matters! | 27