Page 95 - Journal of Special Operations Medicine - Summer 2017

Table 4 Relative Subjective Importance of Negatively Scored General Features of High-Fidelity Simulators
Mean Rating Comparison Mean Significance
Rated Feature (Out of 5) (Out of 5) p-Value
Skin color differences in models (race) 1.95 4.05 .001
Facial hair 2.76 4.05 .001
Gender differences in models 2.86 4.05 .001
Odors from mannequin 2.88 4.05 .001
Body hair 2.98 4.05 .001
Submersible/waterproof 3.39 4.05 .001
Automated movement of limbs 3.44 4.05 .001
Eyes Blink 3.57 4.05 .002
Facial movement with vocalizations 3.61 4.05 .024
Bowel sounds (changeable) 3.61 4.05 .037
Colored urinary catheterization feedback 3.68 4.05 .011
(clear, yellow, black, red)

Table 5 Relative Subjective Importance of Procedures and Injuries Replicated by High-Fidelity Simulators
Mean Rating Comparison Mean Significance
Rated Factors (Out of 5) (Out of 5) p-Value
Positively Rated Factors
Extremity tourniquet 4.85 4.37 <.01
Cricothyroidotomy 4.82 4.37 <.01
Hemorrhagic wound cavity packing 4.79 4.37 <.01
Chest wound seal 4.76 4.37 <.01
Bilateral needle decompression 4.75 4.37 <.01
Inguinal junctional tourniquet 4.66 4.37 .019
Negatively Rated Factors
Urinary catheterization 3.78 4.37 <.01
Nasogastric tube placement 3.68 4.37 <.01
Oral pharyngeal airway placement 3.68 4.37 <.01
Rectal temperature assessment 3.87 4.37 .019
Defibrillation 3.87 4.37 .027
Degloving injury to extremity 3.67 4.48 .039

specifically that practicing with HPS manikins improved of SOF Medics that such experiences would be phased
confidence in skilled procedures. Generally, the skills out or made unavailable to medics in favor of HPSs.
most valued by participants (i.e., those educated via About one in four commented that live-tissue models
manikin HPS) coincided with those difficult-to-practice still represent a superior form of training, with cited rea-
but lifesaving measures, such as cricothyroidotomy, sons including emotional feedback and realism, although
and responses to massive arterial hemorrhage, such as many of these medics also noted that HPSs are a “good
wound packing and extremity tourniquets. Some mani- adjunct” to animal-based training. HPSs and live models
kin features more applicable to tasks of prolonged field do not necessarily need to be mutually exclusive; how-
care, such as nasogastric tube response, had lower im- ever, it appears that, at present, medics are not prepared
portance ratings. These findings demonstrate alignment to lose living-patient interactions and animal models.
between the goals of HPS devices and their use within
the military field medic community. Some features that device manufacturers have aggres-
sively marketed, including prerecorded sounds or
Although our study did not focus on live tissue or animal streaming audio and automated movements of pupils
models, there was significant concern among our cohort and limbs, are less valued by our end-user group. 33,34

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