Page 126 - JSOM Winter 2024

TABLE 8 Pre- and Post-Course General Self-efficacy Scale Scores Per post-course GSES scores. 39,40,43–45 Third, although not a part
Domain for Participant 5 of this pilot project, participants’ tactical knowledge increased
Absolute after taking the TC3 course, as evidenced by a comparison of
Domain Pre-course Post-course difference pre- and post-test written and scenario scores. 17,21,23,26
1 1 3 2
2 2 3 1 There were originally 10 FNP participants scheduled to par-
3 2 4 2 ticipate in the study. Two participants had to drop out due to
4 2 4 2 scheduling conflicts. One participant had to drop out due to a
family emergency, and another participant had to drop out for
5 1 3 2 an acute medical event. This left six participants to complete
6 2 3 1 the EBP pilot study. Although this seems like a small sample
7 1 4 3 size, this number represents 24% of the FNP population of
8 2 3 1 the Level 1 trauma center’s university-based flight program.
9 2 3 1 Demographic information was not collected because the proj-
10 3 4 1 ect leader works with and knows each participant so well that
any demographic information collected would have cued the
TABLE 9 Pre- and Post-course General Self-efficacy Scale Scores Per project leader as to the participant’s identity. Since the self-
Domain for Participant 6
efficacy responses and written test results were blinded to the
Absolute project leader, collecting demographic information was out of
Domain Pre-course Post-course difference the question.
1 3 3 0
2 3 3 0 The TC3 written exam was initially excluded from the EBP pi-
3 3 4 1 lot study because the project leader needed to know if the TC3
4 3 4 1 course had an embedded pre-test, and he could not answer the
5 3 3 0 question before the TC3 class was held. He contacted the TC3
6 4 4 0 administrative office multiple times in the weeks leading up to
7 4 4 0 the TC3 course, but no one at the TC3 administrative office
returned his requests for information. A decision was made not
8 4 4 0 to include the TC3 exam as part of the EBP pilot study. When
9 4 4 0 he observed the TC3 course, the project leader discovered there
10 3 4 1 was indeed an embedded pre-test. Although the decision had
already been made to not include the TC3 exam as part of the
EBP pilot project, the pre-test/post-test results and analysis are
number they obtained at the beginning of the first day of reported here to support the EBP pilot study findings.
the TC3 class. To see if the participants gained statistically
significant improvements in tactical knowledge, the decision Overall, tactical self-efficacy increased across all six partici-
was made to run an additional two-tailed paired t test in the pants. Participant 1 increased self-efficacy in six domains (2,
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same fashion as the other t tests. Again, elements of the PICO 3, 4, 5, 6, and 9) on the GSES. Participant 2 increased self-
question were used to generate the two-tailed t tests, as previ- efficacy in only one domain on the scale (Domain 2). Partici-
ously noted. The results (mean difference, 10.00 [SD 7.899]; pant 3 increased self-efficacy in four domains (1, 3, 7, and 10),
SE 3.225) indicate a clinically relevant and statistically signif- while Participant 4 increased self-efficacy in only two domains
icant overall improvement in tactical knowledge (t =3.101, (3 and 4). Participant 5 increased self-efficacy in all domains
(4)
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P=.027, d=1.27 [95% CI 1.71–18.29]). The pre- and post- on the scale. Participant 6 increased self-efficacy in three do-
test scores for the written exam for each participant are shown mains (3, 4, and 10). This overall increase in self-efficacy is
in Table 10. clinically relevant.
TABLE 10 Blinded Pre- and Post-test Results This was an EBP pilot study, and as such, this project leader was
Absolute only looking for clinical relevance in the pre-course and post-
Participant Pre-test Post-test difference course results and not necessarily statistical significance. The
1 88 96 8 results of the study; however, did show statistically significant
2 88 92 4 improvement in overall tactical self-efficacy and statistically
3 96 100 4 significant improvement in individual tactical self-efficacy in
50% of the participants (Participants 1, 3, and 5).
4 76 96 20
5 72 92 20 However, what is even more important is the fact that there
6 92 96 4 was an overall increase in tactical self-efficacy across all par-
ticipants. This is clinically relevant as it translates to each par-
Paired two-tailed t tests were conducted to calculate the sig- ticipant gaining/increasing the self-efficacy needed to perform
nificance of the mean difference of pre- and post-course GSES the role of the LET-NP, which is the overarching goal of the
scores. Measurable outcomes were threefold. First, overall Level 1 trauma center’s university-based flight program’s ad-
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tactical self-efficacy increased as evidenced by the difference ministration. Increased tactical self-efficacy will also better
in pre-course and post-course GSES scores. 2,39,40,43-45 Second, equip them to operationalize with the metropolitan SWAT
clinical/procedural self-efficacy under stressful/tactical con- team. Finally, the finding that the TC3 course improves the
ditions increased as evidenced by the difference in pre- and self- efficacy of the FNP is clinically relevant, as it will allow

124 | JSOM Volume 24, Edition 4 / Winter 2024