Improving Pediatric Trauma Education by Teaching Non-technical Skills: A Randomized Controlled Trial
Related Experiment Video
Updated: May 5, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Fabio Botelho1, Ayla Gerk2, Jason M Harley3
1Department of Surgery, McGill University, Montreal General Hospital, Montreal, Canada; Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, Montreal, Canada.
Insights
Structured debriefing significantly improved non-technical skills (NTS) and trauma protocol adherence in medical students during pediatric trauma simulations. This training is vital for enhancing pediatric trauma care.
Area of Science:
- Medical Education
- Trauma Care
- Simulation-Based Learning
Background:
- Pediatric trauma is a leading cause of mortality in children.
- Gaps in health providers' non-technical skills (NTS) contribute to patient care errors.
- This study addresses the need for improved NTS in pediatric trauma management.
Purpose of the Study:
- To evaluate the effectiveness of a structured debriefing protocol in enhancing NTS.
- To assess the impact of NTS training on pediatric trauma simulation performance.
- To improve adherence to trauma care protocols.
Main Methods:
- A randomized control trial involving 45 medical students from Brazil and Canada.
- Intervention group received structured NTS debriefing; control group received standard ATLS debriefing.
- NTS assessed using NOTSS scores; performance measured by protocol adherence and self-reported confidence.
Main Results:
- Structured debriefing significantly improved overall NOTSS scores and all subcategories (situational awareness, decision-making, communication, teamwork, leadership).
- Intervention group showed significantly better adherence to trauma protocol steps.
- Student confidence in leading resuscitation increased across both groups.
Conclusions:
- Structured debriefing focusing on NTS is effective in enhancing these skills among medical students.
- NTS training improves protocol adherence in simulated pediatric trauma scenarios.
- Findings support the integration of NTS training into pediatric trauma education curricula.
Background:
Pediatric trauma is a significant cause of child mortality, and the absence of non-technical skills (NTS) among health providers is linked with errors in patients' care. In this study, we evaluate the effectiveness of a structured debriefing protocol in enhancing NTS during pediatric trauma simulation.
Methods:
A total of 45 medical students were successfully recruited from two medical schools, one in Brazil and one in Canada. Medical students were assigned to a control (N = 20) or intervention group (N = 25) in a randomized control trial. Following simulated scenarios, participants in the intervention group underwent NTS debriefing, while the control received standard debriefing based on the Advanced Trauma Life Support (ATLS) protocol. Students' confidence, NTS level, and performance were measured through self-assessment surveys, the Non-Technical Skills for Surgeons (NOTSS) score, and adherence to the trauma protocol, respectively. Baseline characteristics and outcomes were compared using t-tests, Mann-Whitney, Wilcoxon signed-rank Kruskal-Wallis, ANOVA, and a repeated-measures ANCOVA. A significance level was set at p < 0.05.
Results:
The workshop increased students' confidence in leading trauma resuscitation regardless of their assignment to condition. While controlling for covariates, students in the intervention group significantly improved their overall NOTSS compared to those in the control and in all categories: situational awareness, decision-making, communication and teamwork, and leadership. The intervention teams also demonstrated a significant increase in completing trauma protocol steps.
Conclusion:
Implementing structured debriefing focusing on NTS enhanced these skills and improved adherence to protocol among medical students managing pediatric trauma-simulated scenarios. These findings support integrating NTS training in pediatric trauma education.
Level Of Evidence:
I.
