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Training for a mass casualty incident: Conception, development, and implementation of a crew-resource management
Henri de Lesquen1, Raphael Paris, Solenn Lacheze
1From the Department of Thoracic and Vascular Surgery (H.d.L., J.-P.A.), Department of Anesthesiology and Intensive Care (W.M.), Sainte Anne Military Hospital, Toulon; Department of Anesthesiology and Intensive Care (R.P., A.L.), Laveran Military Teaching Hospital, Marseille; Département Recherche Expertise Formation Aéromédicale (S.L., A.V.), French Armed Forces Biomedical Research Institute, Brétigny sur Orge; Department of Digestive and Endocrine Surgery (B.d.l.V.), Laveran Military Teaching Hospital, Marseille; French Military Medical Academy (A.L., P.B., P.P., J.-P.A.), École du Val-de-Grâce, Paris; Department of Anesthesiology and Intensive Care (P.P.), Percy Military Teaching Hospital, Clamart; and French Special Operations Forces Medical Component Command (P.P.), Villacoublay, France.
Background:
Since 2021, the predeployment training of French FSTs has included a simulation-based curriculum consisting of organizational and human factors. The purpose of this article is to describe the development of a crew-resource management (CRM) training course dedicated for the forward surgical teams (FSTs) of the French Military Health Service.
Methods:
The approach was based on three steps: (1) establishment of a conceptual framework of FSTs deployment; (2) development of an aircrew-like CRM training combining lectures, laboratory exercises, and situational training exercises to consider four fundamental "nontechnical" (cognitive and social) skills for effective and safe combat casualty care: (a) leadership, (b) decision-making, (c) coordination, and (d) situational awareness; (3) Implementation of teamwork evaluation tools.
Results:
A multidisciplinary team designed a conceptual framework for FST preparedness, 24 French FSTs completed a high-quality training that takes into account both technical and nontechnical skills to maintain quality of combat care during mass-casualty incidents, FSTs' CRM skills were assessed using an audio/video recording of a simulated mass-casualty incident.
