Residents as Leaders: Creating a Trauma Team Leader Nontechnical Skills Simulation Workshop

Effective trauma resuscitation requires strong leadership and mastery of nontechnical skills (NTS), including communication, situational awareness, decision-making, and teamwork. With trauma team leadership increasingly shared between surgical and emergency medicine physicians, there is a need for structured, interdisciplinary training focused on NTS. This study evaluates the effectiveness of a simulation-based trauma team leader (TTL) curriculum in enhancing NTS among senior residents.

A prospective, mixed-methods educational intervention was conducted from 2020 to 2024 at a single academic institution. Participants included general surgery and emergency medicine residents with prior ATLS certification and trauma rotation experience. The half-day TTL workshop included didactic instruction, eight high-fidelity simulation scenarios with rotating leadership roles, and structured debriefings using the Trauma Non-TECHnical Skills (T-NOTECHS) rubric. Assessments included pre- and postworkshop knowledge tests, confidence surveys, faculty evaluations, and a 1-year follow-up survey. Descriptive statistics and paired comparisons were used for analysis.

Fifty-three residents (29 surgery, 24 emergency medicine) participated. Statistically significant improvements (p < 0.001) were observed across all NTS domains: leadership (2.9-4.4), communication (3.2-4.6), situational awareness (3.1-4.5), decision-making (3.0-4.3), and cooperation/resource management (3.0-4.4). No significant differences were found between specialties. Participant satisfaction was high, with 96% rating the workshop as effective or extremely effective. At 1-year follow-up (n = 34), 88% reported improved readiness for trauma leadership, and 85% applied skills regularly in clinical settings.

The TTL simulation workshop significantly improved NTS confidence and preparedness among senior surgical and emergency medicine residents, with sustained benefits at 1 year. This curriculum represents a valuable model for interdisciplinary trauma leadership training. Future directions include expanding the course to include additional trauma team members and integrating real-time assessment of NTS into clinical practice to further enhance team performance and patient outcomes.