Preparing Emergency Medicine Residents to Lead Level 1 Multidisciplinary Trauma Teams: A Scoping Review

Area of Science:

• Medical Education
• Emergency Medicine
• Trauma Surgery

Background:

• Emergency Medicine (EM) residents typically have limited experience leading trauma teams, as surgeons usually direct care in the US.
• However, EM physicians in rural settings often lead trauma resuscitations without surgical backup.
• This highlights a critical need for specific training in trauma leadership for EM residents.

Purpose of the Study:

• To identify and synthesize educational strategies for training EM residents to lead Level 1 trauma resuscitations.
• To describe how resident confidence, performance, and preparedness are assessed in these training programs.

Main Methods:

• A scoping review following Joanna Briggs Institute methodology was conducted.
• Systematic searches of PubMed and Embase were performed using keywords related to EM, trauma, leadership, and education.
• Twenty-three studies were included after a double-blind screening and data extraction process.

Main Results:

• Simulation-based training (high-fidelity mannequins, cadavers, standardized patients) was the predominant educational modality.
• Combined approaches (didactics, debriefing, mental rehearsal) enhanced leadership, procedural, and nontechnical skills.
• Outcome assessment primarily relied on self-reported confidence and perceived competence, with limited use of validated performance tools or real-world evaluation.

Conclusions:

• Simulation-based training is the most common method for preparing EM residents for trauma leadership, often enhanced by debriefing and didactics.
• Current assessments focus on learner perception and simulated performance, with a gap in evaluating real-world clinical leadership.
• Future directions include developing standardized curricula, validated evaluation tools (e.g., Kirkpatrick levels), and integrated simulation-practice models for robust trauma leadership preparation.