Benefits of surgical task trainers to complement training pathways for junctional haemorrhage control

Junctional haemorrhage remains a recognised cause of preventable trauma mortality. Although uncommon in the United Kingdom, such injuries demand prompt haemorrhage control, open vascular exposure and temporary shunting. Opportunities to develop these skills during routine vascular training are limited. This study evaluated whether high-fidelity pulsatile bleeding simulation improved trainees' self-reported confidence in managing groin junctional haemorrhage.

A prospective pilot educational evaluation was undertaken during a South West Deanery vascular training day. Nine vascular surgery trainees (ST3-ST7) completed a simulation using the Trauma Simulation® Femoral Injury Groin Task Trainer, identifying the bleeding source, obtaining proximal and distal femoral control, and inserting a temporary shunt under pulsatile haemorrhage. Confidence across four procedural domains was rated on a 5-point Likert scale immediately before and after the exercise, and scores compared using Wilcoxon signed-rank testing. No objective performance assessment was undertaken.

All nine trainees completed both questionnaires. Median confidence improved in all four domains, although whole-cohort changes were not statistically significant. Among junior trainees (ST3-ST6, n = 6), improvements in haemorrhage management, proximal and distal vascular control, and shunt insertion were significant (all p < 0.05). The three ST7 trainees showed smaller changes; the groups were not compared statistically. Participants highlighted the realism of pulsatile haemorrhage and the value of consultant-led debriefing.

High-fidelity pulsatile bleeding simulation is feasible, was valued by trainees and may help address an experiential gap in UK vascular training. However, confidence is not competence, and objective performance measures are needed before wider curricular adoption.