February 27, 2004

Present: Robert, Sakti, Pat, Phil, Decker Walker (Professor from School of Education)

Purpose: To revise the validation study design to accommodate the limitations noted previously: Phil’s time and concern about student compliance to remain in intact groups and show up for numerous training sessions conducted over several weeks.

We decided to revise the study as follows:

·        Collect data from teams consisting of 5 students—1 as team leader, 2 as team members, and 2 as observers.  (See table on next page.)

·        Randomly assign volunteer students to the teams, but systematically change team membership so individuals work in a different team role (team leader, team member, observer) for each case.  (See table on next page.)

·        Limit the total number of cases to 5, with 2 cases reserved for pretest and posttest of leadership skills.  If one of the team members does not show up on a given day, allow one of the observers to step in and have only a 4 person team.

·        Assess leadership skills with a rating scale (to be developed) only at the beginning of training, using a pretest case (case 1), and at the completion of training, using a posttest case (case 7).

·        Assess team performance each time any team works through a case, using a rating scale of team performance (to be developed).  (This would not be solely based on the patient outcome data, but rather how well the team performed together—regardless of whether the patient lived or died.)

·        Conduct the null case (for training/orientation to the system) and the pretest (Case 1) in the first session, using only the researchers (no students, other than the team leader) to take the role of team members.  Therefore, Phil is not required at this session.  However, the nurse is required at this session.

·        Phil estimates the time for each team’s performance on a case is 20 minutes to do the case and 20 minutes to do the debrief.  Therefore, it will take 40 minutes to complete a training session for each team, and an individual will participate in two teams each day of training.  Phil will be required all day for three days and a half day on the fourth day.

·        To ensure a “level playing field” (all subjects have the necessary background knowledge in teamwork and trauma assessment & management to do the cases effectively) we would like to videotape Phil’s didactic lecture in the March 17^th training session and create a brief quiz to check their mastery.  And we would put both on the CWP website and ask that participants complete it prior to the first session.

·        Pay students an honorarium (or gift certificate?) of $100 upon completion of all 5 sessions.

Next steps:

• Arrange for videotaping of the March 17^th session & put on CWP (web).
• Write 10 item quiz to check for mastery of Phil’s material & put on CWP.
• Reserve time on Phil’s schedule to implement the study.
• Reserve time on Sandy’s schedule to implement the study.
• Schedule the HPS facility to conduct the study in April and May.
• Develop the rating scales for team leader, team performance.
• Check on the number of subjects required to achieve a reasonable level of power for the statistical analysis
• Review the design with a statistician to see what type of analysis is best,

(and how many subjects are required)

*team leader

^ team members (2)

+ observers (2)

Repeat with 15 volunteer students to participate in the same design for the HPS cases.

These changes make the following possible:

·        Phil’s time is reduced to 3 days for the 3D World part of the validation study, and another 3 days for the HPS part of the validation study—a total of 6 days.

·        The nurse’s time is reduced to 4 days for the 3D World part and 4 days for the HPS part—a total of 8 days.

·        Researchers play team roles for pre and post testing

·        Estimate 2 hours for each student (to do 2 cases)

·        Scheduling students is easier, most students don’t have to stay for the whole day.

·        Total time for each student is about 8 hours, and they will get a $100 honorarium.

·        It is suggested we use the spleen and liver cases as the pre and post test cases, as they are the most similar/equivalent in level of difficulty.