Training for a mass casualty incident: Conception, development, and implementation of a crew-resource management course for forward surgical teams

BACKGROUNDSince 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.METHODSThe 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.RESULTSA 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. To ensure a high-quality predeployment training, French military surgeons institutionalized multivictim trauma care teaching as a side-by-side mentorship for newly graduated surgeons. To maintain this institutional knowledge, an aviator-like training program have been designed for French Forward Surgical Teams preparedness.