Prehospital transfusion training in Canada: a national survey of critical care transport organizations
Notice bibliographique
Résumé
BACKGROUND: Hemorrhagic shock is a leading cause of preventable death, and prehospital transfusion has been associated with improved outcomes in select trauma and medical patients. In Canada, several Critical Care Transport Organizations (CCTOs) have implemented prehospital transfusion programs to reduce geographic disparities in access to definitive care. However, limited evidence exists on how providers are trained to deliver this intervention. While simulation-based education and instructional design features improve skill retention in other contexts, their application in prehospital transfusion training has not been systematically evaluated. This study aimed to assess current training practices among Canadian CCTOs and evaluate their effectiveness. METHODS: We conducted a cross-sectional survey across all Canadian CCTOs. Data were analyzed descriptively using the Kirkpatrick Model framework, which evaluates training effectiveness across four levels: learner satisfaction, knowledge acquisition, behaviour change, and patient outcomes. Reporting followed the Consensus-based checklist for reporting of survey studies (CROSS) guidelines. RESULTS: All seven Canadian CCTOs with active prehospital transfusion programs participated (100% response rate), with respondents including one transport physician, three registered nurses, and three critical care paramedics per organization. Programs represented fixed-wing, rotor-wing, and land-based transport systems operating in urban, suburban, rural, and remote settings. Training approaches varied across CCTOs. Checklists were universally used to assess competency, with four organizations incorporating additional tools such as global rating scales and scenario-based evaluations. Recertification practices were inconsistent: one CCTO required annual recertification, three used bi-annual reviews, and three had no formal recertification process. Using the Kirkpatrick Model, all seven CCTOs demonstrated Level 1 (Reaction) through provision of training; five used structured feedback mechanisms, while two relied on informal feedback. At Level 2 (Learning), six organizations used didactics, practical workshops, and field training, while one relied solely on mentorship. Level 3 (Behaviour) evaluations were conducted by four CCTOs, primarily through structured assessments; three relied on documentation audits or informal peer review. No CCTOs reported Level 4 (Results) assessments through tracking of patient outcomes related to transfusion. CONCLUSIONS: Considerable variability exists in prehospital transfusion training across Canadian CCTOs. Establishing training standards may support improved provider preparedness and contribute to enhanced patient care, although further evaluation is needed.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».