Graduating surgical residents have limited experience with some injuries commonly treated by deployed military surgeons. Our objective was to demonstrate improved surgeon confidence in treating combat-related injury scenarios with a two-day course utilizing validated porcine and cadaveric injury models (American College of Surgeons-affiliated courses ATOM and ASSET) as well as military-specific curriculum.

The Resident Exposure and Combat Trauma (REACT) Course is a two-day trauma surgery course taught by neurosurgeons, orthopedic surgeons and trauma surgeons with combat deployment experience. Our cohort included chief surgical residents and staff surgeons preparing for deployment (n=13). Operative confidence was assessed prior to and following the course using a 5-point Likert-scale self efficacy instrument.

Course participation resulted in a significant increase in operative confidence in 33 of 41 anatomic exposures (mean scores, pre 3.168 vs post 4.142, p < 0.0001). This trend remained when exposures were analyzed by body region to include neck (pre 3.108 vs post 3.939, p < 0.0001), chest (pre 3.069 vs post 4.077, p < 0.0001), abdomen (pre 3.609 vs post 4.231, p < 0.0001), and extremities (pre 3.350 vs post 4.385, p < 0.0001).

A structured skills curriculum taught by surgeons with combat deployment experience enhances participant self confidence in procedures commonly performed by the deployed general surgeon. Many of these fall outside of traditional general surgical curriculum. This represents the first surgeon specific, evidence based pre-deployment course. This model may be beneficial to the deploying general surgeon and should be considered for incorporation into standard pre-deployment training.