INTRO: This project expanded upon previous exploration of emotional intelligence during the habituation for military second year medical students undergoing high-stress simulation with trauma and surgical skill training. The objective was to interpret emotional intelligence data before and after hyper-realistic immersion trauma training and to include a larger sample size than previously investigated. METHODS: Fifty increasingly intense mass casualty scenarios with simulated Emergency Department (ED) and Operating Room (OR) procedures were performed while students lived as if deployed in an Afghan village. Students rotated through a variety of roles in both the ED and the OR throughout the weeklong program. Second year medical students completed the EQ-i 2.0 Model for Emotional Intelligence on the first and last day of the intensive surgical skills week. Three different cohorts from three different graduating classes were followed with a total sample size of 96. Emotional intelligence in this model is defined as a combination of 5 domains each with three subdomains. RESULTS: A statistical analysis of the EQ data shows significant improvement in almost every subdomain of Emotional Intelligence from pre to post testing. The total EQ score was significantly higher with an average improvement of 3.95 points. All of the subdomains, except for emotional expression, empathy, and problem solving significantly improved following the intensive skills course. A 3 factor ANOVA including year and gender was also performed. R-2 of the change in pre to post scores was around 90%, indicating practical significance in the score improvements. CONCLUSION AND IMPACT: Total emotional intelligence significantly improved from pre to post scores as well as each of the 5 domains and most subdomains. Scores improved an average of 4 points after only a 5-day training course. This training led to the most improvement in the self-perception and stress management categories. Medicine, especially high stress specialties like surgery and trauma, require physicians who are able to make decisions at a moment's notice and cope well with stressful situations. It is essential that individuals develop these intangible skills, which can be measured by emotional intelligence. Further research is needed to determine the long-term impacts of the increased emotional intelligence seen with hyper-realistic training. Some specific areas to investigate include physician performance and emotional wellbeing. (C) 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The new open-access journal business model is changing the publication landscape and residents and junior faculty should be aware of these changes.A national survey of surgery program directors and residents was performed.Open-access journals have been growing over the past decade, and many traditional printed journals are also sponsoring open-access options (the hybrid model) for accepted articles. Authors need to be aware of the new publishing paradigm and potential costs involved in publishing their work.

Surgical and simulation development have always been closely associated with military activity. The last ten years have continued that trend, allowing for training in real time, under reality-based conditions, learning technical and clinical skills with the dynamic of true human factors and team training in the actual environment. We present data from diverse activities in three separate scenarios: second-year medical students in clinical scenarios; the U.S. Ski Team physicians training in austere conditions; the U.S. Navy Fleet Surgical Team training for sea and land deployment.

UNLABELLED:A delicate balance exists between a beneficial stress response that enhances memory and recall performance and a detrimental high stress response that impairs memory and learning. Repetitive training in stressful situations enables people to lower their stress levels from the detrimental range to a more beneficial one.1 This is particularly true for physicians in training as they seek to achieve advanced skills and knowledge in the fields of triage, emergency medicine, and surgery prior to graduation. This need is significant for medical students entering military service after graduation. We theorize that military medical students can advance their proficiencies through an Intensive Skills Week (ISW) prior to entering their third and forth year rotations. To test this theory, Rocky Vista University will hold a week long high-intensity first-responder, emergency medicine and surgical training course, facilitated by military medical physicians, to further students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). We also see the possible benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or not feasible.KEYWORDS:Stress, cortisol, medical student, enhanced learning, scenario, high intensity.

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible.