1 The Use of Cognitive Task Analysis and Simulators for After Action Review of Medical Events in Iraq1

This study tested a novel approach to medical after action reviews (AAR) by employing cognitive task analysis (CTA) methods. Ten trauma surgeons, who were either deployed in a Forward Surgical Team (FST) in Iraq or at an urban trauma center, were interviewed separately and asked to describe how to perform an emergency shunt procedure to temporarily restore blood flow to the femoral artery. Of the ten surgeons interviewed, nine provided an unaided (no CTA) description of the shunt procedure, and one was interviewed using CTA methods. When compared to a gold standard surgical protocol, the CTA interview resulted in greater accuracy and completeness, whereas descriptions without CTA omitted nearly 70 % of the steps. Further, those surgeons who used equipment while describing the procedure gave more accurate and complete reports of the procedure than those who did not. The study provides implications for policies related to after-action review and surgical training