{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:40:41Z","timestamp":1787992841980,"version":"build-2784847793"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AEM Education and Training"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Massive hemorrhages (MHs) are rare but serious complications of pediatric trauma and obstetric cases. This study aimed to evaluate the impact of interprofessional simulation to improve adherence to a MH protocol (MHP), teamwork skills and confidence levels during a hemorrhagic crisis situation.<\/jats:p><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a pre\u2010post experimental study conducted at a tertiary care mother\u2013child simulation center. Pediatric emergency and obstetric teams were submitted to simulated trauma and postpartum MH scenarios. Training consisted of two case scenarios followed by debriefing sessions and a lecture on the MHP. The primary outcome was adherence to MHP processes (checklist) measured prior to and 2\u00a0weeks following training sessions. Other outcomes were the measure of teamwork skills (Mayo High Performance Teamwork Scale) and confidence of the participants.<\/jats:p><\/jats:sec><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010two health care professionals were involved in eight interprofessional teams. Mean scores for adherence to the MHP improved from 19.1 in the pretraining phase to 25.8 in the posttraining phase (difference of 6.7; 95% confidence interval [CI]\u00a0=\u00a04.4 to 8.9). Mean scores pertaining to teamwork skills also improved significantly between pre\u2010 and posttraining phases (difference\u00a0=\u00a03.9; 95% CI\u00a0=\u00a01.5 to 6.4). Confidence questionnaires showed significant improvements in the posttraining phase (difference\u00a0=\u00a06.9; 95% CI\u00a0=\u00a05.3 to 8.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Targeted training involving simulation and protocol review improved participant adherence to MHP processes and teamwork skills. Confidence levels improved across all disciplines.<\/jats:p><\/jats:sec>","DOI":"10.1002\/aet2.10513","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T05:36:07Z","timestamp":1596087367000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Massive Hemorrhage Protocol Application and Teamwork Skills"],"prefix":"10.1002","volume":"5","author":[{"given":"G\u00e9raldine","family":"Pettersen","sequence":"first","affiliation":[{"name":"Critical Care Division Department of Pediatrics University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"France","family":"Gauvin","sequence":"additional","affiliation":[{"name":"Critical Care Division Department of Pediatrics University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Robitaille","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Division University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8477-9976","authenticated-orcid":false,"given":"Andr\u00e9e","family":"Sansregret","sequence":"additional","affiliation":[{"name":"Department of Obstetrics\u2010Gynecology University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Lesage","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-0633","authenticated-orcid":false,"given":"Arielle","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine University of Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc8943"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2011.04.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1705649"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182192832"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2008.12.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181d3cc25"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12417"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0000000000000096"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13341-012-0256-z"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31802b68ee"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12161"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnc.2017.01.011"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2015.08.011"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31822c0f20"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24187-6_4"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3267"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181e89270"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182a6439d"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.136"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30563-6"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.04.027"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0506-2"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000078"}],"container-title":["AEM Education and Training"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Faet2.10513","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aet2.10513","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/aet2.10513","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aet2.10513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T05:44:49Z","timestamp":1693287889000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/aet2.10513"}},"subtitle":[],"editor":[{"given":"Stephen J.","family":"Cico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,24]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/aet2.10513"],"URL":"https:\/\/doi.org\/10.1002\/aet2.10513","archive":["Portico"],"relation":{},"ISSN":["2472-5390","2472-5390"],"issn-type":[{"value":"2472-5390","type":"print"},{"value":"2472-5390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,24]]},"assertion":[{"value":"2020-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e10513"}}