{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T07:01:35Z","timestamp":1788850895603,"version":"build-2803163510"},"reference-count":11,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014055","name":"U.S. Army Medical Research Acquisition Activity","doi-asserted-by":"publisher","award":["W81XWH-17-2-0011"],"award-info":[{"award-number":["W81XWH-17-2-0011"]}],"id":[{"id":"10.13039\/100014055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2025,10,9]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exsanguinating hemorrhage is the leading cause of death in combat casualty care. With improvement in body armor, risk for extremity injuries is increasingly making surgical control of vessels and extremity fasciotomies critically important for saving life and\/or limb. Yet, surgeon hands-on experience with major trauma has decreased. In military settings, with limited surgical resources, surgeons could be required to work independently and outside their scope of expertise. We explored whether just-in-time skill refreshment with video review improves performance of selected procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Surgeons (n=44) performed upper and lower extremity fasciotomies and axillary and femoral artery exposures on anatomic donors. They were divided into two groups: one group received Surgical Technical Assistance Tool (STAT) video procedure assistance and the other received no assistance (control group). Performance was evaluated using a five-component (anatomy, pathophysiology, patient management, technical skills, and procedural) Individual Procedure Score (IPS). The total number of compartment decompressions\/constriction releases (maximum 10, combined fasciotomy procedures) and number of vessels controlled (maximum of four, combined vascular procedures) were measured. Each compartment decompression\/constriction release and each vessel controlled are also single data points within the IPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In combined fasciotomies, STAT significantly improved the number of successful compartment decompressions\/constriction releases as well as procedural, anatomy, and technical IPS components. In combined vascular procedures, STAT improved anatomy IPS, but not the number of vessels successfully controlled. For successful compartment decompression\/constriction release, there was a significant linear correlation with procedural, anatomy, and technical IPS components. For successful vascular control, there was a significant linear correlation with procedural and technical IPS components. There was no correlation between success and pathophysiology or patient management scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A video-based, just-in-time refresher tool can dramatically improve procedural success and performance scores in procedural, anatomy, and technical components during trauma-related extremity procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level II, Original Research, Therapeutic\/Care Management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tsaco-2024-001629","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:10:17Z","timestamp":1761736217000},"page":"e001629","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of a video refresher surgical technical assistance tool on surgeon performance of fasciotomies and proximal vascular control"],"prefix":"10.1136","volume":"10","author":[{"given":"Kristina","family":"Fuller","sequence":"first","affiliation":[{"name":"Shock Trauma and Anesthesiology Research, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3810-3729","authenticated-orcid":false,"given":"Samuel","family":"Tisherman","sequence":"additional","affiliation":[{"name":"Department of Surgery and the Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorreen","family":"Agandi","sequence":"additional","affiliation":[{"name":"Touro College of Osteopathic Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin A","family":"Madenci","sequence":"additional","affiliation":[{"name":"Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-1218","authenticated-orcid":false,"given":"Adam C","family":"Puche","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2026010700455514000_10.4.e001629.1","first-page":"72","article-title":"Warfighter Personal Protective Equipment and Combat Wounds","volume":"Apr-June","author":"Klausner","year":"2021","journal-title":"Med J (Ft Sam Houst Tex)"},{"key":"2026010700455514000_10.4.e001629.2","unstructured":"ACGME . Available: https:\/\/apps.acgme.org\/ads\/Public\/Reports\/Report\/25 [Accessed 24 Apr 2024]."},{"key":"2026010700455514000_10.4.e001629.3","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.ajog.2009.04.008","article-title":"Does mental imagery prior to cystoscopy make a difference? A randomized controlled trial","volume":"201","author":"Komesu","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"2026010700455514000_10.4.e001629.4","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ogc.2006.02.004","article-title":"Mental Practice and Acquisition of Motor Skills: Examples from Sports Training and Surgical Education","volume":"33","author":"Rogers","year":"2006","journal-title":"Obstet Gynecol Clin North Am"},{"key":"2026010700455514000_10.4.e001629.5","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.jsurg.2015.06.009","article-title":"Using an Individual Procedure Score Before and After the Advanced Surgical Skills Exposure for Trauma Course Training to Benchmark a Hemorrhage-Control Performance Metric","volume":"72","author":"Mackenzie","year":"2015","journal-title":"J Surg Educ"},{"key":"2026010700455514000_10.4.e001629.6","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/TA.0000000000000685","article-title":"Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training","volume":"79","author":"Shackelford","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"2026010700455514000_10.4.e001629.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000251575.95171.b3"},{"key":"2026010700455514000_10.4.e001629.8","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318207a789"},{"key":"2026010700455514000_10.4.e001629.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12909-021-02987-z","article-title":"Impact of mental imagery on enhancing surgical skills learning in novice\u2019s surgeons: a pilot study","volume":"21","author":"Souiki","year":"2021","journal-title":"BMC Med Educ"},{"key":"2026010700455514000_10.4.e001629.10","doi-asserted-by":"publisher","DOI":"10.1583\/11-3785R.1"},{"key":"2026010700455514000_10.4.e001629.11","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.surge.2016.08.003","article-title":"Cognitive training: How can it be adapted for surgical education?","volume":"15","author":"Wallace","year":"2017","journal-title":"Surgeon"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2024-001629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:46:35Z","timestamp":1767775595000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2024-001629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,10,29]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/tsaco-2024-001629"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2024-001629","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}