The success of a healthcare team relies on the concerted effort of multiple members of an interdisciplinary team and the failure of the team directly translates to patient outcomes. A medical team can consist of several individuals or potentially dozens of members spanning the spectrum of care. Similarly, military medical teams exist at specific echelons of care and may not work in the same hospital, country, or continent. These complex environments require an emphasis on effective communication and a shared understanding of common goals for team success. The criticality of effective communication can be seen in patient handoffs, during which the responsibility of care and a cognitive off-load of patient information is transferred from one provider to another. During these exchanges, a lapse in information transfer can be detrimental to the patient. These critical moments in patient care are even more complex within the context of combat casualty care, where casualty information is transferred in austere environments and providers may be managing multiple casualties with multiple injuries, over long periods of time.
The successful performance of handoffs in these complex situations require reflectively complex training environments; However, there is currently no standard training or certification for combat casualty handoffs. This paper will describe the design and development of a capability aimed to train and assess medical teams on performing combat casualty handoffs. The core of the system is a speech understanding capability that automatically recognizes, captures, and assesses the verbal components of a handoff. The recognized speech populates two user interfaces in real-time: a digital patient chart to facilitate the scenarios and an instructor dashboard to support trainee assessment and performance review. This paper will describe the development and use of this system as a training tool within the medical field, including domain specific design considerations, limitations, and lessons learned.