Statistical Analysis
bleeding
REGRESSION, BLEEDING, CLOT, SECONDARY
Note that the time outcomes (time to targeted coagulation therapy and time to verbalizing targeted coagulation therapy) and the performance outcomes (correct targeted coagulation therapy and correct overall coagulation therapy) are measured on a team level, taking any bias of team members participating in more than 1 scenario into account. The outcomes, perceived decision confidence, perceived workload, and the statement results are measured at the individual participant level. As multiple scenarios, which should represent a wide display of critical bleeding cases, can influence the comparability of results, we included the respective scenario in the regression models so that the influence of the Visual Clot or ROTEM can be interpreted independently from the case.For descriptive statistics, we show medians and ranges for continuous data and numbers and percentages for categorical data.For the time outcomes (time to targeted coagulation therapy and time to verbalizing targeted coagulation therapy), we use Cox regression models, adjusted for the 4 scenarios, to see if there is a difference between the modalities (Visual Clot or ROTEM temograms).To analyze the outcomes, correct targeted coagulation therapy and correct overall coagulation therapy, we use Poisson regression models adjusted for the 4 scenarios, with the maximal number of correct therapy actions as an offset. Note that we treat the teams as independent, although a participant might be a member of different team.For the binary decision confidence variable, we use a mixed logistic regression model with a random intercept per participant. To analyze workload (NASA TLX total score), we use a linear mixed model with a random intercept for each participant. Please note that for these 2 secondary outcomes, we examined data per participant and not an averaged value per team. Therefore, we opted for the calculation of mixed models that take into account that the same person could be present in more than 1 scenario and thus potentially provide more than 1 answer to the confidence and workload questions.Following publications on medical statistics [As the study was conducted as part of the regularly held simulation training at the University Hospital Zurich, Switzerland, no sample size calculation was performed, as the number of participants and the resulting teams were predetermined by the number of planned simulation days.