# Promoting the process of determining brain death through standardized training

## TL;DR

This study introduces a standardized training model to improve the accuracy and consistency of brain death determination among medical professionals.

## Contribution

The study proposes a four-skill and four-step (FFT) training model specifically tailored for brain death determination in China.

## Key findings

- The FFT model achieved low error rates (<5%) in written examinations across four key skills.
- Specialty categories, professional titles, and hospital level were identified as significant factors influencing training outcomes.
- The model highlights the need to address knowledge gaps and improve training quality based on participant characteristics.

## Abstract

This study aims to explore the training mode for brain death determination to ensure the quality of subsequent brain death determination.

A four-skill and four-step (FFT) training model was adopted, which included a clinical neurological examination, an electroencephalogram (EEG) examination, a short-latency somatosensory evoked potential (SLSEP) examination, and a transcranial Doppler (TCD) examination. Each skill is divided into four steps: multimedia theory teaching, bedside demonstration, one-on-one real or dummy simulation training, and assessment. The authors analyzed the training results of 1,577 professional and technical personnel who participated in the FFT training model from 2013 to 2020 (25 sessions), including error rate analysis of the written examination, knowledge gap analysis, and influencing factors analysis.

The total error rates for all four written examination topics were < 5%, at 4.13% for SLSEP, 4.11% for EEG, 3.71% for TCD, and 3.65% for clinical evaluation. The knowledge gap analysis of the four-skill test papers suggested that the trainees had different knowledge gaps. Based on the univariate analysis and the multiple linear regression analysis, among the six factors, specialty categories, professional and technical titles, and hospital level were the independent influencing factors of answer errors (p < 0.01).

The FFT model is suitable for brain death (BD) determination training in China; however, the authors should pay attention to the professional characteristics of participants, strengthen the knowledge gap training, and strive to narrow the difference in training quality.