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* 1. Primary Specialty/Sub-specialty:

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* 2. Branch of Service

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* 3. Number of years of clinical practice following GME graduation?

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* 4. Number of years of clinical practice following GME graduation?

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* 5. Number of years since last deployment?

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* 6. For the settings listed below, please estimate the total number of central venous catheters you have performed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 7. How confident are you in your procedural competency to place a central venous catheter independently?

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* 8. For the settings listed below, please estimate the total number of arterial catheters you have performed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising trainee
LIVE PATIENT
- directly performing

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* 9. How confident are you in your procedural competency to place an arterial catheter independently?

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* 10. For the settings listed below, please estimate the total number of chest tubes (tube thoracostomies) you have performed in within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 11. How confident are you in your procedural competency to place a chest tube independently?

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* 12. For the settings listed below, please estimate the total number of needle decompressions (needle thoracostomies) you have performed in within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 13. How confident are you in your procedural competency to perform needle decompression (needle thoracostomy) independently?

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* 14. For the settings listed below, please estimate the total number of endotracheal intubations you have performed in within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 15. How confident are you in your procedural competency to perform an endotracheal intubation independently?

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* 16. For the settings listed below, please estimate the total number of large bore (18G or larger) IVs you have placed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 17. How confident are you in your procedural competency to place a large bore IV independently?

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* 18. For the settings listed below, please estimate the total number of intraosseous (IO) catheters you have placed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 19. How confident are you in your procedural competency to place an intraosseous (IO) catheters independently?

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* 20. For the settings listed below, please estimate the total number of thoracenteses you have participated in within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 21. How confident are you in your procedural competency to perform a thoracentesis independently?

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* 22. For the settings listed below, please estimate the total number of paracenteses you have participated in within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 23. How confident are you in your procedural competency to perform a paracentesis independently?

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* 25. How many inpatient (non-critical care) patient days have you accrued (as a part of the primary team OR as a consultant) within the past 12 months? 
Patient Days (PDs) are defined as the number patients on service per day multipled by the number of days you are on service.

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* 26. How many critically ill (ICU-level) patient days have you accrued (as a part of the primary team OR as a consultant) within the past 12 months? 
Patient Days (PDs) are defined as the number patients on service per day multipled by the number of days you are on service.

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* 28. For the settings listed below, please estimate the total number of eFAST exams you have performed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee
SIMULATED PATIENT
- directly performing
LIVE PATIENT
- supervising a trainee
LIVE PATIENT
- directly performing

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* 29. How confident are you in your procedural competency to identify life-threatening injuries by eFAST exam independently?

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* 30. For the settings listed below, please estimate the total number of tourniquets you have placed within the past 12 months?

  0 1 2 3 4 5 6 7 8 9 10 > 10
SIMULATED PATIENT
- supervising a trainee