论文信息 - Teaching Effectiveness of the Advanced Trauma Life Support Program as Demonstrated by an Objective Structured Clinical Examination for Practicing Physicians

Teaching Effectiveness of the Advanced Trauma Life Support Program as Demonstrated by an Objective Structured Clinical Examination for Practicing Physicians

Abstract. Although the Advanced Trauma Life Support (ATLS) course is now taught internationally, its teaching effectiveness still requires confirmation. The Objective Structured Clinical Examination (OSCE) reliably assesses clinical performance by utilizing standardized patients. An OSCE of eight 15 minute trauma patient stations and two 40 item MCQ tests were used to test the teaching effectiveness of the ATLS program in 32 practicing physicians who applied for an ATLS program in Trinidad and Tobago. The physicians were randomly assigned to an ATLS group (n = 16) that completed the ATLS course and a non-ATLS group (n = 16). Before and after the ATLS course, all physicians completed MCQ tests and trauma OSCE. Mean (± SD) OSCE scores (standardized to 20) ranged from 9.8 ± 1.7 to 10.0 ± 1.7 and 9.5 ± 1.8 to 10.8 ± 1.3 in the ATLS and non-ATLS groups, respectively, prior to the ATLS course (NS). Post-ATLS OSCE scores ranged from 15.9 ± 1.7 to 17.6 ± 1.7 in the ATLS group (p < 0.05 compared to pre-ATLS) and 9.5 ± 1.4 to 10.1 ± 1.3 in the non-ATLS group, which did not improve their OSCE scores. Adherence to priorities was graded 1 to 7 with the pre-ATLS grades of 1.7 ± 0.6 (ATLS) and 1.8 ± 0.7 (non-ATLS) and post-ATLS grades of 6.4 ± 1.1 (ATLS) and 2.1 ± 0.6 (non-ATLS). Organized approach to trauma was graded 1 to 5 with pre-ATLS grades of 1.6 ± 0.5 (ATLS) and 1.7 ± 0.6 (non-ATLS) and post-ATLS grades of 4.5 ± 0.6 (ATLS) and 1.9 ± 0.6 (non-ATLS). Pre-ATLS MCQ scores (%) were similar: 53.1 ± 8.4 (ATLS) and 57.3 ± 5.4 (non-ATLS), but post-ATLS scores were greater in the ATLS group: 85.8 ± 7.1 (ATLS) and 64.2 ± 3.6 (non-ATLS). Our data support the teaching effectiveness of the ATLS program among practicing physicians as measured by improvement in OSCE scores, adherence to trauma priorities, maintenance of an organized approach to trauma care, and cognitive performance in MCQ examinations.

[1] W. Raboff. Attrition of cognitive and trauma management skills after the advanced trauma life support (ATLS) course , 1997 .

[2] J. Williams,et al. Trauma outcome improves following the advanced trauma life support program in a developing country. , 1993, The Journal of trauma.

[3] P. Collicott,et al. Advanced Trauma Life Support (ATLS): past, present, future--16th Stone Lecture, American Trauma Society. , 1992, The Journal of trauma.

[4] J. Williams,et al. Cognitive and attitudinal impact of the Advanced Trauma Life Support program in a developing country. , 1994, The Journal of trauma.

[5] J. Williams,et al. Advanced trauma life support program increases emergency room application of trauma resuscitative procedures in a developing country. , 1994, The Journal of trauma.

[6] R. Reznick,et al. Demonstration of acquisition of trauma management skills by senior medical students completing the ATLS Program. , 1995, The Journal of trauma.

[7] R. Harden,et al. Assessment of clinical competence using objective structured examination. , 1975, British medical journal.

[8] E. Petrusa,et al. An objective measure of clinical performance. , 1987, The American journal of medicine.

[9] J. Stross,et al. The impact of mandatory continuing medical education. , 1978, Journal of the American Medical Association (JAMA).