Trauma and critical care clinical performance: Impact of undergraduate education

Background: Residency program directors expect medical students to learn trauma and surgical critical care (SCC) clinical skills in medical school. Objective structured clinical examinations (OSCEs) validly and reliably assess clinical skills. Purpose: This study assessed the trauma and SCC clinical skills of surgery interns. Methods: A 3-part, 6-station OSCE was used to assess these clinical skills at 2 periods of internship: beginning (preinterns) and completion (postinterns). Results: Postinterns preformed significantly better, and 44% of score variance was attributable to training level. This indicates that internship provides significant trauma and SCC training. Preinterns frequently did not have an undergraduate trauma rotation (52%) or critical care rotation (48%). Undergraduate education in trauma or critical care did not improve performance or respective clinical skills. Conclusions: The results of this study indicate that undergradute trauma and critical care education is deficient in opportunity and content. This study provides objective suppport for establishing formal undergraduate trauma and critical care curricula.