DEMONSTRATION OF ACQUISITION OF TRAUMA MANAGEMENT-SKILLS BY SENIOR MEDICAL-STUDENTS COMPLETING THE ATLS PROGRAM

Objective: To assess the teaching effectiveness of the Advanced Trauma Life Support (ATLS) Program among senior medical students. Design, Materials, and Methods: We used objective structured clinical examination (OSCE) and multiple choice question (MCQ) testing to assess 40 senior medical students (20 ATLS and 20 non-ATLS) at the University of Toronto. Pre- and post-ATLS, all students had four W-minute OSCE stations and a 40-item MCQ test. The pre- and post-ATLS performance for the ATLS and non-ATLS groups were compared. Measurements and Main Results: Cronbach's reliability coefficients were 0.81 and 0.93 for the pre- and post-ATLS OSCEs. The mean (+/- SD) OSCE scores at the four pre-ATLS OSCE stations were 7.6 +/- 2.8, 7.4 +/- 2.3, 8.3 +/- 2.7, and 10.5 +/- 3.4 for the ATLS group and 6.5 +/- 2.1, 7.0 +/- 2.2, 7.6 +/- 2.5, and 9.6 +/- 3.1 for the non-ATLS group (p = NS). Post-ATLS scores for the four OSCE stations were: 15.5 +/- 1.6, 14.1 +/- 3.2, 12.3 +/- 2.9, and 18.3 +/- 1.0 (ATLS group) and 7.9 +/- 3.5, 6.3 +/- 2.8, 7.6 +/- 2.3, and 10.9 +/- 3.3 (non-ATLS group: p < 0.01). Pre-ATLS MCQ scores were 49 +/- 9 and 52 +/- 8% for the ATLS and non-ATLS groups respectively; the ATLS group increased MCQ scores to 83 +/- 5% and the non-ATLS group did not change (53 +/- 8%). Pre-ATLS scores for adherence to priorities were: 35 +/- 14% (ATLS) and 29 +/- 13% (non-ATLS: p = NS). Post-ATLS scores were 99 +/- 6% (ATLS) and 29 +/- 19% (non-ATLS: p < 0.01). The pre-ATLS organized approach to trauma ratings (range 1 to 5) were: 1.9 +/- 1.5 (ATLS) and 1.6 +/- 0.5 (non-ATLS: p = NS) compared to post-ATLS grades of 4.6 +/- 0.4 (ATLS) and 1.7 +/- 0.5 (non-ATLS: p < 0.01). All 20 students passed the ATLS course. Conclusion: Using highly reliable trauma OSCE stations we have demonstrated trauma management skills acquisition by senior medical students after the ATLS course.