Does ATLS Training Work? 10-Year Follow-Up of ATLS India Program
| Autor: | Amulya Rattan, Parli R. Ravi, Sushma Sagar, Mahesh C. Misra, Radhesh Nambiar, Suresh Sangi, Vinod Jain, Neerja Bannerjee, Amit Gupta, Subodh Kumar |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Delphi Technique Delphi method India 03 medical and health sciences 0302 clinical medicine Trauma management Physicians Humans Medicine Psychomotor learning Trauma Severity Indices business.industry 10 year follow up Indian scenario Advanced Trauma Life Support Care 030220 oncology & carcinogenesis Family medicine Organizational skills Wounds and Injuries Education Medical Continuing 030211 gastroenterology & hepatology Surgery Clinical Competence Curriculum Survey instrument business Follow-Up Studies Program Evaluation |
| Zdroj: | Journal of the American College of Surgeons. 233:241-248 |
| ISSN: | 1072-7515 |
| Popis: | Background Studies evaluating the efficacy of ATLS in low- and middle-income countries are limited. We followed up ATLS providers certified by the ATLS India program over a decade (2009 to 2019), aiming to measure the benefits in knowledge, skills, attitude and their attrition over time. Methods The survey instrument was developed taking a cue from published literature on ATLS and improvised using the Delphi method. Randomly selected ATLS providers were sent the survey instrument via email as a Google form, along with a statement of purpose. Results are presented descriptively. Results ATLS India trained 7,847 providers over the study period. 2500 providers were selected for the survery using computer-generated random number table. One thousand and thirty doctors (41.2%) responded. Improvement in knowledge (n = 1,013 [98.3%]), psychomotor skills (n = 986 [95.7%]), organizational skills (n = 998 [96.9%]), overall trauma management (n = 1,013 [98.7%]) and self-confidence (n = 939 [91%]) were reported. Majority (904 [87.8%]) started ATLS promulgation at workplace in personal capacity. These benefits lasted beyond 2 years in majority (>60%) of respondents. More than 40% reported cognitive (n = 492 [47.8%]), psychomotor (n = 433 [42%]), and organizational benefits (n = 499 [48.4%]) lasting beyond 3 years. Improvement in self-confidence, ATLS promulgation at the workplace, and retention of organizational skills were more pronounced in ATLS faculties than providers. All other benefits were found to be comparable in both sub-groups. Lack of trained staff (n = 660 [64.1%]) and attitude issues (n = 495 [48.1%]) were the major impediments in implementing ATLS at the workplace. More than a third of respondents (n = 373 [36.2%]) could enumerate one or more incidents where ATLS principles were life- or limb- saving. Conclusions Cognitive, psychomotor, organizational, and affective impact of ATLS is overwhelmingly positive in the Indian scenario. Until formal trauma systems are established, ATLS remains the best hope for critically injured patients in resource-contrained settings. |
| Databáze: | OpenAIRE |
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