Trauma mannequin assessment of management skills of surgical residents after advanced trauma life support training.

BACKGROUND: We tested the effectiveness of Advanced Trauma Life Support (ATLS) training among surgical residents using a specially designed mannequin.

MATERIALS AND METHODS: Thirty-two Postgraduate Year I surgical residents were randomly assigned to two groups of 16 each. By use of a trauma mannequin, the 32 residents' performances were scored using four trauma scenarios before 16 residents (ATLS group) completed a standard ATLS course. Performances were also scored after the ATLS course on another four trauma scenarios. The scores were standardized to a maximum of 20 for each scenario. Organized Approach scores with a range of 1 to 5, Priority scores ranging from 1 to 7, and global ratings of Honors, Pass, Borderline, or Fail were assigned for each clinical scenario.

RESULTS: The pre-ATLS assessment scores were similar for both groups ranging between 9.4 +/- 3.5 and 11.4 +/- 2.9 for the ATLS group and between 10.2 +/- 3.8 and 11.4 +/- 3.9 for the non-ATLS group. The ATLS group scores ranged from 16.0 +/- 1.3 to 17.4 +/- 3.1 after the course and the non-ATLS group scores ranged from 11.4 +/- 4.2 to 12.9 +/- 4.0 (P < 0.05). Pre-ATLS Organized Approach scores were 2.9 +/- 1.0 and 2.7 +/- 1.1 (NS) for the ATLS and non-ATLS groups, respectively, with post-ATLS scores being significantly higher in the ATLS group (4.9 +/- 1.2 compared with 2.8 +/- 1.2 for the non-ATLS group, P < 0. 05). Initial Priority scores were also similar for both groups (3.2 +/- 1.4 for the ATLS group and 3.3 +/- 2.0 for the non-ATLS group). Post-ATLS Priority scores were significantly higher (6.4 +/- 1.4) in the ATLS group compared with 4.2 +/- 1.9 for the non-ATLS group (P < 0.05). The pre-ATLS global ratings were similar for both groups and post-ATLS there were 10 Honors ratings in the ATLS group and none for the control group.

CONCLUSIONS: Using a trauma mannequin, for assessment, surgical residents completing the ATLS course demonstrated superior resuscitation skills compared with a non-ATLS group.