EVALUATION OF THE ADVANCED TRAUMA LIFE SUPPORT COURSE DESIGNED BASED ON TEAMWORK APPROACH

Yıl 2016, Cilt: 15 Sayı: 47, 0 - 0, 28.12.2016

Emine Vatansever Nilüfer Demiral Yilmaz Zeynep Sofuoglu Ahmet Ozcevikel Ebru Araz Haluk Agah Irem Akbulut Okan Ok Sirin Cinar Volkan Ergun Zuhtu Benli Halil Ibrahim Durak

Öz

Background: Training of health care teams who work in prehospital medical care and in emergency units plays an important role to reduction of trauma-related deaths. The purpose of this study is to share the design method, the content and the evaluation results of an  Advanced Trauma Life Support (ATLS) course which was developed based on the “European Trauma Course the Team Approach” course.

Methods: This study has a one-shot case study design. In the instructional design of the course, the ADDIE model was used. The course was evaluated with the participants’ feedback obtained through the survey and the test scores they obtained from the pre-test, post-test and practice exam. Participants' mean pre- and post-test scores were compared with the paired-sample t test.

Results: The evaluation of the participants’ perceptions of competence related to trauma management revealed that 39.2 % of them (n = 40) considered themselves as completely confident, 57.8 % (n = 59) as confident and 2.9 % (n = 3) as moderately confident. In the course evaluation survey, it was determined that the participants were very satisfied with the items under the following headings: the contents of the scenarios, teaching methods, educational environment, trainers, team work, leadership, situational awareness, communication, and contribution of education to the profession. The difference between the mean scores the participants obtained from the pre- and post-tests was statistically significant high (t = 26.5, p <0.00). The mean scores the participants obtained from the practice exam were also high (mean scores = 94.5; SD = 5.1).

Conclusions: The course improved the participants’ knowledge, technical, non-technical skills and scenario management knowledge. The team approach with the prescriptive ADDIE model for The ATLS course can be used as an effective training method. 

Anahtar Kelimeler

trauma course, team training; teamwork; experimental research; ADDIE

Kaynakça

• World Health Organization. Injuries and violence the facts. Available at:
• (http://apps.who.int/iris/bitstream/10665/149798/1/9789241508018_eng.pdf?ua=1&ua=1); 2014 cited 30.06.2016.
• Turkish Statistical Institute. Ölüm nedeni istatistikleri. Available at: (http://www.tuik.gov.tr/PreHaberBultenleri.do?id=18855); 2014 cited 07.04.2015.
• NAEMT. PHTLS Prehospital Trauma Life Support In Division 1: PHTLS Past , Present , and Future. (7th ed., pp. 1-14). USA: Jones & Bartlett Learning, 2010.
• Thies, K., Gwinnutt, C., Driscoll, P., Carneiro, A., Gomes, E., Araújo, R., Cassar, M.R., Davis, M. (2007). The European Trauma Course - from concept to course. Resuscitation, 74 (1), 135–141.
• Baker, G.R., Norton, P.G. (2006). Adverse events and patient safety in Canadian health care. BC Medical Journal, 48 (7), 326–328.
• Maurette, P. (2002). To err is human: building a safer health system. Annales Françaises d'Anesthésie et de Réanimation, 21, 453–4.
• Briggs, A., Raja, A.S., Joyce, M.F., Yule, S.J., Jiang, W., Lipsitz, S.R. (2015). The Role of Nontechnical Skills in Simulated Trauma Resuscitation. Journal of Surgical Education, (617), 1–8.
• Capella, J., Smith, S., Philp, A., Putnam, T., Gilbert, C., Fry, W., Harvey, E., Wright, A., Henderson, K., Baker, D., Ranson, S., ReMine, S. (2010). Teamwork Training Improves the Clinical Care of Trauma Patients. Journal of Surgical Education, 67 (6), 439–443.
• Steinemann, S., Berg, B., Ditullio, A., Skinner, A., Terada, K., Anzelon, K., Ho, H.C. (2012). Assessing teamwork in the trauma bay: Introduction of a modified “nOTECHS” scale for trauma. American Journal of Surgery, 203 (1), 69–75.
• Turkish Government’s Official Gazette. Available at: (http://www.resmigazete.gov.tr/default.aspx#) cited 28.10.2016.
• Lott, C., Araujo, R., Cassar, M.R., Di Bartolomeo, S., Driscoll, P., Esposito, I et al. (2009). The European Trauma Course (ETC) and the team approach: Past, present and future. Resuscitation, 80 (10), 1192–1196.
• Davis, M., Cassar, M., Driscoll, P., Gwinnutt, C., Lott, C., Thies, K. (2011). The European Trauma Course: Using experience to refine an educational initiative. Trauma, 13 (2), 101–112.
• Gwinnutt, C., Driscoll, P., Grünfeld, M., Hüpfl, M., Kuhn, S., Lott, C., Perfetti, P., Thies, K. (2013). European Trauma Course The Team Approach. (3rd ed., pp. 357-381). Belgium: European Trauma Course Organization.
• Campbell, D.T. Stanley, J.C. (1963). Experımental and Quasi-Experiment al Designs for Research. (pp. 6). USA: Mifflin Company.
• Fraenkel, J.R., Wallen, N.E. (2006). How to Design and Evalaute Research in Education. (6th ed., pp. 271). NY: McGraw-Hill Companies Inc.
• Allen, W.C. (2006). Overview and Evolution of the ADDIE Training System. Advances in Developing Human Resources, 8 (4), 430–441.
• Falcone, R.A., Daugherty, M., Schweer, L., Patterson, M., Brown, R.L., Garcia, V.F. (2008). Multidisciplinary pediatric trauma team training using high-fidelity trauma simulation. Journal of Pediatric Surgery, 43 (6), 1065–1071.
• Frank, C.B., Wölfl, C.G., Hogan, A., Suda, A.J., Gühring, T., Gliwitzky, B., Münzberg, M. (2014). PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany – who takes part and what do participants think about prehospital trauma care training? Journal of Trauma Management & Outcomes, 8 (1), 7.
• Jayaraman, S., Sethi, D., Wong, R. (2014). Advanced training in trauma life support for ambulance crews. Cochrane Database of Systematic Reviews, 8, Art. No: CD003109. doi:10.1002/14651858.CD0031.
• Miller, D., Crandall, C., Washington, C., McLaughlin, S. Improving teamwork and communication in trauma care through in situ simulations. Academic Emergency Medicine, 19 (5), 608–612.
• O’Reilly, G.M., Fitzgerald, M., Dewan, Y., Chou, K., Mathew, J., Peters, N. (2011). The Alfred Trauma Team Training Program in India and Sri Lanka. Emergency Medicine Australasia, 23 (5), 632–639.
• Shapiro, M.J., Morey, J.C., Small, S.D., Langford, V., Kaylor, C.J., Jagminas, L., Suner, S., Salisbury, M.L., Simon, R., Jay, G.D. (2004). Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum? Quality & Safety in Health Care, 13 (6), 417–421.
• Steinemann, S., Berg, B., Skinner, A., Di Tulio, A., Anzelon, K., Terada, K., Oliver, C., Ho, H.C., Speck, C. (2011). In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. Journal of Surgical Education, 68 (6), 472–477.
• Wisborg, T., Brattebø, G., Brinchmann-Hansen, A., Hansen, K.S. (2009). Mannequin or standardized patient: participants’ assessment of two training modalities in trauma team simulation. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 17, 59.
• Hamilton, N., Freeman, B.D., Woodhouse, J., Ridley, C., Murray, D., Klingensmith, M.E. (2009). Team Behavior During Trauma Resuscitation: A Simulation-Based Performance Assessment. J Grad Med Educ, 1 (2), 253–259.
• Peckler, B., Campbell, T., Prewett, M., Brannick, M. (2012). Teamwork in the trauma room evaluation of a multimodal team training program. Journal of Emergencies, Trauma, and Shock, 5 (1), 23.
• Ziesmann, M.T., Widder, S., Park, J., Kortbeek, J.B., Brindley, P., Hameed, M., Patton-Gay, J.D., Engels, P.T., Hicks, C., Fata, P., Ball, C.G., Gillman, L.M. (2013). S.T.A.R.T.T.: development of a national, multidisciplinary trauma crisis resource management curriculum-results from the pilot course. J Trauma Acute Care Surg, 75 (5), 753–758.
• Gjeraa, K., MØller, T.P., Østergaard, D. (2014). Efficacy of simulation-based trauma team training of non-technical skills. A systematic review. Acta Anaesthesiologica Scandinavica, 58 (7), 775–787.
• Roberts, N.K., Williams, R.G., Schwind, C.J., Sutyak, J.A., McDowell, C., Griffen, D., Wall, J., Sanfey, H., Chestnut, H., Meier, A.H., Wohltmann, C., Clark, T.R., Wetter, N. (2014). The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings. The American Journal of Surgery, 207 (2), 170–178.
• Taviloğlu, K., Ertekin, C., Güloğlu, R., Tokyay, R., Akgün, Y. (2001). Trauma and resuscitation course (TRC) evaluation of the first 2 years. Turkish Journal of Trauma & Emergency Surgery, 7 (1), 8–12.
• Bergman, S., Deckelbaum, D., Lett, R., Haas, B., Demyttenaero, S., Munthali, V., Razek, T. (2008). Assessing the impact of the trauma team training program in Tanzania. The Journal of Trauma, 65 (4), 879–883.