The Advanced Trauma Life Support ATLS course

The Advanced Trauma Life Support (ATLS) course was developed by the American College of Surgeons, Committee on Trauma in the 1980s. The ATLS course provides participants with a safe and reliable method for the immediate treatment of injured patients. The scope of the ATLS course includes rapid assessment of a patient\'s condition, resuscitation, and stabilization in addition to the arrangement of transfer when the patient\'s needs exceed a facility\'s resources. Many clinical studies have demonstrated the positive impact of the ATLS course on the outcome of trauma patients in several countries. The Taiwan Surgical Association (TSA) implemented the ATLS course in Taiwan in 1996. Currently, 63 countries are a part of the ATLS international community. Despite the effort of the TSA to promote superior trauma care through the ATLS course, it LY2606368 remains unknown whether this course improves physicians\' ability to care for severely injured patients or is responsible for the recent decline in trauma deaths in Taiwan. Therefore, the purpose of this study was to report our experience in conducting the ATLS course in Taiwan and to identify areas for improvement.
Materials and methods
Results In 2012, a total of 274 students attended the provider courses and 258 students attended the refresher courses. The demographic data of these participants are presented in Table 1. Most of the participants were men. The age distribution is shown in Fig. 2. The provider course consisted of more participants from regional hospitals, whereas the refresher course had more participants from medical centers (p < 0.0001). The provider course had an almost equal number of doctors from Levels I and II trauma centers, whereas the refresher course had a majority of doctors from Level I trauma centers. The provider course had 125 (45.6%) participants who were residents and the refresher course had 17 (12%) residents. More surgeons than ER physicians participated in both types of ATLS courses. The results of the course evaluation for 2012 are summarized in Table 2. As shown, the course met the participants\' personal expectations of the learning objectives of the ATLS provider and refresher courses with Likert scale scores of 4.47 and 4.51, respectively. The majority believed that the knowledge and skills obtained from these courses would improve their ability to care for trauma patients with Likert scale scores of 4.54 and 4.55, respectively. We next examined the PRs of the ATLS courses. The overall PRs for the provider and refresher courses were 76.6% and 89.5%, respectively (Table 3). Participants aged ≤ 40 years were more likely to pass either course than those over the age of 40 years (p < 0.001). Participants working at Level I trauma centers were also more likely to pass either course (p < 0.05). By comparison, the PR for participants from medical centers was higher for the provider course (p < 0.05), but not for the refresher course, than those from regional hospitals. However, the PR did not vary based on sex or levels of training. Finally, we compared the number of correct responses to pre- and post-test MCQs for the ATLS provider courses. We assigned each question to a maximum of up to three relevant trauma topics covered in the course materials (Table 4). After the provider course was completed, more post-test questions on initial assessment and airway management topics were answered correctly (76.8% vs. 96.0% and 77.6% vs. 90.35%, respectively). By comparison, more questions on shock management were answered incorrectly in the post-test MCQs (p < 0.0001). No significant differences in the number of correct responses to questions on head, neck, or thermal trauma topics were noted between the two tests.
Discussion The ATLS is a peer-to-peer educational program that is designed by physicians and offered only to physicians working in different levels of hospitals or clinics. Learning is a process of acquiring attitudes, knowledge, and skills that enables a person to know or do something new or different. Therefore, in order for the course to be relevant for learners, the principles of adult learning and teaching should be applied so that the students retain and practice what nucleolus have learned. These principles include motivation, materials that are applicable to real life, active involvement of learners, clearly defined goals, and constructive feedback during evaluation. The ultimate goal is to apply these critical ATLS principles and skills outside the course environment in clinical practice; however, without effective learning this goal cannot be achieved.