J. Ali et al., COGNITIVE AND ATTITUDINAL IMPACT OF THE ADVANCED TRAUMA LIFE-SUPPORT PROGRAM IN A DEVELOPING-COUNTRY, The journal of trauma, injury, infection, and critical care, 36(5), 1994, pp. 695-702
Improvement in trauma patient outcome has been reported after Advanced
Training Life Support training (ATLS) in the developing country of Tr
inidad and Tobago (T & T). The cognitive impact of ATLS training was a
ssessed from pre-ATLS and post-ATLS performance of T & T physicians in
multiple choice question tests and comparison with post-ATLS test per
formance among Nebraska physicians. Overall, improvement between the p
re-test and post-test among the T & T physicians was 22.0% +/- 2.0%. A
ll physicians including failures (199 out of 212 passed) improved in t
heir post-test scores. Individual item analysis of the post-test, incl
uding the KR-20 determination, varied but the overall performance was
similar for both physician groups with the T & T physicians performing
slightly better in test 2 (6 of 16 vs. 25 of 100 failures, p < 0.05).
Attitudinal impact was assessed through 87 questionnaires from 50 phy
sicians (92% response) and 37 nurses (89% response). Physicians (97.8%
compared with 69.7%) were more aware of the ATLS training, and both g
roups (physicians, 77.3%; nurses, 69.6%) differentiated ATLS-trained p
hysicians based on better resuscitation, more timely and appropriate c
onsultation, greater confidence in trauma management, and improvement
in trauma mortality and morbidity; all respondents recommended ATLS tr
aining for all emergency room physicians. The demonstrated positive co
gnitive and attitudinal effects very likely contributed to the improve
d post-ATLS trauma patient outcome.