Comparison of performance of interns completing the old [1993] and new interactive [1997] Advanced Trauma Life Support courses

Background: The 1997 edition of the Advanced Trauma Life Support (ATLS) cou rse emphasized interactivity as its major change. The impact of this change is assessed in this study. Methods: We compared two matched groups of 16 interns completing either the old (group I) or new (group II) ATLS course. Cognitive skills (40 standard ATLS questions plus 10 additional questions on airway and shock) and clini cal trauma management skills (four trauma objective structured clinical exa minations [OSCEs] on simulated trauma patients) were tested. OSCE station s cores (standardized to a maximum of 20), priority scores (graded 1-7), orga nized approach global passing grades (graded 1-5), and initial assessment t est station stores (graded 1-5) were compared. Results: Using ATLS criteria, three interns failed in each group. Post-ATLS examination question scores were similar (84.5 +/- 6.9 for group I, 85.9 /- 7.1 for group II); scores for the airway and shock questions were higher but not different between the two groups. The four OSCE station mean score s varied between 13.9 +/- 2.0 and 15.4 +/- 2.1 for group I and were higher( p < 0.05) for group Il (17.9 +/- 1.6 to 19.1 +/- 1.0). Priority scores were similar (group I, 6.3 +/- 1.1; group II, 6.4 +/- 1.2), but approach scares (3.9 +/- 0.1 for group I and 4.9 +/- 0.8 for group II) were lower in group I, as were the initial assessment test scores (2.9 +/- 0.2 for group I and 3.9 +/- 0.8 for group II). There were 8 honors grades in group I and 40 (p < 0.05) in group II. Interactive teaching, adult education principles, opp ortunities for discussion, provision of feedback, and stimulation of self-l earning were rated more highly in the new course. Conclusion: Using standard ATLS pass criteria, performance after the new an d old ATLS courses was similar. Superior performances were measured using O SCE methodology for clinical trauma management skills after the new compare d with the old ATLS course in this population of interns.