Teaching the trauma teachers: an international review of the Advanced Trauma Life Support Instructor Course

MCQ tests in Advanced Trauma Life Support (ATLS©): Development and revision

BACKGROUND

In Advanced Trauma Life Support (ATLS©) courses, multiple choice question (MCQ) tests are used to assess student's post course knowledge. As part of the ninth Edition Revision Process, existing MCQ tests were reviewed and revised by an International MCQ Revision group. The aim of this study was to evaluate the revision procedure and its effects.

METHODS

Based on psychometric data and evidence based guidelines for adequate MCQ item and test development, a detailed stepwise approach was determined and followed to evaluate the existing MCQs, and to guide test item revision or replacement.

RESULTS

The MCQ Revision group composed three new draft test versions comprising of 40 MCQs each. These were beta-tested among ATLS Instructors in various countries involved in ATLS. Psychometric analysis demonstrated that a minority of MCQ items required revision to create three equally balanced tests. After these final adjustments, a new set of three validated MCQ tests was available for use in 9th edition ATLS provider courses. Beta testing was performed using instructors but not students. The failure rate amongst students of ATLS provider courses increased significantly after introduction of the new MCQ tests.

CONCLUSION

ATLS tests were revised and updated using current evidence based guidelines and psychometric analysis. Difficulty of the tests was not initially beta-tested on students. Increasing test item discrimination and quality resulted in lower test scores by students.

Spontaneous non-traumatic massive intraabdominal spleen bleeding in young females: Importance of ATLS principles and trauma alarm

Patient: Female, 28

Final Diagnosis: Rupture of the splenic artery aneurysm

Symptoms: Hypovolemic shock

Medication: —

Clinical Procedure: —

Specialty: Surgery

International collaborative faculty development program on simulation-based healthcare education: a report on its successes and challenges

PURPOSE

Countries that are less experienced with simulation-based healthcare education (SBHE) often import Western programs to initiate their efforts to deliver effective simulation training. Acknowledging cultural differences, we sought to determine whether faculty development program on SBHE in the United States could be transported successfully to train faculty members in Korea.

METHODS

An international, collaborative, multi-professional program from a pre-existing Western model was adapted. The process focused on prioritization of curricular elements based on local needs, translation of course materials, and delivery of the program in small group facilitation exercises. Three types of evaluation data were collected: participants' simulation experience; participants' ratings of the course; and participant's self-assessment of the impact of the course on their knowledge, skills, and attitudes (KSA) toward simulation teaching.

RESULTS

Thirty faculty teachers participated in the course. Eighty percent of the participants answered that they spent less than 25% of their time as simulation instructors. Time spent on planning, scenario development, delivering training, research, and administrative work ranged from 10% to 30%. Twenty-eight of 30 participants agreed or strongly agreed that the course was excellent and relevant to their needs. The participants' assessment of the impact of the course on their KSA toward simulation teaching improved significantly.

CONCLUSION

Although there were many challenges to overcome, a systematic approach in the adaptation of a Western simulation faculty development course model was successfully implemented in Korea, and the program improves self-confidence and learning in participants.

Clinical teaching improvement: The transportability of the Stanford Faculty Development Program

BACKGROUND

The Stanford Faculty Development Center (SFDC) at Stanford University developed a teaching improvement course for medical teachers that has been widely disseminated using a train-the-trainer model. We were curious to see if cultural factors might influence the applicability and impact of the course when delivered to non-American participants by a facilitator from that culture.

METHODS

A Swedish anaesthesiologist at Uppsala University Hospital, Sweden, was trained in October 2004 at Stanford University. From January 2005 to March 2007 he delivered five faculty development seminar series at Uppsala University Hospital to 40 physicians from different departments. Participants rated the usefulness of the seminar series and retrospective pre- and post-seminar ratings were used to assess effects on participants' teaching skills and behaviours.

RESULTS

Participants rated the seminars as highly useful (M = 4.8, SD = 0.4). Participants' ratings of their teaching ability indicated significant increases across a variety of clinical and non-clinical teaching settings (p < 0.001), and positive changes in teaching behaviours were found for all seven educational categories assessed (p < 0.001).

CONCLUSIONS

This faculty development model is highly transportable to medical teachers in Sweden, and capable of producing positive results, consistent with those found in the United States.

An International Fellowship in Trauma Research and the Potential Benefits for Fellows, Sponsoring Institution, and the Global Trauma Community

For over a decade, the Los Angeles County/University of Southern California Hospital has supported an international fellowship in trauma that provides research experience, education, and opportunity for clinical observation at a high-volume American College of Surgeons (ACS) designated Level I trauma center. We performed a descriptive study of the design, implementation, and results of an international fellowship in trauma and critical care. Fellows from 27 countries throughout the world have actively engaged in trauma research at Los Angeles County/University of Southern California Hospital. Our program involves intensive education and clinical observation components designed to facilitate dissemination of evidence-based trauma practices throughout the world by graduates. The majority of alumni responding to a survey returned to their countries of origin, remaining active in trauma care and research. Motivation for participation varied, but former fellows universally rated their experience highly and stated they would recommend the program to their colleagues. An international research fellowship in trauma and critical care provides foreign medical trainees opportunities for exposure to research and evidence-based practices at a high-volume trauma center. The program is designed to be beneficial to both the participating fellow and sponsoring institution; and is constructed to effectively promote improved trauma education and the dissemination of quality trauma practices internationally

Can performance indicators be used for pedagogic purposes in disaster medicine training?

Background

Although disaster simulation trainings were widely used to test hospital disaster plans and train medical staff, the teaching performance of the instructors in disaster medicine training has never been evaluated. The aim of this study was to determine whether the performance indicators for measuring educational skill in disaster medicine training could indicate issues that needed improvement.

Methods

The educational skills of 15 groups attending disaster medicine instructor courses were evaluated using 13 measurable performance indicators. The results of each indicator were scored at 0, 1 or 2 according to the teaching performance.

Results

The total summed scores ranged from 17 to 26 with a mean of 22.67. Three indicators: 'Design', 'Goal' and 'Target group' received the maximum scores. Indicators concerning running exercises had significantly lower scores as compared to others.

Conclusion

Performance indicators could point out the weakness area of instructors' educational skills. Performance indicators can be used effectively for pedagogic purposes.