H. W. Li1, C. Donnelley3, M. Boeck2, C. Keung1 1Indiana University School Of Medicine,Indianapolis, IN, USA 2New York Presbyterian Hospital,New York, NY, USA 3Columbia University College Of Physicians And Surgeons,New York, NY, USA
Introduction: Ninety percent of trauma injuries, responsible for 10% of the world’s deaths, occur in low resource countries like Kenya. This surpasses the combined fatalities due to malaria, tuberculosis, and HIV/AIDS worldwide. Advanced Trauma Life Support (ATLS) is the gold standard for basic trauma training. However, ATLS is limited to training physicians only, and is not designed for medical students. Thus, the condensed Trauma Evaluation and Management (TEAM) course was developed in response. This study retrospectively assessed the effectiveness of incorporating TEAM into the Moi University School of Medicine (MUSM) curriculum in Eldoret, Kenya.
Methods: The course took place over two afternoons in May 2017. Participants completed a baseline survey, an identical but scrambled 20 question pretest and posttest, and course evaluation. Test scores were analyzed using paired t-tests, and Wilcoxon signed rank test for confidence levels.
Results: N=34 participants met criteria for study inclusion, of which 61.8% (N=21) were male, and the median age was 23 years (IQR 22, 25). There were equal numbers of fourth and sixth year medical students (50.0% vs. 47.1%), and only 29.4% (N=10) reported previous trauma training. Overall mean test scores increased by 12.8% (51.1% vs. 64.0%, SD 12.1, p<0.001) from pre- to post-course. Subjective confidence to provide trauma care (0-5) significantly increased after course completion [median (IQR): pre 2 (1, 3); post 4 (4, 4); difference 2 (1,3); p<0.001].
Conclusion: TEAM was created as a systematic approach to trauma care teaching for medical students. For students in resource-limited areas, this can be their only exposure to formal trauma training. Early results show the course is effective at improving immediate trauma knowledge and subjective confidence levels, and due to its low demands for supplies and personnel, TEAM is a feasible tool that medical schools of all backgrounds can utilize, including those in low resource countries. Investigations into the application of learned knowledge to patient care via follow-up surveys, as well as trauma patient outcomes via a new trauma registry, will further elucidate the true impact of this course to improve trauma care in this region of Kenya.
