Assessing the impact of the trauma team training program in Tanzania.
BACKGROUND
In sub-Saharan Africa, injury is responsible for more deaths and disability-adjusted life years than AIDS and malaria combined. The trauma team training (TTT) program is a low-cost course designed to teach a multidisciplinary team approach to trauma evaluation and resuscitation. The purpose of this study was to assess the impact of TTT on trauma knowledge and performance of Tanzanian physicians and nurses; and to demonstrate the validity of a questionnaire assessing trauma knowledge.


METHODS
This is a prospective study of physicians and nurses from Dar es Salaam undergoing TTT (n = 20). Subjects received a precourse test and, after the course, an alternate postcourse test. The equivalence and construct validity of these 15-item multiple-choice questionnaires was previously demonstrated. After the course, subjects were divided into four teams and underwent a multiple injuries simulation, which was scored with a trauma resuscitation simulation assessment checklist. A satisfaction questionnaire was then administered. Test data are expressed as median score (interquartile ratio) and were analyzed with the Wilcoxon's signed rank test.


RESULTS
After the TTT course, subjects improved their scores from 9 (5-12) to 13 (9-13), p = 0.0004. Team performance scores for the simulation were all >80%. Seventy-five percent of subjects were very satisfied with TTT and 90% would strongly recommend it to others and would agree to teach future courses.


CONCLUSIONS
After completion of TTT, there was a significant improvement in trauma resuscitation knowledge, based on results from a validated questionnaire. Trauma team performance was excellent when assessed with a novel trauma simulation assessment tool. Participants were very supportive of the course.
Department of Surgery, McGill University, Montreal, Canada.
Simon
S
Bergman
Dan
D
Deckelbaum
Ronald
R
Lett
Barbara
B
Haas
Sebastian
S
Demyttenaere
Victoria
V
Munthali
Naboth
N
Mbembati
Lawrence
L
Museru
Tarek
T
Razek
D002983:Clinical Competence; D003906:Developing Countries; D004502:Education, Medical, Continuing / Q000458:organization & administration; D004504:Education, Medical, Undergraduate; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D015999:Multivariate Analysis; D010348:Patient Care Team; D011336:Probability; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013636:Tanzania; D014193:Trauma Centers / Q000592:standards / Q000639:trends; D014194:Traumatology / Q000193:education*