title: Correlation between ATLS training and junior doctors' anatomical knowledge of intercostal chest drain insertion.
abstract: OBJECTIVE
  To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this.
  
  
  METHODS
  We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact preferred site for intercostal chest drain insertion.
  
  
  METHODS
  This study was conducted in a large metropolitan university hospital in South Africa.
  
  
  RESULTS
  A total of 152 JDs participated in the study. Among them, 63 (41%) were men, and the mean age was 24 years. There were 90 (59%) PGY1 doctors and 62 (41%) PGY2 doctors. Overall, 28% (42/152) of all JDs correctly identified the site that was located within the accepted safe triangle. A significantly higher proportion of PGY2 doctors selected the correct site when compared with PGY1 doctors (39% vs 20%, p = 0.026). Those who had prior ATLS provider training were 6.8 times more likely to be able to identify the correct site (RR = 6.8, 95% CI: 3.7-12.5).
  
  
  CONCLUSIONS
  Most of the JDs do not have sufficient anatomical knowledge to identify the safe insertion site for intercostal chest drain. Those who had undergone ATLS training were more likely to be able to identify the safe insertion site.
authors: Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa. Electronic address: victorywkong@yahoo.com.
authors: Victor Y
authors: VY
authors: Kong
authors: Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
authors: George V
authors: GV
authors: Oosthuizen
authors: Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
authors: Benn
authors: B
authors: Sartorius
authors: Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
authors: Claire M
authors: CM
authors: Keene
authors: Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
authors: Damian L
authors: DL
authors: Clarke
mesh_terms: D061906:Advanced Trauma Life Support Care; D015505:Chest Tubes; D002983:Clinical Competence; D004322:Drainage / Q000295:instrumentation*; D004503:Education, Medical, Graduate; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010781:Photography; D011446:Prospective Studies; D013019:South Africa; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ATLS; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; chest drain; junior doctors