title: Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial.
abstract: OBJECTIVE
  Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness.
  
  
  METHODS
  This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation.
  
  
  RESULTS
  In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p < 0.001) in the "AMP" information in the documentation. The subgroups analysis of "allergies" (+47.2%), "drugs" (+38.1%), and "medical history" (+27.8%) before and after the PHTLS course showed a significant increase in the information content.
  
  
  CONCLUSIONS
  In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.
authors.affiliation: Faculty of Medicine, Eberhard Karls University Tübingen, Tuebingen, Germany.
authors.forename: David
authors.identifier: http://orcid.org/0000-0001-5190-3937
authors.initials: D
authors.lastname: Häske
authors.affiliation: Department of Anesthesiology, University Hospital RWTH, Aachen, Aachen, Germany.|Emergency Medical Service, Fire Department, City of Aachen, Aachen, Germany.
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Beckers
authors.affiliation: Faculty of Health, University of Witten/Herdecke, Witten, Germany.
authors.forename: Marzellus
authors.initials: M
authors.lastname: Hofmann
authors.affiliation: Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Megamed Emergency Management GbR, Annweiler, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gliwitzky
authors.affiliation: Department of Orthopedics, Trauma Surgery and Sports Traumatology, Hospital Hetzelstift, Neustadt, Germany.
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Wölfl
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Grützner
authors.affiliation: Department of Traumatology and Reconstructive Surgery, BG Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stöckle
authors.affiliation: Fire Service, Emergency Preparedness and Crisis Management, City of Wiesbaden, Wiesbaden, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Dieroff
authors.affiliation: Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Münzberg
mesh_terms: D001364:Awareness; D004282:Documentation / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education*; D005858:Germany; D006801:Humans; D008020:Life Support Care; D008137:Longitudinal Studies; D011446:Prospective Studies