Tchorz Kathryn M, Thomas Naveen, Jesudassan Sujatha, Kumar Ramegh, Chinnadurai R, Thomas Asha, Tchorz Rosemarie I, Murthy Chaturvedula Prabhkara, Parks Jennifer K, Naylor Rebekah A
Surgery-Burn/Trauma/Critical Care, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9158, USA.
J Surg Res. 2007 Oct;142(2):373-7. doi: 10.1016/j.jss.2006.07.010. Epub 2007 May 9.
Trauma has become a major cause of death and disability in developing countries. In India, most trauma patients receive initial care at general practitioner-staffed hospitals. We hypothesize that general practitioners (GPs) could improve their knowledge of trauma care after attending an educational course.
A 2-day trauma course was conducted at a teaching hospital (170 bed) in Bangalore, India. Referral GPs, local surgeons and residents in training attended. A pre-course test was given to assess baseline trauma knowledge. The core didactic sessions included: resuscitation/recognition of shock states, airway prioritization, and evaluation/initial management of head, cardiothoracic, abdominal, pelvic/genitourinary, and thermal injuries. A post-course test was used to assess trauma knowledge obtained from the course. Paired t tests were performed on the test scores and demographic data were stratified by specialty and training status.
Of the 44 participants, 32 (72%) met study inclusion criteria: MBBS degree and course completion. The study population was 62.5% male with 47% surgeons and 53% GPs. Residents were 71.8% of the entire group. Overall, the pre- and post- course scores improved from 70.7% +/-11.2 to 87.5% +/-8.9, P = 0.000 (95%CI 12.1, 21.2). There was an increase of mean scores: 21.4% (SD +/-13.7) for GPs and 11.3% (SD +/-8.5) for surgeons (P = 0.02).
Although GPs had significantly lower pre-course scores than surgeons, at the end of the course, GPs performed as well as surgeons. These findings suggest allocation of limited educational resources for trauma care in India may be best used by GPs.
创伤已成为发展中国家死亡和残疾的主要原因。在印度，大多数创伤患者在由全科医生坐诊的医院接受初始治疗。我们假设全科医生在参加一门教育课程后能够提高他们的创伤护理知识。
在印度班加罗尔的一家拥有170张床位的教学医院举办了为期2天的创伤课程。受邀的全科医生、当地外科医生和实习住院医师参加了课程。在课程开始前进行了一次测试以评估创伤知识基线。核心教学课程包括：复苏/休克状态的识别、气道优先处理，以及头部、心胸、腹部、盆腔/泌尿生殖系统和热损伤的评估/初始处理。课程结束后进行了一次测试以评估从课程中学到的创伤知识。对测试分数进行配对t检验，并按专业和培训状态对人口统计学数据进行分层。
44名参与者中，32名（72%）符合研究纳入标准：拥有医学学士学位且完成课程。研究人群中男性占62.5%，外科医生占47%，全科医生占53%。住院医师占整个群体的71.8%。总体而言，课程前后的分数从70.7%±11.2提高到了87.5%±8.9，P = 0.000（95%CI 12.1，21.2）。全科医生的平均分数提高了21.4%（标准差±13.7），外科医生提高了11.3%（标准差±8.5）（P = 0.02）。
尽管全科医生在课程开始前的分数显著低于外科医生，但在课程结束时，全科医生的表现与外科医生相当。这些发现表明，印度有限的创伤护理教育资源分配可能最好由全科医生使用。
