Lule Herman, Mugerwa Micheal, Ssebuufu Robinson, Kyamanywa Patrick, Posti Jussi P, Wilson Michael Lowery
Department of Surgery, Kiryandongo Regional Referral Hospital, Kigumba, Uganda.
Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Department of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland.
BMC Med Educ. 2025 Jan 29;25(1):148. doi: 10.1186/s12909-025-06755-1.
Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of rural trauma team training amongst medical trainees and traffic law enforcement professionals in Uganda.
Prospective multi-centre interrupted time series analysis of an interventional training based on the 4th edition of rural trauma team development course of the American College of Surgeons. Trauma related multiple choice questions (MCQs), and trauma non-technical skills were assessed pre-and post-training between September 2019- August 2023. Acceptability of the training for promulgation to other rural regions and its relevance to participants' work needs were evaluated on 5- and 3-point Likert scales respectively. The median MCQ scores (IQR) were compared before and after training at 95% CI, regarding p < 0.05 as statistically significant. Triangulation with open-ended questions was obtained. Time series regression models were applied to test for autocorrelation in performance using Stata 15.0. Ethical approval was obtained from Uganda National Council for Science and Technology (Ref: SS 5082).
A total of 500 participants including: 66 (13.2%) traffic police officers, 30 (6.0%) intern doctors, 140 (28.0%) fifth year and 264 (52.8%) third-year medical students were trained. Among the 434 medical trainees who completed the trauma-based MCQ assessment, the median pre- and post-test scores were 60%, IQR (50-65) and 80%, IQR (70-85) respectively. Overall, the mean difference between pre- and post-test scores was statistically significant (z = 16.7%, P|z|=<0.0001). Most participants strongly agreed to promulgate 389 (77.8%), relevance to their educational 405 (81.0%), and work needs 399 (79.8%). Each of the course components was rated above 76.0% as being very relevant. There was an overall increment in median (IQR) trauma-nontechnical skills team performance scores from 12 (9-14) to 17 (15-20) after the training (p < 0.001), with police teams advancing from 9.5 (6.0-12.5) to 19.5 (17.0-21.5) (p < 0.001).
This study demonstrates that rural trauma team development training had a positive effect on the test scores of course participants. The training is feasible, highly acceptable and regarded as relevant amongst medical trainees and traffic law enforcement professionals who provide first-aid to trauma patients in resource-limited settings. The findings could inform the design of future trauma teams in rural communities.
Retrospective registration (UIN: researchregistry9450).
研究表明，组建创伤团队可能会提高农村地区创伤护理的效果。本研究的目的是确定在乌干达的医学实习生和交通执法专业人员中开展农村创伤团队培训的可行性。
基于美国外科医师学会第4版农村创伤团队发展课程进行前瞻性多中心间断时间序列分析，对干预性培训进行研究。在2019年9月至2023年8月期间，在培训前后对创伤相关多项选择题（MCQ）和创伤非技术技能进行评估。分别使用5点和3点李克特量表评估培训对推广到其他农村地区的可接受性及其与参与者工作需求的相关性。在95%置信区间比较培训前后的MCQ中位数分数（IQR），p < 0.05被视为具有统计学意义。通过开放式问题进行三角验证。使用Stata 15.0应用时间序列回归模型测试绩效中的自相关性。获得了乌干达国家科学技术委员会的伦理批准（参考号：SS 5082）。
共有500名参与者接受了培训，其中包括：66名（13.2%）交通警察、30名（6.0%）实习医生、140名（28.0%）五年级和264名（52.8%）三年级医学生。在完成基于创伤的MCQ评估的434名医学实习生中，测试前和测试后的中位数分数分别为60%，IQR（50 - 65）和80%，IQR（70 - 85）。总体而言，测试前和测试后分数的平均差异具有统计学意义（z = 16.7%，P|z| = <0.0001）。大多数参与者强烈同意推广培训的占389名（77.8%），与他们的教育相关的占405名（81.0%），与工作需求相关的占399名（79.8%）。每个课程组成部分的相关性评分均高于76.0%，被认为非常相关。培训后，创伤非技术技能团队绩效分数的中位数（IQR）总体从12（9 - 14）提高到17（15 - 20）（p < 0.001），警察团队从9.5（6.0 - 12.5）提高到19.5（17.0 - 21.5）（p < 0.001）。
本研究表明，农村创伤团队发展培训对课程参与者的测试成绩有积极影响。该培训是可行的，高度可接受的，并且在为资源有限环境中的创伤患者提供急救的医学实习生和交通执法专业人员中被认为是相关的。这些发现可为农村社区未来创伤团队的设计提供参考。
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