Effects of Nationwide Training of Multiprofessional Trauma Teams in Norwegian Hospitals

Abstract

Norway has 50 trauma hospitals serving a geographically disperse population (4.6 million) and many have low trauma case loads. We showed that personnel find functioning as a team especially challenging, and developed a 1-day training course, arranged locally at each hospital, focused on team training in communication, leadership, and cooperation during simulated patient treatment. This study evaluates the effects of training on participants' knowledge, confidence, and perceived trauma team performance, controlling for hospital size and the participants' previous experience. Anonymous, written questionnaires were answered by 4,203 participants (28% physicians, 55% nurses) in 44 hospitals before and immediately after training courses, and by 1,368 trauma team members in 26 of the hospitals 6 months after their last training course. Outcome measures were knowledge and confidence concerning the respondent's own role, and evaluation of trauma team performance in live trauma resuscitations. There was a significant increase in self-reported knowledge and confidence among all participants. Community hospitals and participants without recent trauma experience had the lowest preintervention scores, but reached levels comparable to participants at the other hospitals after training. The effects increased after 6 months, with trauma team performance evaluated as having improved, even by team members who had not participated in the training. Practical team training in hospitals improved the participants' perceived knowledge and confidence, which continued to increase for 6 months after training independent of participants' experience level, suggesting that small hospitals may reach levels comparable to major hospitals.