Trauma Evaluation and Management (TEAM): Who benefits among senior medical students?

Abstract

Introduction. The ATLS Subcommittee designed TEAM for teaching senior medical students concepts of trauma resuscitation. The program has been shown to improve trauma knowledge among these students. This study examines whether or not TEAM is more appropriately directed to third-year medical students. Materials. Eighty third-year (Y3) and 34 fourth-year (Y4) students were divided into control (41 Y3 and 17 Y4) and experimental (39 Y3 and 17 Y4) groups. The experimental (EXP) groups had a 20-item, multiple-choice question exam before, and a similar exam after, TEAM. The control (CTL) group had the same exams but no TEAM between exams. Mean scores (%) were compared by paired and unpaired t tests for within and between group comparisons, respectively. The proportions of students achieving a pass mark of 70 or 60% were compared (χ 2 analysis). Results. Means ± SD, ∗ P < 0.05 compared to Y4, † P < 0.05 compared to pretest. Y4 CTL: Pretest 58.8 ± 10.5% with 3/17 ≥ 70%, Posttest 54.4 ± 11.2 with 3/17 ≥ 70%. Y3 CTL: Pretest 53.0 ± 11.8%∗ with 4/41 ≥ 70%, Posttest 47.6 ± 11.4%∗ with 0/41 ≥ 70%. Y4 EXP: Pretest 59.4 ± 11.5% with 2/17 ≥ 70%, Posttest 69.1 ± 8.3%+ with 10/17 ≥ 70%. Y3 EXP: Pretest 49.2 ± 11.4%∗ ± with 4/39 > 70%, Posttest 55.0 ± 10.9%∗+ with 5/39 ≥ 70%. A pretest 60% mark was reached in 24/80 (Y3) versus 22/34 (Y4) and the posttest 60% mark in 13/39 (Y3) versus 16/17 (Y4), P < 0.05. Conclusions. Although both third- and fourth-year students improved their performance following TEAM, the fourth-year tended to have greater improvement. Fourth-year students without TEAM achieved scores similar to or greater than those of students who completed TEAM in their third year. With TEAM, 33% of Y3 students achieved a mark of 60% compared to 94% of Y4 students. TEAM appears to be more effectively directed to fourth-year than to third-year medical students.