[Assessment of IDF physicians in in-field trauma]

The system of care delivery of in-field trauma was assessed, leading to suggestions for improving the system and military medical training. This study reports the feasibility and validity of various methods of assessing the performance of Israel Defense Force physicians in administering trauma care. The methods included a standardized medical debriefing with filling in of a report form by a senior traumatologist, his review of the physician's performance, self-assessment by the physician, and a written test. 5 senior traumatologists with extensive experience in military trauma care were trained to assess the physicians' performance within 24-48 hours of incidents involving moderate to severe trauma injuries. 75 physicians who had been involved in the care of the in-field trauma patients during a 1-year period, November 1988 to October 1989, were assessed. Analysis of the results clearly indicated 2 areas for assessment: a) knowledge, mainly levels of comprehension and application in relevant areas of trauma and b) performance, including immediate diagnosis, treatment skills, and triage. The best method for evaluating knowledge was the written test, not peer review nor self-evaluation. However, the traumatologist's evaluation of care performance was highly correlated with the physician's self-assessment. For comprehensive assessment of in-field care it is advisable to integrate the 2 methods: performance review by a traumatologist and a comprehensive written test. Information gained from such assessment could improve the planning of in-service trauma training and the posting of physicians within the military framework.