Trauma evaluation and management: who benefits among medical students?

This study examines whether or not the ACS ATLS Subcommittee's Trauma Evaluation and Management (TEAM) course is more appropriate for third (Y3) or fourth year (Y4) medical students.

Y3 and Y4 students were divided into control (CTL: 41 Y3, 17 Y4) and experimental (EXP: 39 Y3, 17 Y4) groups. The EXP groups had a 20-item, multiple-choice question exam before, and a similar exam after TEAM. The control CTL group took both exams prior to TEAM. Repeated measures analysis of variance was used for statistical comparison with group and year as between subject factors and with P < 0.05 being considered statistically significant.

For the Y4 CTL, pretest was 58.8 +/- 10.5% and posttest was 54.4 +/- 11.2%. For the Y3 CTL, pretest was 53.0 +/- 11.8% and posttest was 47.6% +/- 11.4%. For the Y4 EXP, pretest was 59.4% +/- 11.5% and posttest was 69.1 +/- 8.3%. For the Y3 EXP, pretest was 49.2 +/- 11.4% and posttest was 55.0 +/- 10.9%. The difference between experimental and control groups was statistically significant (P = 0.042). The scores for Y4 were higher than Y3 in all groups (P < 0.001). The distribution of scores of Y4 control was nearly identical to Y3 experimental, suggesting that the improvement with TEAM in Y3 was equivalent to the improvement following the traditional curriculum in Y4 without TEAM.

Y3 and Y4 students improved their performance following TEAM, but Y4 students had greater improvement. Y4 students without TEAM achieved scores similar to or greater than students who completed TEAM in Y3. TEAM appears to be more effectively directed to Y4 medical students.