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Risks of Failure in Advanced Trauma Life Support Courses
Zachary C Newman1, David V Deshpande2, Jim Doherty3
1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
The Journal of Surgical Research
|February 1, 2026
Summary
Factors influencing performance in the Advanced Trauma Life Support (ATLS) course were examined. Marginal performance was more common in initial student courses than refresher courses, varying by specialty and training level.
Area of Science:
- Medical Education
- Trauma Care
Background:
- The Advanced Trauma Life Support (ATLS) course is a standard for trauma patient care.
- Minimal evidence exists on individual risk factors affecting ATLS course performance.
Purpose of the Study:
- To identify individual student risk factors for marginal performance in hybrid ATLS courses.
- To analyze performance differences between student and refresher courses.
Main Methods:
- Retrospective study of 996 students from hybrid ATLS courses (2022-2023).
- Marginal performance defined as <80% on written or failed practical exam.
- Univariable and multivariable logistic regression analyses were used.
Main Results:
- 19% of students (191/996) had marginal ATLS performance.
- Marginal performance was higher in student courses (24%) vs. refresher courses (9%).
- Lower pretest scores and certain specialties/training levels were associated with marginal performance.
Conclusions:
- Marginal ATLS performance is influenced by specialty, training level, and trauma center designation.
- Further research is needed to identify and support at-risk students in ATLS courses.
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