Launching the Advanced Trauma Operative Management (ATOM), Course in Trinidad and Tobago

Abstract

Background: The Advanced Trauma Operative Management (ATOM) course which is aimed at improving penetrating trauma management skills is very challenging to conduct. We assessed the feasibility and potential impact of ATOM training in Trinidad and Tobago through the University of Toronto Global surgery initiative and its potential for improving penetrating trauma care in this developing country. Methods : Senior General Surgical trainees were randomly assigned to participate. Other partici pants consisted of: an experienced international ATOM course Director, one experienced ATOM instructor, an ATOM instructor candidate, an experienced ATOM veterinary medicine technologist, 2 veterinary medicine trainees, 8 senior general surgical trainees who completed the course using the 2 student to one faculty training model. Pre and post course self efficacy scores (a measure of confidence in surgical approach) and scores on multiple choice question exams (MCQ) were compared by paired t tests. The trainees completed 5-point Likert scales to assess different components of the course. Results : The course was successfully completed locally. Mean and SD self efficacy scores im proved from 55.4 ± 18.5 to 80.5 ± 9.1 and MCQ improved from 63.0 ± 8.8 to 82.5 ± 9.6 ( p < .001). Rating of lectures, procedures and general assessment by Likert scores ranked the experiences as very good to excellent. Conclusions : Based on trainee course performance and their evaluations , there was significant improvement in trauma skills, knowledge and attitude with enthusiastic support for continuing the program, to improve penetrating trauma care locally and extending this training to other parts of the Caribbean.