Does the rural trauma team development course shorten the interval from trauma patient arrival to decision to transfer?

BACKGROUND: The Rural Trauma Team Development Course (RTTDC) was developed by the ad hoc Rural Trauma Committee of the American College of Surgeons, Committee on Trauma to address the increased mortality of the rural trauma patient. The effectiveness of the RTTDC in shortening the interval from patient arrival to decision to transfer and the effect on the transfer process of communication training emphasizing team building is the focus of this study. METHOD: Rural level III and level IV trauma centers (N=18) were enrolled in a multiinstitutional 3-month longitudinal study of transferred trauma patients. Results were compared with institutions having hosted RTTDC versus those institutions not yet exposed to the course. RESULTS: One-way analysis of variance was conducted. Results indicated that RTTDC training alone and RTTDC including communication training resulted in a statistically significantly shorter (p<0.05) time for decision to transfer. Transferring squad arrival time was also significantly reduced (p<0.01) as was the number of transferring squads contacted (p<0.01). No differences were observed among the trauma facilities and the number of receiving facilities contacted, (p=0.64) or in the time required to find an accepting facility (p=0.72). CONCLUSION: The RTTDC alone and with the embedded communication module significantly reduce delays in the transfer process of the rural trauma patient.

A team approach in communication instruction: a qualitative description.

OBJECTIVE: To establish communication instructional goals and objectives (IGOs) adapted to a postgraduate surgical residency program. DESIGN: The curriculum that was tested in the current study is predicated on the following concepts: Leadership is a communication skill, not a medical skill; perception and interpretation are individual events and always will be imperfect; team is a relational-based concept, not a medical one; the concept of a perfect world is unrealistic and should not be the focus of any communication skills training; and change cannot occur locally if it is not nurtured globally. RESULTS: A communication curriculum designed to teach "affirming communication" as well as to focus on how acquiring the knowledge and skill associated with competent communication can result in positive organizational and clinical outcomes were tested using subjects from a rural trauma network. Statistically significant findings were observed regarding knowledge acquisition as well as perceptions and attitudes toward communication. CONCLUSION: Any communication curriculum designed to educate needs to be grounded theoretically in both communication and medicine. Personnel from both disciplines need to be consulted in efforts to design a curriculum based in the social sciences yet applicable to surgery.