Quality of Documentation as a Surrogate Marker for Awareness and Training Effectiveness of PHTLS-Courses. Part of the Prospective Longitudinal Mixed-Methods EPPTC-Trial.

OBJECTIVE: Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. METHODS: This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation. RESULTS: In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p < 0.001) in the "AMP" information in the documentation. The subgroups analysis of "allergies" (+47.2%), "drugs" (+38.1%), and "medical history" (+27.8%) before and after the PHTLS course showed a significant increase in the information content. CONCLUSION: In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.

Teaching Advanced Trauma Life Support (ATLS): A nationwide retrospective analysis of 8202 lessons taught in Germany.

OBJECTIVE: To examine whether faculty who teach the Advanced Trauma Life Support (ATLS) course would improve with experience and, correspondingly, ratings from course evaluations would increase. DESIGN: Retrospective analysis of student evaluations of 262 ATLS courses held between 2008 and 2012. SETTING: All ATLS courses held between 2008 and 2012 nationwide in Germany. PARTICIPANTS: All ATLS student course evaluations covering 8202 lessons, 81 instructors, 36 course directors, and 5 coordinators. RESULTS: ATLS courses in Germany attained high levels of student satisfaction. Satisfaction levels increased steadily over the 5-year period studied. The entire staff influenced this finding. Teaching quality improved the most within the first 100 lessons taught. Skill stations received better evaluations than lectures, and local courses were less satisfactory than national course formats. The 2 demonstrations that open the course were the top rated events. Skill stations, including a human phantom, were highly rated; the cricothyrotomy station was top rated. CONCLUSION: The German ATLS course evaluations indicated steady improvement over the 5-year study. The level of experience of course coordinators, directors, and instructors influenced this finding. Teaching quality improved most within the first 100 lessons taught, and then reached a steady state. Skill stations received better evaluations than lectures, and local courses were less satisfactory than national course formats.