Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 9 , ISSUE 2 ( May-August, 2020 ) > List of Articles

Original Article

Efficacy of the Basic Trauma Course in Family Medicine Resident Physicians in Southern Ecuador: It is Time to Innovate Education in Trauma

Juan F Figueroa, Christian Loyola, Fray Martínez, Juan C Salamea

Citation Information : Figueroa JF, Loyola C, Martínez F, Salamea JC. Efficacy of the Basic Trauma Course in Family Medicine Resident Physicians in Southern Ecuador: It is Time to Innovate Education in Trauma. Panam J Trauma Crit Care Emerg Surg 2020; 9 (2):97-100.

DOI: 10.5005/jp-journals-10030-1286

License: CC BY-NC 4.0

Published Online: 18-11-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Introduction: In Ecuador, as in other Latin American countries, trauma has become one of the main reasons to seek medical care in the country. According to data obtained from the National Institute of Statistics and Censuses (INEC), the rate of homicides, car accidents, suicides, and burns, grouped together, represent the main cause of morbidity and mortality in people aged between 18 years and 40 years, surpassing mortality due to cardiovascular causes or diabetes. Additionally, one study on geolocation of calls made to the emergency services (SIS-ECU 9-1-1) indicated that trauma in the country is becoming more and more frequent in marginal urban and rural areas, where health services are scarce. Due to this emerging situation, it is necessary to evaluate the short- and long-term effectiveness of the Basic Trauma Course (BTC), a course designed to educate students, general practitioners, prehospital staff and primary healthcare physicians. Objective: To evaluate the effect of the BTC in family medicine residents who work in Health Centers in marginalurban and rural areas of the Azuay, Cañar, and Morona Santiago provinces in southern Ecuador. Materials and methods: Quasi-experimental study in which knowledge is evaluated at three stages in time (before the course, at the end of the course and one year later) in 39 family medicine residents. Comparison of means of the test scores was made using formulas in SPSS of analysis of variance (ANOVA) and Tukey HSD. Results: ANOVA brought significant differences between measurements (F = 8.38, p value < 0.0005). The increase in the score between the pretest and the immediate posttest was significant (p value < 0.01). The difference between pretest and late posttest was not significant. The comparison of the immediate and late posttest results showed a decrease in the mean, being statistically significant (p value < 0.01). Conclusion: The BTC, as a unique training course, does not guarantee the permanence of long-term knowledge in participants who do not regularly attend to the trauma patient, requiring constant training using spaced repetition methods, for adequate consolidation.

  1. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support Student Course Manual. Chicago, IL: American College of Surgeons; 2012.
  2. Sarmiento G, Sarmiento V, Martínez F, et al. Comportamiento del Proceso Prehospitalario ante la Llamada de Auxilio Por trauma, CsC-911, 2011. Panam J trauma, Crit Care Emerg Surg 2012. 168–174.
  3. Salamea JC, Sacoto H, Rodas EB, et al. Emergencias en el Sur del Ecuador; Historia, Realidad Y Perspectivas. Panam J trauma. Crit Care Emerg Surg 2014;3(2):73–75.
  4. Aboutanos MB, Rodas EB, Aboutanos SZ, et al. Trauma education and care in the jungle of Ecuador, where there is no advanced trauma life support. J Trauma 2007;62(3):714–719. DOI: 10.1097/TA.0b013e318031b56d.
  5. World Health Organization. The Injury Chart Book: a Graphical Overview of the Global Burden of Injuries. Geneva: World Health Organization Department of Injuries and Violence Prevention. Noncommunicable Diseases and Mental Health Cluster; 2002.
  6. Mock C, Joshipura M, Arreola-Risa C, et al. An estimate of the number of lives that could be saved through improvements in trauma care globally. World J Surg 2012;36(5):959–963. DOI: 10.1007/s00268-012-1459-6.
  7. Instituto Nacional de Estadísticas y Censos. Anuario de Estadísticas Vitales: Nacimientos y Defunciones; 2013. Internet:
  8. Carolina D, León V. Trauma en base a los reportes de los principales diarios de la ciudad de Cuenca. 2014.
  9. Rogers FB, Shackford SR, Hoyt DB, et al. Trauma deaths in a mature urban vs rural trauma system. A comparison. Arch Surg 1997;132(4):376–381. DOI: 10.1001/archsurg.1997.01430280050007; discussion 381-2.
  10. Ozgediz D, Jamison D, Cherianc M, et al. The burden of surgical conditions and access to surgical care in low and middle-income countries. Bull World Health Organ 2008;86(8):646–647. DOI: 10.2471/BLT.07.050435.
  11. Simões RL, Bermudes FAM, Andrade HS, et al. Trauma leagues: an alternative way trauma to teach surgery to medical students. Rev Col Bras Cir 2014;41(4):297–302. DOI: 10.1590/0100-699120140040013.
  12. Amiri H, Gholipour C, Mokhtarpour M, et al. Two-day primary trauma care workshop: early and late evaluation of knowledge and practice. Eur J Emerg Med 2013;20(2):130–132. DOI: 10.1097/MEJ.0b013e32835608c6.
  13. Delgado-Reyes L, Gasca-González OO, Delgado-Guerrero F, et al. Effectiveness of trauma evaluation and management course for mexican senior medical students: when to implement it? Cir Cir 2015;84(3):220–224.
  14. Ortiz Figueroa F, Moftakhar Y, Dobbins Iv AL, et al. Trauma boot camp: a simulation-based pilot study. Cureus 2016;8(1):e463. DOI: 10.7759/cureus.463.
  15. Peter N, Pandit H, Le G, et al. Delivering a sustainable trauma management training programme tailored for low-resource settings in east, central and Southern African countries using a cascading course model. Injury 2015;47(5):1128–1134. DOI: 10.1016/j.injury.2015.11.042.
  16. Bergman S, Deckelbaum D, Lett R, et al. Assessing the impact of the trauma team training program in Tanzania. J Trauma 2008;65(4): 879–883. DOI: 10.1097/TA.0b013e318184a9fe.
  17. Pemberton J, Rambaran M, Cameron BH. Evaluating the long-term impact of the trauma team training course in Guyana: an explanatory mixed-methods approach. Am J Surg 2013;205(2):119–124. DOI: 10.1016/j.amjsurg.2012.08.004.
  18. Jayaraman S, Mabweijano JR, Lipnick MS, et al. First things first: effectiveness and Scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One 2009;4(9):e6955. DOI: 10.1371/journal.pone.0006955.
  19. Blumenfeld A, Ben Abraham R, Stein M, et al. Cognitive knowledge decline after advanced trauma life support courses. J Trauma 1998;44(3):513–516. DOI: 10.1097/00005373-199803000-00017.
  20. Ali J, Howard M, Williams I. Do factors other than trauma volume affect attrition of ATLS-acquired skills? J Trauma 2003;54(5):835–841. DOI: 10.1097/01.TA.0000057233.97051.81.
  21. Mohammad A, Branicki F, Abu-Zidan FM. Educational and clinical impact of advanced trauma life support (ATLS) courses: a systematic review. World J Surg 2014;38(2):322–329. DOI: 10.1007/s00268-013-2294-0.
  22. Augustin M. How to learn effectively in medical school: test yourself, learn actively, and repeat in intervals. Yale J Biol Med 2014;87(2):207.
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