Improving Trauma Care in India: the Potential Role of the Rural Trauma Team Development Course (RTTDC)

Abstract

The Rural Trauma Team Development Course (RTTDC) was devised to optimize trauma resuscitation training in under-resourced rural institutions. This program appears ideal for India because of its dense traffic, large population, and high frequency of rural trauma. We report on the feasibility and desirability of introducing RTTDC in India. An instructor course for 20 faculties and a provider course for 23 were conducted in New Delhi, India. The courses were evaluated by multiple choice question (MCQ) performance, by rating the modules on a three-point scale (1 0 very relevant, 2 0 relevant, and 3 0 not relevant) for communication skills, principles of performance improvement and patient safety (PIPS), and clinical scenarios. Evaluation questionnaires including desirability of promulgation in India were completed using a five-point Likert Scale (1 0 strongly agree, 2 0 agree, 3 0 neutral, 4 0 disagree, and 5 0 strongly disagree). Overall written comments were also provided. Both faculty and providers improved post-course MCQ scores (p<0.05) with lower scores in the provider group. Seventy-eight percent faculty and 74 % providers rated the communication module very relevant. PIPS was rated very relevant by 72 % faculty and 65 % providers. There were over 150 comments, generally positive with over 90 % of both faculty and providers rating strongly agree to agree that the course be promulgated widely in India. The RTTDC including plans for promulgation was enthusiastically received in India, and its potential for improving trauma care including communication skills and PIPS appears excellent.

Participants’ perception of the AIIMS Trauma Assessment and Management (ATAM) course for management of polytrauma: A multi-institutional experience from India

“…The efficacy of course content was evaluated using a five-point Likert scale for feedback from participants. 14,15 In a previous study on the efficacy of the content of the RTTDC course, more than 94% of participants strongly agreed or agreed that the course content had a positive impact on them. 15 In a study on RTTDC course, 100% of participants who were training to be RTTDC providers and 80%e95% participants training to be RTTDC instructors perceived that course content was highly effective.…”

“…15 In a study on RTTDC course, 100% of participants who were training to be RTTDC providers and 80%e95% participants training to be RTTDC instructors perceived that course content was highly effective. 14 In another study (16), 100% of participants perceived that the course objectives were achieved by the content of the TEAM course. In the present study, 84.7%e86.5% of participants strongly agreed or agreed that the ATAM course content was effective.…”

“…14e21 The gain in cognitive knowledge was evaluated using pre-training and post-training MCQs. 14,15,17,18,20,21 In our study cognitive knowledge was tested using MCQ having 30 items whereas other previously published studies had MCQs consisting of 18e20 items. 14,15,17,18,20,21 In previously published studies, the improvement in cognitive knowledge has been 11.5%e34.4%.…”

“…14,15,17,18,20,21 In our study cognitive knowledge was tested using MCQ having 30 items whereas other previously published studies had MCQs consisting of 18e20 items. 14,15,17,18,20,21 In previously published studies, the improvement in cognitive knowledge has been 11.5%e34.4%. 14,15,17,18,20e22 The improvement in cognitive knowledge in our study was 23.7% and this is comparable to that of published work.…”

Acute Critical Care Course for Clinicians—Why, What, and How?

“…J Ali et al demonstrated how ATLS course was established in an Indian rural setting [12]. Theteam at AIIMS formulated a ACCC consensus committee consisting of 8 members to develop ACCC course material over 10 months in 2014 by using that infrastructure and expertise.…”