Intern Perceptions of Procedural Skills in Trauma Patients in Regional and General Hospitals of Ministry of Public Health, Thailand
Abstract
OBJECTIVE
This research aimed to evaluate the perception procedural skills and essential knowledge required in trauma patient care of medical internship in the regional and general hospital of the Ministry of Public Health (MOPH), Thailand.
METHODS
This is an observational questionnaire-based survey study. The assessments were made through a series of electronic questionnaires for the medical internship in Thailand. This study was made throughout medical interns after the first year of postgraduate during 1997– 2017.
RESULTS
A total of 792 medical internships were complete the survey questionnaires. There were 578 (74.1%) medical internships that had one 1-year experience. There were 467 (59%) who graduated from university hospitals and 431 (54.4%) working at regional hospitals. Three essential procedures consist of surgical cricothyroidotomy, needle cricothyroidotomy, and central venous catheter insertion which were significant differences in the necessity requirement between workplace-based groups. The percentage necessary procedural requirement in the regional hospital group compare to the general hospital group in surgical cricothyroidotomy were 19.7% VS 13.2%, (P=0.011), needle cricothyroidotomy 43.5% VS 35.1%, (P=0.025) and central venous catheter 42.1% VS 26.1%, (P<0.001) respectively.
CONCLUSION
The procedural skill is important and necessary for medical internships in the improvement of the performance of trauma patient care. The development of surgical skills would be beneficial for improved trauma patient care outcomes. Improvement of medical program training adding the essential requirement procedures to the program is warranted.
References
Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF Bundle in Critical Care. Critical care clinics. 2017;33(2):225-43.
Mock C, Nguyen S, Quansah R, Arreola-Risa C, Viradia R, Joshipura M. Evaluation of Trauma Care capabilities in four countries using the WHO-IATSIC Guidelines for Essential Trauma Care. World journal of surgery. 2006;30(6):946-56.
Paulozzi LJ, Mercy J, Frazier L, Annest JL. CDC’s National Violent Death Reporting System: background and methodology. Injury Prevention. 2004;10(1):47-52.
Pal R, Ghosh A, Kumar R, Galwankar S, Paul SK, Pal S, et al. Public health crisis of road traffic accidents in India: Risk factor assessment and recommendations on prevention on the behalf of the Academy of Family Physicians of India. J Family Med Prim Care. 2019;8(3):775-83.
Ahmadi K, Sedaghat M, Safdarian M, Hashemian AM, Nezamdoust Z, Vaseie M, et al. Effect of Advanced Trauma Life Support program on medical interns’ performance in simulated trauma patient management. Chinese Journal of Traumatology. 2013;16(3):145-8.
Carmont MR. The Advanced Trauma Life Support course: a history of its development and review of related literature. Postgrad Med J. 2005;81(952):87-91.
Berwick DM, Downey AS, Cornett EA. A National Trauma Care System to Achieve Zero Preventable Deaths After Injury: Recommendations From a National Academies of Sciences, Engineering, and Medicine Report. Jama. 2016;316(9):927-8.
Olson CJ, Arthur M, Mullins RJ, Rowland D, Hedges JR, Mann NC. Influence of trauma system implementation on process of care delivered to seriously injured patients in rural trauma centers. Surgery. 2001;130(2):273-9.
Jayaraman S, Sethi D. Advanced trauma life support training for ambulance crews. The Cochrane database of systematic reviews. 2010(1):Cd003109.
Medical Competency Assessment Criteria for National License 2012. http://www.cmathai.org.
McGaghie WC, Miller GE, Sajid AW, Telder TV. Competency-based curriculum development on medical education: an introduction. Public health papers. 1978(68):11-91.
Biffl WL, Harrington DT, Cioffi WG. Implementation of a tertiary trauma survey decreases missed injuries. The Journal of trauma. 2003;54(1):38-43; discussion -4.
Hajibandeh S, Hajibandeh S, Idehen N. Meta-analysis of the effect of tertiary survey on missed injury rate in trauma patients. Injury. 2015;46(12):2474-82.
Richards CF, Mayberry JC. Initial management of the trauma patient. Critical care clinics. 2004;20(1):1-11.
Brenner M, Hicks C. Major Abdominal Trauma: Critical Decisions and New Frontiers in Management. Emergency medicine clinics of North America. 2018;36(1):149-60.
Peters F, van Wyk J, van Rooyen M. Intern to independent doctor: basic surgical skills required for South African practice and interns’ reports on their competence. South African Family Practice. 2015;57(4):261-6.
Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. International journal of general medicine. 2012;5:117-21.
Patel SA, Meyer TK. Surgical airway. International journal of critical illness and injury science. 2014;4(1):71-6.
Weston V. Assessment for Catheter Function, Dressing Adherence and Device Necessity. In: Moureau NL, editor. Vessel Health and Preservation: The Right Approach for Vascular Access. Cham: Springer International Publishing; 2019. p. 219-33.
Mackenzie CF, Tisherman SA, Shackelford S, Sevdalis N, Elster E, Bowyer MW. Efficacy of Trauma Surgery Technical Skills Training Courses. Journal of surgical education. 2019;76(3):832-43.
Stewart RA, Hauge LS, Stewart RD, Rosen RL, Charnot-Katsikas A, Prinz RA. A CRASH course in procedural skills improves medical students' self-assessment of proficiency, confidence, and anxiety. American journal of surgery. 2007;193(6):771-3.
