A1 Refereed original research article in a scientific journal

Prospective multi-centre analysis of rural trauma team development training for medical trainees and traffic law enforcement professionals in Uganda: an interrupted time series study




AuthorsLule Herman, Mugerwa Micheal, Ssebuufu Robinson, Kyamanywa Patrick, Posti Jussi P, Wilson Michael Lovery

Publication year2025

JournalBMC Medical Education

Journal name in sourceBMC medical education

Journal acronymBMC Med Educ

Volume25

Issue1

eISSN1472-6920

DOIhttps://doi.org/10.1186/s12909-025-06755-1

Web address https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-025-06755-1

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/484419968


Abstract

Background: Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of rural trauma team training amongst medical trainees and traffic law enforcement professionals in Uganda.

Methods: Prospective multi-centre interrupted time series analysis of an interventional training based on the 4th edition of rural trauma team development course of the American College of Surgeons. Trauma related multiple choice questions (MCQs), and trauma non-technical skills were assessed pre-and post-training between September 2019- August 2023. Acceptability of the training for promulgation to other rural regions and its relevance to participants' work needs were evaluated on 5- and 3-point Likert scales respectively. The median MCQ scores (IQR) were compared before and after training at 95% CI, regarding p < 0.05 as statistically significant. Triangulation with open-ended questions was obtained. Time series regression models were applied to test for autocorrelation in performance using Stata 15.0. Ethical approval was obtained from Uganda National Council for Science and Technology (Ref: SS 5082).

Results: A total of 500 participants including: 66 (13.2%) traffic police officers, 30 (6.0%) intern doctors, 140 (28.0%) fifth year and 264 (52.8%) third-year medical students were trained. Among the 434 medical trainees who completed the trauma-based MCQ assessment, the median pre- and post-test scores were 60%, IQR (50-65) and 80%, IQR (70-85) respectively. Overall, the mean difference between pre- and post-test scores was statistically significant (z = 16.7%, P|z|=<0.0001). Most participants strongly agreed to promulgate 389 (77.8%), relevance to their educational 405 (81.0%), and work needs 399 (79.8%). Each of the course components was rated above 76.0% as being very relevant. There was an overall increment in median (IQR) trauma-nontechnical skills team performance scores from 12 (9-14) to 17 (15-20) after the training (p < 0.001), with police teams advancing from 9.5 (6.0-12.5) to 19.5 (17.0-21.5) (p < 0.001).

Conclusion: This study demonstrates that rural trauma team development training had a positive effect on the test scores of course participants. The training is feasible, highly acceptable and regarded as relevant amongst medical trainees and traffic law enforcement professionals who provide first-aid to trauma patients in resource-limited settings. The findings could inform the design of future trauma teams in rural communities.

Trial registration: Retrospective registration (UIN: researchregistry9450).


Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.




Funding information in the publication
HL was supported by Neurocentre, Turku University Hospital, Finland (grant no VTR2023). JPP was supported by the Academy of Finland (grant no 17379) and the Maire Taponen Foundation. The study sponsors did not have any role in the design, collection, analysis, interpretation, writing or decision to submit the study report for publication.


Last updated on 2025-02-04 at 09:04