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

Abstract

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 shortand 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.