Feasibility of rural trauma team development amongst medical trainees and traffic law enforcement professionals in a low-income country: a prospective multi-centre study of interrupted time series of interventional training

Abstract

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 the use of rural medical trainees and road traffic law enforcement professionals in the formation of rural trauma teams in Uganda. Multi-center interrupted time series of interventional rural health professions education, using the American College of Surgeons’ 4th edition of rural trauma team development course model. Trauma related multiple choice questions (MCQs) were administered 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).

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. The overall 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 promulgation 389 (77.8%), relevance to their educational 405 (81.0%), and work needs 399 (79.8%). All the course elements scored above 76.0% as being very relevant.

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.