Correlation Between ATLS Training and Junior Doctors’ Anatomical Knowledge of Intercostal Chest Drain Insertion

Objective To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this. Design We performed a prospective, observational study using a structured survey an...

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Bibliographic Details
Published in:Journal of surgical education 2015-07, Vol.72 (4), p.600-605
Main Authors: Kong, Victor Y., PhD, Oosthuizen, George V., FCS (SA), Sartorius, Benn, PhD, Keene, Claire M., MBBCh, Clarke, Damian L., FCS (SA)
Format: Article
Language:English
Subjects:
Advanced Trauma Life Support Care
ATLS
chest drain
Chest Tubes
Clinical Competence
Drainage - instrumentation
Education, Medical, Graduate
Female
Health Knowledge, Attitudes, Practice
Humans
Internship and Residency
junior doctors
Male
Medical Knowledge
Patient Care
Photography
Practice-Based Learning and Improvement
Prospective Studies
South Africa
Surgery
Surveys and Questionnaires
Young Adult
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Summary:Objective To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this. Design We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact preferred site for intercostal chest drain insertion. Setting This study was conducted in a large metropolitan university hospital in South Africa. Results A total of 152 JDs participated in the study. Among them, 63 (41%) were men, and the mean age was 24 years. There were 90 (59%) PGY1 doctors and 62 (41%) PGY2 doctors. Overall, 28% (42/152) of all JDs correctly identified the site that was located within the accepted safe triangle. A significantly higher proportion of PGY2 doctors selected the correct site when compared with PGY1 doctors (39% vs 20%, p = 0.026). Those who had prior ATLS provider training were 6.8 times more likely to be able to identify the correct site (RR = 6.8, 95% CI: 3.7-12.5). Conclusions Most of the JDs do not have sufficient anatomical knowledge to identify the safe insertion site for intercostal chest drain. Those who had undergone ATLS training were more likely to be able to identify the safe insertion site.
ISSN:1931-7204
1878-7452
DOI:10.1016/j.jsurg.2015.01.022