Predictors of failure in the Advanced Trauma Life Support course
BACKGROUND: Over 1 million healthcare providers have participated in the Advanced Trauma Life
Support course. No studies have evaluated factors that predict course performance. This study aims to
identify these predictors.
METHODS: All participants taking the course at 2 centers over a 4-year period were identified.
Demographics, background, and performance data were extracted. Participants who failed were
compared with those who did not. Stepwise logistic regression analysis was used to identify independent
risk factors for failure.
RESULTS: Seven hundred forty-four healthcare providers participated in the course; 89.5% passed
and 10.5% failed. Failure rates were lowest (.0%) among Trauma/Surgical Critical Care (SCC)
providers and highest among pediatric providers (28.6%). Stepwise logistic regression identified age
greater than 55, English as a second language, pretest score less than 75, and non-Trauma/SCC and
non-Emergency Medicine background as predictors of failure.
CONCLUSIONS: A failure rate of 10.5% was demonstrated among the course participants. Age
greater than 55, English as second language, pretest score less than 75, and non-Trauma/SCC and
non-Emergency Medicine backgrounds were associated with failure. These subgroups may benefit
from performance improvement measures.