Predictors of failure in the Advanced Trauma Life Support course

• We examine ATLS course participants at 2 medical centers over 4 years.
• Logistic regression analysis is used to identify risk factors for course failure.
• Age greater than 55, English as a second language, and low pretest scores predict failure.
• In addition, non-Trauma and non-Emergency Medicine backgrounds predict failure.
• These subgroups may benefit from performance improvement measures.

BackgroundOver 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.MethodsAll 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.ResultsSeven 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.ConclusionsA 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.