Background: Despite China’s 1.4 billion population and massive investment in improving medical education, there is no transformational national or international course focused on emergency trauma care. In order to overcome recognized deficiencies, we developed an affordable knowledge and skills workshop called Essential Trauma Critical Care China (ETCCC). Methods: Pre-course and post-course MCQs were used to test knowledge and simulation scenarios quantified clinical competence. Structured feedback was obtained. To evaluate the effect of ETCCC on staff performance, we analyzed the clinical records and questioned resuscitation team peers for trauma patients requiring resuscitation room intervention in the 10 consecutive patients before and after the workshops. Results: During 2022–2023, five workshops were delivered to participants from six hospitals in two Chinese provinces. Cost per participant did not exceed US$125. Fifty-eight doctors and 37 nurses participated. For all delegates pre-course knowledge scores increased from mean 35% to 70% post-course. 99% (n = 82/83) participants reached the required standard in the post-course written test. Post-course skills tests scores were mean 67% for doctors and 84% for nurses. Nurses demonstrated significant improvements in the rate and quality of trauma history acquisition as well as triage skills after the course (all p < 0.01). Doctors scored significant improvement in the areas of leadership and teamwork, care of cervical spine, circulation assessment and fluid resuscitation (all p < 0.02). Conclusion: Essential Trauma Critical Care China (ETCCC) is the first economically developed medical educational tool shown to improve performance of emergency room staff. Its success may have relevance for trauma-care education in similar medium-resource environments.

Ali, J., Cohen, R., Adam, R., et al. (1996). Teaching Effectiveness of the Advanced Trauma Life Support Program as Demonstrated by an Objective Structured Clinical Examination for Practicing Physicians. World Journal of Surgery, 20(8), 1121–1126. https://doi.org/10.1007/s002689900171

Ali, J., Howard, M., Williams, J. (2002). Is attrition of advanced trauma life support acquired skills affected by trauma patient volume? The American Journal of Surgery, 183(2), 142–145.

American College of Surgeons’ Committee. (2013). Advanced trauma life support (ATLS(R): The ninth edition. Journal of Trauma and Acute Care Surgery, 74(5), 1363–1366.

Bergs, E. A. G., Rutten, F. L. P. A., Tadros, T., et al. (2005). Communication during trauma resuscitation: do we know what is happening? Injury, 36(8), 905–911. https://doi.org/10.1016/j.injury.2004.12.047

Blumenfeld, A., Abraham, R. B., Stein, M., et al. (1998). Cognitive Knowledge Decline after Advanced Trauma Life Support Courses. The Journal of Trauma: Injury, Infection, and Critical Care, 44(3), 513–516. https://doi.org/10.1097/00005373-199803000-00017

Duan, L., Ye, P., Haagsma, J. A. (2019). The burden of injury in China, 1990–2017: Findings from the Global Burden of Disease Study 2017. Lancet Public Health 4(9): e449–e461. https://doi.org/10.1016/S2468-2667(19)30125-2

He, A. J. (2014). The doctor–patient relationship, defensive medicine and overprescription in Chinese public hospitals: Evidence from a cross-sectional survey in Shenzhen city. Social Science & Medicine, 123, 64–71. https://doi.org/10.1016/j.socscimed.2014.10.055

He, J., Gu, D., Wu, X., et al. (2005). Major Causes of Death among Men and Women in China. New England Journal of Medicine, 353(11), 1124–1134. https://doi.org/10.1056/nejmsa050467

Hedges, J. R., Adams, A. L., & Gunnels, M. D. (2002). ATLS practices and survival at rural level iii trauma hospitals, 1995–1999. Prehospital Emergency Care, 6(3), 299–305. https://doi.org/10.1080/10903120290938337

Holcomb, J. B., Dumire, R. D., Crommett, J. W., et al. (2002). Evaluation of Trauma Team Performance Using an Advanced Human Patient Simulator for Resuscitation Training. The Journal of Trauma: Injury, Infection, and Critical Care, 52(6), 1078–1086. https://doi.org/10.1097/00005373-200206000-00009

Jayaraman, S., Sethi, D., Chinnock, P., et al. (2014). Advanced trauma life support training for hospital staff. Cochrane Database of Systematic Reviews, 2014(8). https://doi.org/10.1002/14651858.cd004173.pub4

Joshipura, M. K. (2008). Trauma Care in India: Current Scenario. World Journal of Surgery, 32(8). https://doi.org/10.1007/s00268-008-9634-5

Klapper, M. S. (1973). Understanding continuing medical education. The Journal of the Medical Association of the State of Alabama, 42(8), 535–536.

Li, Y., Li, C., Xu, J., et al. (2016). Emergency department enlargement in China: Exciting or bothering. Journal of Thoracic Disease, 8(5), 842–847. https://doi.org/10.21037/jtd.2016.03.19

Long, D. M. (2001). Competency based residency training: The next advance in graduate medical education. Acta Neurochir Suppl, 78, 153–158.

Mock, C., Nguyen, S., Quansah, R., et al. (2006). Evaluation of Trauma Care Capabilities in Four Countries Using the WHO‐IATSIC Guidelines for Essential Trauma Care. World Journal of Surgery, 30(6), 946–956. https://doi.org/10.1007/s00268-005-0768-4

Moore, D. E., Green, J. S., & Gallis, H. A. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29(1), 1–15. https://doi.org/10.1002/chp.20001

Morgan, R., Lloyd-Williams, F., Morgan-Warren, R. (1997). An early warning scoring system for detecting developing critical illness. Clin Intensive Care, 8(100).

Ologunde, R., Le, G., Turner, J., et al. (2017). Do trauma courses change practice? A qualitative review of 20 courses in East, Central and Southern Africa. Injury, 48(9), 2010–2016. https://doi.org/10.1016/j.injury.2017.06.007

Ornato, J. P., Craren, E. J., Nelson, N. M., et al. (1985). Impact of Improved Emergency Medical Services and Emergency Trauma Care on the Reduction in Mortality from Trauma. The Journal of Trauma: Injury, Infection, and Critical Care, 25(7), 575–579. https://doi.org/10.1097/00005373-198507000-00001

Pemberton, J., Rambaran, M., & Cameron, B. H. (2013). Evaluating the long-term impact of the Trauma Team Training course in Guyana: an explanatory mixed-methods approach. The American Journal of Surgery, 205(2), 119–124. https://doi.org/10.1016/j.amjsurg.2012.08.004

Peter, N. A., Pandit, H., Le, G., et al. (2016). Delivering a sustainable trauma management training programme tailored for low-resource settings in East, Central and Southern African countries using a cascading course model. Injury, 47(5), 1128–1134. https://doi.org/10.1016/j.injury.2015.11.042

Steinemann, S., Berg, B., Skinner, A., et al. (2011). In Situ, Multidisciplinary, Simulation-Based Teamwork Training Improves Early Trauma Care. Journal of Surgical Education, 68(6), 472–477. https://doi.org/10.1016/j.jsurg.2011.05.009

Sugrue, M., Seger, M., Kerridge, R., et al. (1995). A Prospective Study of the Performance of the Trauma Team Leader. The Journal of Trauma: Injury, Infection, and Critical Care, 38(1), 79–82. https://doi.org/10.1097/00005373-199501000-00021

Wang, H., & Xu, T. (2007). Attitudes to triage of Chinese emergency room patients in a Beijing tertiary hospital. Emergency Medicine Journal, 24(3), 232–232. https://doi.org/10.1136/emj.2006.043422

Wang, P., Li, N., Gu, Y., et al. (2010). Comparison of severe trauma care effect before and after advanced trauma life support training. Chinese Journal of Traumatology, 13(6), 341–344.

Wang, Z., Liu Q., Wang, H. (2013). Medical simulation-based education improves medicos’ clinical skills. The Journal of Biomedical Research, 27(2), 81–84.

Williamson, K., Williamson, K., Ramesh, R., Grabinsky, A. (2011). Advances in prehospital trauma care. International Journal of Critical Illness and Injury Science, 1(1), 44–50.

Xu, Z., Shi, T., Huang, L., et al. (2016). Analysis of the training effect of ETC training model in the emergency trauma surgery team within hospital. Journal of Clinical Emergency, 17(4), 256–256.

Yang, G., Wang. Y., Zeng. Y., et al. (2013). Rapid health transition in China, 1990–2010: Findings from the Global Burden of Disease Study 2010. Lancet, 381(9882), 1987–2015.

Yang, J. S., Hao, D. J. (2018). Dilemmas for nurses in China. Lancet, 392(10141), 30.