Cognitive Knowledge Decline after Advanced Trauma Life Support Courses

A. Blumenfeld, R. Abraham, Margit Stein, S. C Shapira, Anat Reiner-Benaim, Benjamin Reiser, Avraham Rivkind, J Shemer

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


To assess the cognitive knowledge decline among graduates of the Advanced Trauma Life Support (ATLS) program in Israel, to compare the rate of decline between surgeons and nonsurgeons, and to recommend appropriate timing for refresher courses. A prospective study based on multiple-choice question test results of 220 ATLS course graduates was conducted 3 to 60 months after course completion. These results were then compared with the examination results immediately after the course. A statistical model based on survival analysis was used to evaluate the decline pattern and extent and to compare the study groups. A significant decline of cognitive knowledge over time among ATLS graduates was demonstrated. This decline was significantly greater in the nonsurgical group. A critical point of 20% cognitive knowledge loss among 50% of the examined physicians was observed around the 180th week after completion of the course. Physicians taking the ATLS course lose a significant part of their acquired cognitive knowledge after 3.5 years. Surgeons retain their cognitive knowledge for longer periods of time. Based on the study results, the optimal timing for a refresher course is between 3 and 4 years after the initial ATLS course.
Original languageEnglish
Pages (from-to)513-516
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Issue number3
StatePublished - 1 Mar 1998
Externally publishedYes


  • ATLS
  • Knowledge decline

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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