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Larraga-García B, Quintana-Díaz M, Gutiérrez Á. The Need for Trauma Management Training and Evaluation on a Prehospital Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13188. [PMID: 36293767 PMCID: PMC9602774 DOI: 10.3390/ijerph192013188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Trauma is one of the leading causes of death in the world, being the main cause of death in people under 45 years old. The epidemiology of these deaths shows an important peak during the first hour after a traumatic event. Therefore, learning how to manage traumatic injuries in a prehospital setting is of great importance. Medical students from Universidad Autónoma performed 66 different simulations to stabilize a trauma patient on a prehospital scene by using a web-based trauma simulator. Then, a panel of trauma experts evaluated the simulations performed, observing that, on average, an important number of simulations were scored below 5, being the score values provided from 0, minimum, to 10, maximum. Therefore, the first need detected is the need to further train prehospital trauma management in undergraduate education. Additionally, a deeper analysis of the scores provided by the experts was performed. It showed a great dispersion in the scores provided by the different trauma experts per simulation. Therefore, a second need is identified, the need to develop a system to objectively evaluate trauma management.
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Affiliation(s)
- Blanca Larraga-García
- Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Álvaro Gutiérrez
- Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Sarmasoglu Kilikcier S, Celik N, Elcin M, Keskin G, Senel E. Impact of interprofessional in situ simulations on acute pediatric burn management: Combining technical and non-technical burn team skills. Burns 2021; 48:1653-1661. [PMID: 34955296 DOI: 10.1016/j.burns.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 10/22/2021] [Accepted: 11/11/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aimed to evaluate the impact of interprofessional in situ simulations on the technical and non-technical skills of pediatric burn teams in acute burn management. METHODS This quasi-experimental study consisted of a one-group pre- and post-test design conducted in a pediatric burn center in Turkey. The sample consisted of nine interprofessional burn team members. Data collection tools consisted of the following: descriptive data form, burn technical skills checklists, simulation evaluation form, and Anesthesiologists' non-technical skills in Denmark rating form. RESULTS We found no statistically significant difference between the pre- and post-test scores for technical (p = 0.285) and non-technical skill (p = 0.180) scores. Burn team members evaluated the highest score in almost all criteria for in situ simulations. CONCLUSION The interprofessional in situ simulations did not improve the burn teams' acute burn management; however, according to a self-report, burn team members were satisfied with the interprofessional in situ simulation experiences and achieved their own gains.
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Affiliation(s)
- Senay Sarmasoglu Kilikcier
- Hacettepe University, Faculty of Nursing, Department of Fundamentals of Nursing/Graduate School of Health Sciences, Department of Simulation in Healthcare, 06100 Ankara, Turkey.
| | - Nazmiye Celik
- University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Department of Pediatric Burn Center, 06110 Ankara, Turkey.
| | - Melih Elcin
- Hacettepe University, Faculty of Medicine, Department of Medical Education and Informatics/Graduate School of Health Sciences, Department of Simulation in Healthcare 06100 Ankara, Turkey.
| | - Gulsen Keskin
- University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Department of Anesthesia, 06110 Ankara, Turkey.
| | - Emrah Senel
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Pediatric Surgery,06110 Ankara, Turkey.
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Jouda M, Finn Y. Training in polytrauma management in medical curricula: A scoping review. MEDICAL TEACHER 2020; 42:1385-1393. [PMID: 32877262 DOI: 10.1080/0142159x.2020.1811845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Polytrauma (PT) is a leading cause of morbidity and mortality worldwide. However, it is unknown if PT teaching is taught or adequately included in undergraduate medical curricula. We conducted this scoping review to explore the literature on undergraduate PT training. METHODS Using Arksey and O'Malley's five stage framework, a scoping review was conducted. Nine medical and educational databases, including PubMed, MEDLINE, Scopus, CINAHL, PsycINFO, and EMBASE were searched using keywords identified by the authors. Eligible studies were limited to the English language, with no set limitations on the year of publication. Studies reporting on PT teaching in undergraduate medical curricula were included. RESULTS Nine studies were included. The articles were sub-categorised into three themes: current teaching of PT in medical curricula, trauma management courses and simulation-based trauma education. Four out of five studies on PT teaching in the curriculum were rated as inadequate by current or past students; on the other hand, three out of four trauma management/simulation courses were evaluated and all three were rated positively by students. Three trauma management courses compared students pre- and post-course scores on a written or practical test and reported significant improvement in post-course scores. CONCLUSIONS There is a relative paucity of literature on undergraduate PT training. There is a need for more research to explore how to deliver effective PT teaching to medical students.
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Affiliation(s)
- Mohammed Jouda
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Yvonne Finn
- School of Medicine, National University of Ireland Galway, Galway, Ireland
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Egro FM, Johnson ED, Kenny EM, Foglio AM, Smith BT, Corcos AC, Ziembicki JA. A Qualitative Survey Study of United States Burn Units: Pathways to a Career in Burn Surgery. J Burn Care Res 2020; 40:595-600. [PMID: 31032517 DOI: 10.1093/jbcr/irz071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
With current changes in training requirements, it is important to understand the venues in the United States for a general surgery (GS) and plastic surgery (PS) resident interested in pursuing a burn surgery career. The study aims to evaluate the pathways to a career in burn surgery and the current state of leadership. A cross-sectional study was conducted between August and September 2017. A 12-question survey was sent to all burn unit directors in the United States, asking about their background, who manages various aspects of burn care and the hiring requirements. Responses were received from 55 burn unit directors (47% response rate). Burn units are lead most commonly by physicians who received GS training (69%), but the majority either did not undergo fellowship training (31%) or completed a burn surgery fellowship (29%). While surgical care (GS = 51%, PS = 42%) and wound care (GS = 51%, PS = 42%) were predominantly managed by GS- or PS-trained burn teams, management of other aspects of burn care varied depending on the institution, demonstrating that a shift in burn care management. The desired hiring characteristics, including GS (67%) or PS residency (44%) and a burn surgery (55%), trauma surgery (15%), or critical care (44%) fellowship. Directors' training significantly influenced their preferences for hiring requirements. While leadership in burn surgery is dominated by GS-trained physicians, the surgical and wound care responsibilities are shared among PS and GS. Although one third of current directors did not undergo fellowship training, aspiring surgeons are advised to obtain a burn surgery and/or critical care fellowship.
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Affiliation(s)
- Francesco M Egro
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Erica D Johnson
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Elizabeth M Kenny
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Aaron M Foglio
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Brandon T Smith
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Alain C Corcos
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
| | - Jenny A Ziembicki
- University of Pittsburgh Medical Center Mercy Burn Center, Pennsylvania
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Schyma BM, Cole E, Wren SM, Brohi K, Brundage SI. Delivering trauma mastery with an international trauma masters. Injury 2019; 50:877-882. [PMID: 30935745 DOI: 10.1016/j.injury.2019.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/14/2018] [Accepted: 03/16/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Trauma is a global problem. The goal of optimising multidisciplinary trauma care through speciality education is a challenge. No single pathway exists to educate care providers in trauma knowledge, management and skills. Queen Mary University of London (QMUL) devised an online electronic learning (e-learning) Master's degree (MSc) in Trauma Sciences in 2011. E-learning is increasingly popular however low progression rates question effectiveness. The further post-graduate impact is unknown. Our goal was to establish whether this program is a successful method of delivering multidisciplinary trauma education to an international community. We hypothesized that graduating students make a global impact in trauma care, education and research. METHODS The Trauma Sciences MSc programs launched in 2011. Electronic surveys were distributed worldwide to students who successfully completed the program between 2013-2016. Graduation rates, degree/qualification awarded, clinical involvement in trauma management, presentation of MSc work, academic progression and roles in trauma education were explored. Supporting demographics were extracted from the QMUL student database. RESULTS A total of 176 students, of 29 nationalities, enrolled in the two year course between 2011 and 2014. Clinical backgrounds included multi-speciality physicians (83.5%), nurses (9.6%) and paramedics (6.8%). 119 (67.6%) graduated within the study period, 108 (60.8%) with the full masters award. Completion was independent of clinical background (p = 0.20) and age (p = 0.99). Highest completion rates were seen in students from Australia and New Zealand, Asia and Europe (p = 0.03). All survey responders were currently providing regular clinical care to trauma patients. 73% (n = 36) were delivering trauma education, many at national or international level. 49% (n = 24) had presented work from the MSc and 23% (n = 11) published their dissertation.12% (n = 6) subsequently enrolled in a PhD program. CONCLUSION Compared with other e-learning courses this Masters program has an enviable completion rate. Graduates go on to make an international multidisciplinary impact with diverse roles in clinical management, research and trauma education. This programme provides a robust trauma education curriculum. The QMUL Trauma Sciences MSc program is an excellent resource for clinicians participating in any form of trauma care or who wish to augment sub-speciality training in trauma.
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Affiliation(s)
- Barry M Schyma
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK.
| | - Elaine Cole
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
| | - Sherry M Wren
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK; Department of Surgery, Stanford University, USA
| | - Karim Brohi
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
| | - Susan I Brundage
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, UK
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Hill KA, Johnson ED, Lutomia M, Puyana JC, Lee KK, Oduor PR, MacLeod JB. Implementing the Trauma Evaluation and Management (TEAM) Course in Kenya. J Surg Res 2018; 232:107-112. [PMID: 30463705 DOI: 10.1016/j.jss.2018.05.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/24/2018] [Accepted: 05/30/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Trauma training provides crucial knowledge and skills for health-care providers in low- and middle-income countries (LMICs). Although such training has been adapted for physicians and emergency personnel in LMICs, few courses have been offered for medical students. The Trauma Evaluation and Management (TEAM) course, developed by the American College of Surgeons, provides a valuable framework for providing this content to medical students in an LMIC-context. MATERIALS AND METHODS We implemented the TEAM course at a single medical school in rural Kenya, for final-year medical students, utilizing the multimodal instruction and reference materials provided by the American College of Surgeons. We administered precourse and postcourse assessments, adapted the content for particular low-resource considerations, expanded the course to 2 d, and utilized a multidisciplinary and multinational group of surgical expert instructors. RESULTS The entire final-year medical school class participated, and all completed pretesting and posttesting (100%, n = 61). Posttesting revealed significant improvement (P < 0.001), demonstrating successful knowledge acquisition, with the greatest improvements among the poorest performing decile on the pretest (P < 0.05). On narrative course feedback (100% completion, n = 61), participants appreciated instructors' interactive teaching style and the course's practical demonstrations, while requesting more time allotment for trauma training. CONCLUSIONS We describe the feasibility of implementing TEAM training for final-year medical students in Kenya and demonstrate the course's effectiveness in this context as shown by knowledge acquisition. We plan for additional study to assess interval knowledge and skill retention. With refinement based on these results, we plan to repeat and expand trauma-education initiatives for medical students in LMICs.
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Affiliation(s)
- Katherine A Hill
- Department of Surgery, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, Pennsylvania.
| | - Erica D Johnson
- Department of Surgery, Division of Trauma and General Surgery, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, Pennsylvania
| | - Mark Lutomia
- Department of Surgery, Egerton University Medical School, Nakuru, Kenya
| | - Juan C Puyana
- Department of Surgery, Division of Trauma and General Surgery, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, Pennsylvania
| | - Kenneth K Lee
- Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, Digestive Disorders Center, Presbyterian Hospital, Pittsburgh, Pennsylvania
| | - Peter R Oduor
- Department of Surgery, Egerton University Medical School, Nakuru, Kenya
| | - Jana B MacLeod
- Department of Surgery, Division of Trauma and General Surgery, University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, Pennsylvania; Department of Surgery, Egerton University Medical School, Nakuru, Kenya
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LaGrone L, Riggle K, Joshipura M, Quansah R, Reynolds T, Sherr K, Mock C. Uptake of the World Health Organization's trauma care guidelines: a systematic review. Bull World Health Organ 2016; 94:585-598C. [PMID: 27516636 PMCID: PMC4969985 DOI: 10.2471/blt.15.162214] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/29/2016] [Accepted: 02/15/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To understand the degree to which the trauma care guidelines released by the World Health Organization (WHO) between 2004 and 2009 have been used, and to identify priorities for the future implementation and dissemination of such guidelines. METHODS We conducted a systematic review, across 19 databases, in which the titles of the three sets of guidelines - Guidelines for essential trauma care, Prehospital trauma care systems and Guidelines for trauma quality improvement programmes - were used as the search terms. Results were validated via citation analysis and expert consultation. Two authors independently reviewed each record of the guidelines' implementation. FINDINGS We identified 578 records that provided evidence of dissemination of WHO trauma care guidelines and 101 information sources that together described 140 implementation events. Implementation evidence could be found for 51 countries - 14 (40%) of the 35 low-income countries, 15 (32%) of the 47 lower-middle income, 15 (28%) of the 53 upper-middle-income and 7 (12%) of the 59 high-income. Of the 140 implementations, 63 (45%) could be categorized as needs assessments, 38 (27%) as endorsements by stakeholders, 20 (14%) as incorporations into policy and 19 (14%) as educational interventions. CONCLUSION Although WHO's trauma care guidelines have been widely implemented, no evidence was identified of their implementation in 143 countries. More serial needs assessments for the ongoing monitoring of capacity for trauma care in health systems and more incorporation of the guidelines into both the formal education of health-care providers and health policy are needed.
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Affiliation(s)
- Lacey LaGrone
- Harborview Injury Prevention and Research Center, Campus Box #356410, University of Washington, Seattle, WA 98104, United States of America (USA)
| | - Kevin Riggle
- Department of Surgery, University of Washington, Seattle, USA
| | | | - Robert Quansah
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, USA
| | - Charles Mock
- Harborview Injury Prevention and Research Center, Campus Box #356410, University of Washington, Seattle, WA 98104, United States of America (USA)
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Namias N, Marttos AC, Kuchkarian FM, Rojas DF, Collet-Silva FS, Costa CDA, Garcia GD, Schulman CI. Global Connections: Telemedicine as a Tool to extend Trauma Education. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10030-1060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Introduction
Telemedicine is revolutionizing the delivery of trauma care and education. The International Trauma Tele- Grand Rounds is a series that unites institutions worldwide to discuss complex clinical cases and advanced trauma and critical care topics.
Materials and methods
Multiple remote institutions connect simultaneously to discuss the management of a trauma patient from the prehospital phase to discharge. Weekly, a case is presented in English by one institution on a rotating basis. Key points include mechanism of injury, resuscitation, laboratory and imaging diagnostics, surgical interventions, postoperative patient care, evaluation of treatment decisions and review of the literature. The highly interactive format allows participants to evaluate differences in trauma care across international health systems.
Results
During 2010 to 2011, 68 sessions were documented. Cases include blunt (42.6%), penetrating (48.5%), blast (7.4%) and crushing (1.5%) traumas. Gunshot wounds were the most frequent (25%). A holistic range of injuries were represented including injuries to major arteries, veins, lungs, heart, pericardium, esophagus, diaphragm, abdominal wall, stomach, intestines, liver, kidneys, pelvis, and the extremities. A variety of surgical and nonsurgical interventions were explored. To date, there have been 42 participating institutions from the United States, Brazil, Colombia, Bahamas, Canada, Mexico, Venezuela, Argentina, Panama, Puerto Rico, Dominican Republic, British Virgin Islands, Spain, Thailand, Turkey and Iraq; ranging from academic medical centers military hospitals, community hospitals, and rural hospitals. In 2011, the series received accreditation by the Accreditation Council for Continuing Medical Education.
Conclusion
Telemedicine offers a solution to address the disparities in access to trauma care and education. The diversity of institutional settings allows participants to learn from others on how to best treat trauma patients, despite differences in resources and expertise. In addition to serving as an educational tool, the series provides a mechanism for physicians to network and collaborate on future endeavors.
How to cite this article
Marttos AC, Kuchkarian FM, Rojas DF, Fraga GP, Collet-Silva FS, de Almeida Costa C, Garcia GD, Ginzburg E, Schulman CI, Namias N. Global Connections: Telemedicine as a Tool to extend Trauma Education. Panam J Trauma Critical Care Emerg Surg 2013;2(1):62-66.
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