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Implementation of structured trauma training for firstyear surgical residents in Ethiopia: a novel pilot program in a low income country

  • Segni Kejela (Department of Surgery, Addis Ababa University College of Health Sciences) ;
  • Meklit Solomon Gebremariam (Addis Ababa University College of Health Sciences)
  • 투고 : 2024.02.09
  • 심사 : 2024.05.08
  • 발행 : 2024.06.30

초록

Purpose: Curricula for surgical residents should include training in trauma care; however, such training is absent in many low income countries. At the largest surgical training institution in Ethiopia, a trauma training program was developed, integrated into the existing surgical curriculum, and implemented. This study was conducted to evaluate the trainees' response to the new program. Methods: Over a 5-month period, 35 first-year surgical residents participated in weekly trauma care training sessions. The program included journal clubs, practical sessions, didactic sessions, and case-based discussions. Six months after the conclusion of the training, changes in knowledge, attitude, and practices were evaluated through a self-report survey. Results: For knowledge-based items, the survey data revealed reported improvements in 83.8% to 96.8% of students. Furthermore, 90.3% to 93.5% of participants indicated improvements in practice, while 96.7% exhibited a change in attitude. Respondents reported that attending didactic courses improved their presentation skills and facilitated the acquisition of knowledge. They suggested the inclusion of additional practical sessions. Conclusions: Training structures that are simple to implement are crucial for residency programs with limited resources. Such programs can be developed using existing academic staff and can aid residents in delivering improved care to trauma patients.

키워드

과제정보

The authors acknowledge Dr. Alliya S. Qazi (University of California, Irvine, Irvine, CA, USA) for her contributions to the preparation of the curriculum and this manuscript.

참고문헌

  1. Haagsma JA, Graetz N, Bolliger I, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev 2016;22:3-18. 
  2. World Health Organization (WHO). Injuries and violence: the facts 2014. WHO; 2014. 
  3. Laytin AD, Debebe F. The burden of injury in low-income and middle-income countries: knowing what we know, recognising what we don't know. Emerg Med J 2019;36:387-8. 
  4. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1789-858. 
  5. Petroze RT, Byiringiro JC, Ntakiyiruta G, et al. Can focused trauma education initiatives reduce mortality or improve resource utilization in a low-resource setting? World J Surg 2015;39:926-33. 
  6. Navarro S, Montmany S, Rebasa P, Colilles C, Pallisera A. Impact of ATLS training on preventable and potentially preventable deaths. World J Surg 2014;38:2273-8. 
  7. Riaz Q, Saqib SU, Siddiqui NA. Changing face of trauma and surgical training in a developing country: a literature review. J Pak Med Assoc 2020;70(Suppl 1):S89-94. 
  8. Kornfeld JE, Katz MG, Cardinal JR, Bat-Erdene B, Jargalsaikhan G, Nunez J. Cost analysis of the Mongolian ATLS© program: a framework for low- and middle-income countries. World J Surg 2019;43:353-9. 
  9. Tolppa T, Vangu AM, Balu HC, Matondo P, Tissingh E. Impact of the primary trauma care course in the Kongo Central province of the Democratic Republic of Congo over two years. Injury 2020;51:235-42. 
  10. Wanjiku G, Janeway H, Foggle J, et al. Assessing the impact of an emergency trauma course for senior medical students in Kenya. Afr J Emerg Med 2017;7:167-71. 
  11. Goldstein E, Murray-Garcia J, Sciolla AF, Topitzes J. Medical students' perspectives on trauma-informed care training. Perm J 2018;22:17-126. 
  12. Lin HL, Chen CW, Lee WC, et al. Effects of the Emergency Trauma Training Course on the confidence of final-year medical students dealing with trauma patients. Kaohsiung J Med Sci 2009;25:10-5. 
  13. Ramadurai D, Knoeckel J, Stace RJ, Stella S. Feasibility and impact of trauma-informed care training in internal medicine residency: a pilot study. Cureus 2022;14:e22368. 
  14. Alwawi A, Amro N, Inkaya B. The effectiveness of the primary trauma care courses in West Bank, Palestine: are the outcomes acceptable? J Educ Pract 2019;10:105-9. 
  15. Odendaal JJ, Kong VY, Liu T, Sartorius B, Oosthuizen GV, Clarke DL. Barriers to accessing ATLS provider course for junior doctors at a major university hospital in South Africa. S Afr J Surg 2017;55:10-5. 
  16. Kadhum M, Sinclair P, Lavy C. Are Primary Trauma Care (PTC) courses beneficial in low- and middle-income countries: a systematic review. Injury 2020;51:136-41. 
  17. Nogaro MC, Pandit H, Peter N, et al. How useful are Primary Trauma Care courses in sub-Saharan Africa? Injury 2015;46:1293-8. 
  18. Joseph EA, Martins RS, Tariq J, Aziz N, Inam H, Malik MA. Surgical education and training during the COVID-19 pandemic: strategies and solutions for Pakistan. J Pak Med Assoc 2021;71(Suppl 1):S83-8. 
  19. Chenard-Roy J, Guitton MJ, Thuot F. Online residency training during the COVID-19 pandemic: a national survey of otolaryngology head and neck surgery program directors. J Otolaryngol Head Neck Surg 2021;50:65.