Assessing the impact of an emergency trauma course for senior medical students in Kenya

Wanjiku, Grace; Janeway, Hannah; Foggle, John; Partridge, Robert; Wang, Yvonne; Kearney, Alexis; Levine, Adam C.; Carter, Jane; Tabu, John

doi:10.1016/j.afjem.2017.04.013

Cited by 19 publications

(21 citation statements)

References 14 publications

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“…Medical education in Kenya is based at one of 11 approved universities and six years of undergraduate medical education are split between pre-clinical work, and clinical rotations [23] . Medical school graduates then disseminate across Kenya to fulfill a 12-month internship where individuals rotate through internal medicine, surgery, pediatrics, obstetrics and gynecology, and psychiatry and community mental health 24. , 25.…”

Section: Kenyan Health Educationmentioning

confidence: 99%

The status and future of emergency care in the Republic of Kenya

Lee

Wanjiku

Nduku

et al. 2022

African Journal of Emergency Medicine

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Kenya is a rapidly developing country with a growing economy and evolving health care system. In the decade since the last publication on the state of emergency care in Kenya, significant developments have occurred in the country's approach to emergency care. Importantly, the country decentralized most health care functions to county governments in 2013. Despite the triple burden of traumatic, communicable, and non-communicable diseases, the structure of the health care system in the Republic of Kenya is evolving to adapt to the important role for the care of emergent medical conditions. This report provides a ten-year interval update on the current state of the development of emergency medical care and training in Kenya, and looks ahead towards areas for growth and development. Of particular focus is the role emergency care plays in Universal Health Coverage, and adapting to challenges from the devolution of health care.

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Section: Kenyan Health Educationmentioning

confidence: 99%

The status and future of emergency care in the Republic of Kenya

Lee

Wanjiku

Nduku

et al. 2022

African Journal of Emergency Medicine

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“…Recommendations for improvement included more practical sessions, focus on orthopedics, and longer course duration Berndtson, 2019 [ 48 ] Ghana Trauma Evaluation and Management (TEAM) Medical students (62) TEAM training resulted in higher post-course scores (69.1%) compared to pre-course (44.2%) scores (p < 0.001). Ghanaian medical students indicated infrastructure, teamwork issues and lack of physical equipment as major barriers to trauma care Wanjiku, 2017 [ 49 ] Kenya “Emergency trauma course” Medical students (22) Immediately post-course, test scores and simulation scores increased by a mean of 15.5% and 45.5%, respectively (p = 0.0001). At nine months follow-up, simulation, knowledge and confidence scores had not significantly changed Hill, 2018 [ 50 ] Kenya Trauma Evaluation and Management (TEAM) Medical students (61) TEAM training resulted in higher post-course scores (72%) compared to pre-course (57%) scores (p < 0.001) Young, 2016 [ 51 ] Malawi Postgraduate Medical Education for Surgical Trauma Residents (12) The study reported on the creation of cohesive, national surgical residency programs with training in trauma care.…”

Section: Resultsmentioning

confidence: 99%

“…However, only 15/45 (33.3%) studies completed a formal needs assessment before implementing a trauma course. The needs assessments that were done examined factors such as availability of resources and personnel [ 14 , 19 , 24 , 25 , 29 , 41 , 44 , 49 , 60 , 62 , 63 ] local injury burden [ 24 , 44 , 60 ]; current training methods, gaps in training and future training requirements [ 14 , 16 , 19 , 25 , 29 , 41 , 46 , 49 , 56 , 60 , 63 ]; cost and suitability of the program [ 25 , 41 , 56 , 62 ]; and optimal course delivery plans [ 16 , 44 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…No studies described a recertification process. The two studies comparing retention of knowledge several months after course administration reported retained competencies in trauma knowledge and skills at nine months [ 49 ] and two years [ 45 ]. None of the studies examined long-term patient mortality and morbidity for a period greater than one year, nor compared results to pre-course parameters.…”

Section: Resultsmentioning

confidence: 99%

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Trauma Training Courses and Programs in Low‐ and Lower Middle‐Income Countries: A Scoping Review

et al. 2021

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Background Injury is the leading cause of morbidity and mortality in low- and lower middle-income countries (LMICs). Trauma training is a cost-effective way to improve injury outcomes. Several trauma programs have been implemented in LMICs; however, their scope and effectiveness remain unclear. In this review, we sought to describe and assess the current state of trauma training in LMICs. Methods We searched MEDLINE, Embase, Global Health, Cochrane Library, and ProQuest Dissertations & Theses Global for trauma training courses in LMICs. An additional gray literature search was conducted on university, governmental, and non- governmental organizations’ websites to identify trauma-related postgraduate medical education (PGME) opportunities. Results Most studies occurred in sub-Saharan Africa and participants were primarily physicians/surgeons, medical students/residents, and nurses. General and surgical trauma management courses were most common, followed by orthopedic trauma or plastic surgery trauma/burn care courses. 32/45 studies reported on participant knowledge and skills, 27 of which had minimal follow-up. Of the four studies commenting on cost of courses, only one demonstrated cost-effectiveness. Three articles evaluated post-course effects on patient outcomes, two of which failed to demonstrate significant improvements. Overall, 43.0% of LMICs have PGME programs with defined trauma competency requirements. Conclusions Current studies on trauma training in LMICs do not clearly demonstrate sustainability, cost-effectiveness, nor improved outcomes. Trauma training programs should be in response to a need, championed locally, and work within a cohesive system to demonstrate concrete benefits. We recommend standardized and contextualized trauma training with recertifications in LMICs for lasting and improved trauma care.

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“…Fifteen of the high-scoring manuscripts focus on seven specific content areas (ultrasound, trauma, pediatrics, pediatric trauma, neurological emergencies, toxicological emergencies). They span the years 2012-2018, are pub- lished in twelve journals, and highlight work in thirteen countries ( Table 2) [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Eleven of the manuscripts discuss general EM programs.…”

Section: Overview Of High-scoring Manuscriptsmentioning

confidence: 99%

Emergency Medicine Training Programs in Low- and Middle-Income Countries: A Systematic Review

Rybarczyk

Ludmer

Broccoli

et al. 2020

Annals of Global Health

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Background: Despite the growing interest in the development of emergency care systems and emergency medicine (EM) as a specialty globally, there still exists a significant gap between the need for and the provision of emergency care by specialty trained providers. Many efforts to date to expand the practice of EM have focused on programs developed through partnerships between higher-and lower-resource settings. Objective: To systematically review the literature to evaluate the composition of EM training programs in low-and middle-income countries (LMICs) developed through partnerships. Methods: An electronic search was conducted using four databases for manuscripts on EM training programs-defined as structured education and/or training in the methods, procedures, and techniques of acute or emergency care-developed through partnerships. The search produced 7702 results. Using a priori inclusion and exclusion criteria, 94 manuscripts were included. After scoring these manuscripts, a more in-depth examination of 26 of the high-scoring manuscripts was conducted. Findings: Fifteen highlight programs with a focus on specific EM content (i.e. ultrasound) and 11 cover EM programs with broader scopes. All outline programs with diverse curricula and varied educational and evaluative methods spanning from short courses to full residency programs, and they target learners from medical students and nurses to mid-level providers and physicians. Challenges of EM program development through partnerships include local adaptation of international materials; addressing the local culture(s) of learning, assessment, and practice; evaluation of impact; sustainability; and funding. Conclusions: Overall, this review describes a diverse group of programs that have been or are currently being implemented through partnerships. Additionally, it highlights several areas for program development, including addressing other topic areas within EM beyond trauma and ultrasound and evaluating outcomes beyond the level of the learner. These steps to develop effective programs will further the advancement of EM as a specialty and enhance the development of effective emergency care systems globally.

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Assessing the impact of an emergency trauma course for senior medical students in Kenya

Cited by 19 publications

References 14 publications

The status and future of emergency care in the Republic of Kenya

The status and future of emergency care in the Republic of Kenya

Trauma Training Courses and Programs in Low‐ and Lower Middle‐Income Countries: A Scoping Review

Emergency Medicine Training Programs in Low- and Middle-Income Countries: A Systematic Review

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