Medical Progress and Medical Education During the War

Maintaining health professional education during war: A scoping review

“…[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Barriers involving the curriculum included time constraints, 20,27 lack of expertise with wartime topics, 30 decreased training in civilian topics such as primary and preventative care, 18,[38][39][40] and lack of standardisation and quality of the curriculum. 41,42 The interventions implemented included shortening of training time such as eliminating summer vacations or planned breaks and opening new schools. 18,21,32,[43][44][45][46] Many countries adapted their curricula to integrate the management of war casualties, trauma care, infectious diseases, and mental health.…”

“…18,21,32,[43][44][45][46] Many countries adapted their curricula to integrate the management of war casualties, trauma care, infectious diseases, and mental health. 27,29,41 Residency training programmes were adapted to address military needs such as increased demand for anaesthesia and surgical training programmes. 19,30,39 There were educational advances in clinical care and surgical specialty development (e.g., trauma surgery and neurosurgery), along with research (e.g., advances in wound care and new operative techniques) and health professional development.…”

“…19,30,39 There were educational advances in clinical care and surgical specialty development (e.g., trauma surgery and neurosurgery), along with research (e.g., advances in wound care and new operative techniques) and health professional development. 38,41 More recent interventions included the use of telemedicine and web-based educational platforms to address gaps in faculty expertise and clinical experience. 34,42 Disruptions in access to educational resources such as supplies, teaching materials, and infrastructure were a common theme throughout the literature.…”

“…44 In contrast, of these interventions decrease trainee breadth of experience and exposure, and trainees may not be adequately prepared for treating civilian chronic and primary care maladies in the future. 18,41 Post conflict efforts need to be implemented to assess these students' clinical competency necessitating remediation of identified gaps in knowledge and skills. Despite interventions to mitigate resource and infrastructure destruction and personnel depletion, medical education is designed around clinical patient care encounters, which must be maintained to provide adequate training but are challenging to maintain in appropriate numbers for learning in war settings.…”

Bromine, bear-claw scratch fasciotomies, and the Eagle effect: management of group A streptococcal necrotising fasciitis and its association with trauma

“…51 Whilst deaths of the wounded in the US army was 8.26% in the First World War, this decreased to 4.5% in the Second World War during which American soldiers were issued sulphonamide powder in first aid packs, along with improved surgical techniques. 52,61 Sulphonamide usage on wounds escalated from 1942, but rather than sprinkling, the drug was dumped in lumps on wounds, thereby reducing drug absorption. Meanwhile, the importance of adequate wound debridement was neglected.…”