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Training in paediatric trauma: the problem of safer societies
James Hamill1, Spencer W Beasley
1Department of Paediatric Surgery, Starship Children's Hospital, Auckland, New Zealand. jamesh@adhb.govt.nz
Insights
Paediatric surgeons need diverse training experiences due to declining major trauma cases in children. Ensuring advanced trainees gain varied skills is crucial for competent care of severely injured children.
Area of Science:
- Pediatric Surgery
- Trauma Care
- Surgical Education
Background:
- Childhood trauma is a leading global cause of death.
- Major pediatric trauma incidence is decreasing in developed nations.
- This decline impacts surgical training opportunities.
Purpose of the Study:
- To assess paediatric surgeons' and trainees' views on trauma training.
- To evaluate the perceived importance of different trauma training modalities.
Main Methods:
- A survey was distributed to Australasian paediatric surgeons and trainees.
- Questionnaires gathered data on completed trauma courses, surgical experience, and training attitudes.
Main Results:
- Response rate was 49% (51/105).
- Most consultants (82%) and all trainees completed the Early Management of Severe Trauma course.
- Definitive Surgical Trauma Care course completion was lower (22% consultants, 1 trainee).
- 71% of responders performed 1-5 trauma laparotomies annually.
- Consultants with general surgery fellowships valued adult trauma experience more.
Conclusions:
- Limited major pediatric trauma cases necessitate varied training sources.
- Advanced paediatric surgical trainees require diverse skills for complex trauma cases.
- Ensuring comprehensive training is vital for pediatric trauma patient outcomes.
Background:
Trauma remains the most common cause of child death worldwide but the incidence of major trauma is declining in many developed countries: this has implications for training.
Methods:
A survey of paediatric surgeons and paediatric surgical trainees was undertaken to evaluate perceptions of the relative importance of various forms of trauma training. A questionnaire was e-mailed to Australasian paediatric surgeons and trainees to determine trauma courses they had undertaken, operative and non-operative paediatric trauma experience and attitudes towards trauma training.
Results:
The overall response rate was 49% (40 of 83 consultants and 11 of 22 trainees). The Early Management of Severe Trauma course had been undertaken by 82% of consultants and all trainees. The Definitive Surgical Trauma Care course had been undertaken by 22% of consultants and one trainee. The number of trauma laparotomies carried out in the previous year was in the one to five range for 71% of responders. Greater emphasis was placed on the value of adult trauma experience by consultants who had a general surgical fellowship.
Conclusion:
In societies where major trauma in children is relatively rare (fortunately) and the opportunities for training are limited, it is important to ensure that advanced trainees in paediatric surgery gain sufficient skills from a variety of sources to enable them to treat competently the severely injured child with multiple injuries.