"A short trauma course for physicians in a resource-limited setting: Is low-cost simulation effective?"

Area of Science:

• Medical Education
• Trauma Care
• Global Health

Background:

• Intentional and unintentional injuries pose a significant disease burden in low- and middle-income countries (LMICs).
• Enhancing healthcare capacity for injury management is crucial for reducing morbidity and mortality.
• A tailored trauma curriculum using low-cost simulation was implemented in Managua, Nicaragua.

Purpose of the Study:

• To assess the effectiveness of a low-cost trauma curriculum in improving knowledge and skills of physicians in a low-resource setting.
• To evaluate the impact of traditional didactic methods combined with novel simulation techniques on trauma care education.

Main Methods:

• A 5-day trauma course was delivered to 33 attending and resident physicians in Managua, Nicaragua.
• Participants were evaluated using pre- and post-training written exams (26 questions) and simulation cases.
• The Wilcoxon signed-rank test analyzed differences in exam scores and simulation performance; time to critical actions was also assessed.

Main Results:

• Written examination scores improved by 26.3% (mean increase of 15.4%, p<0.001).
• Simulation scores, measured by critical actions completed, improved by 91.4% (mean increase of 33.67, p<0.001).
• Time to critical actions, including primary survey and cervical spine immobilization, was reduced by 55.9% and 46.6%, respectively.

Conclusions:

• The trauma curriculum demonstrated statistically significant improvements in participants' trauma knowledge and skills.
• Participants showed the greatest gains in simulation scenarios, adopting a standardized approach to trauma patient assessment and management.
• Low-cost simulation is a valuable and effective educational tool for improving trauma care in LMICs.