Developing sustainable prehospital trauma education in Rwanda.

Area of Science:

• Emergency Medicine
• Trauma Care
• Medical Education

Background:

• Over 5 million annual global deaths result from trauma.
• In Kigali, Rwanda, 50% of prehospital care by the public system (SAMU) is trauma-related.
• International best practices informed the development of a localized training program.

Purpose of the Study:

• To implement and evaluate a context-specific prehospital Emergency Trauma Care Course (ETCC) and train-the-trainers program for Rwandan prehospital providers.
• To assess the effectiveness of the ETCC in improving trauma care knowledge and skills.
• To establish a sustainable, local capacity for prehospital trauma education.

Main Methods:

• A two-day ETCC was designed with lectures and simulation-based practical sessions, including skills like IV access and needle decompression.
• Two cohorts were trained: an instructor core from SAMU and hospital emergency staff.
• Pre- and post-course assessments were conducted and analyzed using statistical tests (Student's t-test, paired t-tests, ANOVA).

Main Results:

• Participant scores significantly improved post-course (ETCC 1: 40% to 63%; ETCC 2: 41% to 78%; p < 0.001).
• ANOVA indicated that all participants achieved similar post-course scores regardless of baseline training.
• The train-the-trainers model successfully equipped local staff to deliver the ETCC.

Conclusions:

• The study confirms the successful implementation and effectiveness of a context-specific prehospital trauma training program in Kigali, Rwanda.
• The ETCC and train-the-trainers model demonstrably improved knowledge for both the instructor core and hospital staff.
• This program offers a viable strategy for building sustainable prehospital trauma care capacity in Rwanda through local expertise.