Clinical Practices Following Train-The-Trainer Trauma Course Completion in Uganda: A Parallel-Convergent...

Area of Science:

• Global Health
• Medical Education
• Trauma Surgery

Background:

• Evidence on trauma training impact in low- and middle-income countries (LMICs) is limited.
• Trauma care practices in Uganda were investigated to assess the effectiveness of training interventions.

Purpose of the Study:

• To evaluate the impact of the Kampala Advanced Trauma Course (KATC) on clinical practice in Ugandan facilities.
• To identify factors influencing the adoption of guideline-concordant trauma care behaviors.

Main Methods:

• Direct observation of 23 resuscitations using a structured tool.
• 27 semi-structured interviews with course-trained providers.
• Validated surveys assessing trauma resource availability.

Main Results:

• 83% of resuscitations lacked trained providers; inconsistent performance of essential assessments observed.
• Limited skill transference between trained and untrained staff; resource shortages were significant.
• Providers found KATC valuable but insufficient for facility-wide improvement due to retention and resource issues.

Conclusions:

• Short-term trauma training may have limited long-term impact without addressing systemic barriers.
• Recommendations include training more frontline providers, fostering skill retention, and improving facility resources.
• Sustainable improvements in trauma care require addressing both provider capacity and essential infrastructure.