Trauma Training for Emergency Department Physicians in Low- and Middle-Income Countries: A Scoping Review

Trauma is a leading cause of morbidity and mortality globally, and a disproportionate burden falls on low- and middle-income countries (LMICs). Proper triage and prompt resuscitation are critical to providing life-saving care for these patients. Emergency Medicine (EM) is a rapidly growing field, and Emergency Department (ED) physicians often manage the immediate care for trauma patients. However, given a lack of EM residencies and EM-specialized physicians in many LMICs, EDs are often staffed by general practitioners who may have limited formal trauma training. This review assesses the scope of published literature on trauma-specific training for ED physicians in LMICs.

A literature search was conducted in April 2025 using PubMed, EMBASE, and Scopus databases for publications about trauma training efforts for ED physicians in LMICs. Titles and abstracts were screened by two independent reviewers with discrepancies resolved by a third reviewer. Full-text articles in English were included. Secondary literature and articles addressing pre-hospital settings were excluded. Full-text review and data extraction were performed by two independent reviewers.

261 unique articles were identified in the search and 14 articles from 12 LMICs were included. Studies primarily assessed the impact of short trauma courses averaging 2.65 days. Ten articles studied their impact on provider knowledge and confidence, three assessed clinical impact, and one detailed the process of creating a trauma course. Overall, articles were limited by small sample sizes and heterogeneous participant cohorts.

ED physicians play a critical role in trauma care, yet in LMICs their trauma-specific training is limited. This review identified various short trauma courses demonstrating promising, yet limited, results in LMICs. Longitudinal assessment of knowledge retention, evaluation of skill application in clinical practice, and measurement of training effectiveness through clinical outcomes are opportunities to ensure adequate trauma education for ED physicians and strengthen trauma systems globally.