Telesimulation as a digital strategy for scaling trauma skills training for reach: a global partnership case study...

Injuries account for 8.5% of global deaths, with 83% occurring in low and middle-income countries (LMICs). India faces a significant trauma burden, with 153 972 road traffic fatalities in 2021, alongside a pronounced shortage of trained emergency care providers. Existing trauma training models, such as WHO-ICRC Basic Emergency Care and the Advanced Trauma Life Support course, while valuable, are resource-intensive. The COVID-19 pandemic has accelerated the adoption of virtual education, presenting an opportunity to scale trauma training in LMICs.This paper describes a novel, gamified trauma telesimulation activity designed to address these challenges. Using the each, Effectiveness, Adoption, Implementation and Maintenance framework, we assessed its reach, effectiveness, adoption, implementation and potential for maintenance. The activity involved 20 emergency medicine residents across four hospitals in India who participated in a competitive, single-elimination trauma simulation via Zoom. Scenarios focused on managing paediatric head trauma and adult polytrauma. A further 159 residents from 13 remote sites observed and contributed to scoring and debrief discussions. The initiative reached 179 trainees across 17 hospitals in 12 cities, spanning distances of over 2000 km. Adoption was facilitated by familiarity with online platforms, English as a shared language and stable connectivity. The model demonstrated feasibility for scaling trauma skills training in resource-limited settings. Future work should include mixed-methods evaluation, tracking clinical outcomes and establishing frameworks for local faculty to sustain delivery. Integrating telesimulation into national programmes and trauma registries may support broader health system strengthening. This model offers a promising, low-cost strategy to help address critical gaps in trauma training and workforce capacity in LMICs.