Open AccessTrauma Training Courses and Programs in Low‐ and Lower Middle‐Income Countries: A Scoping Review
Author(s) -
Livergant Rachel J.,
Demetrick Selina,
Cravetchi Xenia,
Kung Janice Y.,
Joos Emilie,
Hawes Harvey G.,
Saleh Abdullah
Publication year - 2021
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-021-06283-1
Subject(s) - medicine , cochrane library , medline , occupational safety and health , global health , health care , family medicine , medical education , nursing , public health , surgery , randomized controlled trial , pathology , political science , law , economics , economic growth
Background Injury is the leading cause of morbidity and mortality in low‐ and lower middle‐income countries (LMICs). Trauma training is a cost‐effective way to improve injury outcomes. Several trauma programs have been implemented in LMICs; however, their scope and effectiveness remain unclear. In this review, we sought to describe and assess the current state of trauma training in LMICs. Methods We searched MEDLINE, Embase, Global Health, Cochrane Library, and ProQuest Dissertations & Theses Global for trauma training courses in LMICs. An additional gray literature search was conducted on university, governmental, and non‐ governmental organizations’ websites to identify trauma‐related postgraduate medical education (PGME) opportunities. Results Most studies occurred in sub‐Saharan Africa and participants were primarily physicians/surgeons, medical students/residents, and nurses. General and surgical trauma management courses were most common, followed by orthopedic trauma or plastic surgery trauma/burn care courses. 32/45 studies reported on participant knowledge and skills, 27 of which had minimal follow‐up. Of the four studies commenting on cost of courses, only one demonstrated cost‐effectiveness. Three articles evaluated post‐course effects on patient outcomes, two of which failed to demonstrate significant improvements. Overall, 43.0% of LMICs have PGME programs with defined trauma competency requirements. Conclusions Current studies on trauma training in LMICs do not clearly demonstrate sustainability, cost‐effectiveness, nor improved outcomes. Trauma training programs should be in response to a need, championed locally, and work within a cohesive system to demonstrate concrete benefits. We recommend standardized and contextualized trauma training with recertifications in LMICs for lasting and improved trauma care.