Laura Pinkham1,2, Fabio Botelho3,4, Minahil Khan5, Elena Guadagno4, Dan Poenaru6,4. 1. Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montreal, QC, H3G 2M1, Canada. laura.pinkham@mail.mcgill.ca. 2. , Montreal, Canada. laura.pinkham@mail.mcgill.ca. 3. Pediatric Surgeon, Hospital das Clínicas UFMG, Av. Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil. 4. Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada. 5. Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montreal, QC, H3G 2M1, Canada. 6. Centre for Health Outcomes Research (CORE), McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada.
Abstract
PURPOSE: Injury remains an important cause of death and disability globally, with 95% of all childhood injury deaths occurring in low- and lower-middle-income countries (LMICs). Pediatric trauma training, tailored to the resources in LMICs, represents an opportunity to improve such outcomes. We explored the nature of course offerings in pediatric trauma in resource-limited settings. METHODS: Seven databases were interrogated up to June 12, 2020, to retrieve articles examining pediatric trauma training in LMICs, as defined by the World Bank, without language restrictions. Independent authors reviewed and selected abstracts based on set criteria. Data from included studies was extracted and analyzed. An adapted Critical Appraisal Skills Programme checklist designed for cohort studies was used to assess the risk of bias. RESULTS: After screening 3960 articles for eligibility, 16 were included for final analysis. Course delivery methods included didactic modules, simulations, clinical mentorship, small group discussion, audits, assessments, and feedback. Knowledge acquisition was primarily assessed through pre/post-tests, clinical skills assessments, and self-assessment questionnaires. Twelve studies detailed course content, nine of which were based on the WHO Emergency Triage, Assessment and Treatment model, which is not specific to trauma. The other three studies involved locally developed pediatric trauma-focused training courses, including airway management, head trauma and cervical spine management, thoracic and abdominal trauma, orthopedic trauma, burn and wound management, and shock. CONCLUSION: Despite being essential to decreasing pediatric trauma morbidity and mortality worldwide, educational programs in pediatric trauma are not a widespread reality in low-and-middle-income countries. The development of accessible and efficient pediatric trauma education programs is critical for improving pediatric trauma quality of care.
PURPOSE: Injury remains an important cause of death and disability globally, with 95% of all childhood injury deaths occurring in low- and lower-middle-income countries (LMICs). Pediatric trauma training, tailored to the resources in LMICs, represents an opportunity to improve such outcomes. We explored the nature of course offerings in pediatric trauma in resource-limited settings. METHODS: Seven databases were interrogated up to June 12, 2020, to retrieve articles examining pediatric trauma training in LMICs, as defined by the World Bank, without language restrictions. Independent authors reviewed and selected abstracts based on set criteria. Data from included studies was extracted and analyzed. An adapted Critical Appraisal Skills Programme checklist designed for cohort studies was used to assess the risk of bias. RESULTS: After screening 3960 articles for eligibility, 16 were included for final analysis. Course delivery methods included didactic modules, simulations, clinical mentorship, small group discussion, audits, assessments, and feedback. Knowledge acquisition was primarily assessed through pre/post-tests, clinical skills assessments, and self-assessment questionnaires. Twelve studies detailed course content, nine of which were based on the WHO Emergency Triage, Assessment and Treatment model, which is not specific to trauma. The other three studies involved locally developed pediatric trauma-focused training courses, including airway management, head trauma and cervical spine management, thoracic and abdominal trauma, orthopedic trauma, burn and wound management, and shock. CONCLUSION: Despite being essential to decreasing pediatric trauma morbidity and mortality worldwide, educational programs in pediatric trauma are not a widespread reality in low-and-middle-income countries. The development of accessible and efficient pediatric trauma education programs is critical for improving pediatric trauma quality of care.
Authors: Jaymie Henry; Andrew Hill; James Jin; Salesi' Akau'ola; Cheng-Har Yip; Peter Nthumba; Emmanuel A Ameh; Stijn de Jonge; Mira Mehes; Iferemi Waiqanabete Journal: World J Surg Date: 2021-04-09 Impact factor: 3.352
Authors: Robin T Petroze; Jean Claude Byiringiro; Georges Ntakiyiruta; Susan M Briggs; Dan L Deckelbaum; Tarek Razek; Robert Riviello; Patrick Kyamanywa; Jennifer Reid; Robert G Sawyer; J Forrest Calland Journal: World J Surg Date: 2015-04 Impact factor: 3.352