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World Journal of Surgery
Published in: World Journal of Surgery 12/2021

Open Access 01-12-2021 | Scientific Review

Trauma Training Courses and Programs in Low- and Lower Middle-Income Countries: A Scoping Review

Authors: Rachel J. Livergant, Selina Demetrick, Xenia Cravetchi, Janice Y. Kung, Emilie Joos, Harvey G. Hawes, Abdullah Saleh

Published in: World Journal of Surgery | Issue 12/2021

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Abstract

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.
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Metadata
Title
Trauma Training Courses and Programs in Low- and Lower Middle-Income Countries: A Scoping Review
Authors
Rachel J. Livergant
Selina Demetrick
Xenia Cravetchi
Janice Y. Kung
Emilie Joos
Harvey G. Hawes
Abdullah Saleh
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 12/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-06283-1

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