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Developing sustainable trauma care education in Egypt: sequential trauma education program, steps to success.

ABSTRACT: As one of the leading causes of death and disability in the world, human trauma and injury disproportionately affects individuals in developing countries. To meet the need for improved trauma care in Egypt, the Sequential Trauma Emergency/Education ProgramS (STEPS) course was created through the collaborative effort of U.S. and Egyptian physicians. The objective of course development was to create a high-quality, modular, adaptable, and sustainable trauma care course that could be readily adopted by a lower- or middle-income country.We describe the development, transition, and host nation sustainability of a trauma care training course between a high-income Western nation and a lower-middle-income Middle Eastern/Northern African country, including the number of physicians trained and the challenges to program development and sustainability.STEPS was developed at the University of Maryland, based in part on World Health Organization's Emergency and Trauma Care materials, and introduced to the Egyptian Ministry of Health and Population and Ain Shams University in May 2006. To date, 639 physicians from multiple specialties have taken the 4-day course through the Ministry of Health and Population or public/governmental universities. In 2008, the course transitioned completely to the leadership of Egyptian academic physicians. Multiple Egyptian medical schools and the Egyptian Emergency Medicine Board now require STEPS or its equivalent for physicians in training.Success of this collaborative educational program is demonstrated by the numbers of physicians trained, the adoption of STEPS by the Egyptian Emergency Medicine Board, and program continuance after transitioning to in-country leadership and trainers.

SUBMITTER: El-Shinawi M

PROVIDER: S-EPMC4469532 | biostudies-other | 2015 Jul-Aug

REPOSITORIES: biostudies-other

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Developing sustainable trauma care education in Egypt: sequential trauma education program, steps to success.

El-Shinawi Mohamed M McCunn Maureen M Sisley Amy C AC El-Setouhy Maged M Hirshon Jon Mark JM

Journal of surgical education 20150116 4

<h4>Introduction</h4>As one of the leading causes of death and disability in the world, human trauma and injury disproportionately affects individuals in developing countries. To meet the need for improved trauma care in Egypt, the Sequential Trauma Emergency/Education ProgramS (STEPS) course was created through the collaborative effort of U.S. and Egyptian physicians. The objective of course development was to create a high-quality, modular, adaptable, and sustainable trauma care course that co ...[more]

PMID: 25600355

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Project description:Importance:Studies suggest that a postnatal parental intervention may reduce the incidence of abusive head trauma (AHT) of infants and young children. Objective:To assess the effect of statewide universal AHT education for parents on AHT hospitalization rates in Pennsylvania and on parents' self-reported knowledge gains and parenting behaviors. Design, Setting, and Participants:Changes in AHT hospitalization rates in Pennsylvania before and during the intervention were compared with those in 5 other states lacking universal parental AHT education during the same period. Data were collected from maternity units and birthing centers throughout Pennsylvania from the parents of 1?593?834 infants born on these units from January 1, 2003, to December 31, 2013. Parental behavior and knowledge were assessed through immediate (n?=?16?111) and 7-month postintervention (n?=?146) parent surveys in a per protocol analysis of evaluable parents. Interventions:Parents read a brochure, viewed an 8-minute video about infant crying and AHT, asked questions of the nurse, and signed a commitment statement affirming their participation. Educational posters were displayed on each unit. Main Outcomes and Measures:Changes in AHT hospitalization rates before and during the intervention in Pennsylvania and 5 other states. Secondary outcomes included self-reported knowledge gains and changes in parenting practices. Results:A total of 1?180?291 parents (74.1%) of children ranging in age from 0 to 23 months signed a commitment statement. Incidence rate ratios for hospitalization for AHT increased in Pennsylvania from 24.1 (95% CI, 22.1-26.3) to 26.6 (95% CI, 24.9-28.4) per 100?000 children aged 0 to 23 months during the intervention period; changes in Pennsylvania were not significantly different from aggregate changes in the 5 other states, from 22.4 (95% CI, 21.2-23.6) to 22.0 (95% CI, 21.2-22.8) per 100?000 children aged 0 to 23 months. A total of 16?111 parents (21.5% men, 78.5% women) completed the postnatal survey. Despite an overall 74.1% adherence with the intervention, only 20.6% of parents saw the brochure and video and only 5.7% were exposed to the entire intervention. Among the respondents answering individual questions on the postnatal surveys, 10?958 mothers (91.0%) and 2950 fathers (88.6%) reported learning a lot about understanding infant crying as normal; 11?023 mothers (92.2%) and 2923 fathers (88.9%), calming their infant, 11?396 mothers (94.6%) and 3035 fathers (91.9%), calming themselves; 10?060 mothers (85.1%) and 2688 fathers (83.4%), selecting other infant caregivers; and 11?435 mothers (94.8%) and 3201 fathers (95.8%), that the information would decrease the likelihood of shaking an infant. Among the 143 respondents completing the 7-month survey, 109 (76.2%) reported remembering the information while their child was crying. Conclusions and Relevance:This intervention was not associated with a reduction in pediatric AHT hospitalization rates but was associated with self-reported gains in parental knowledge that were retained for 7 months.

Project description:Cancer incidence, morbidity, and mortality in the Commonwealth of Kentucky are among the highest in the nation. The University of Louisville was the recipient of a National Cancer Institute (NCI)-funded cancer education program grant in 1975 under the leadership of Dr. Norbert Burzynski. A new and totally redesigned performance-based University of Louisville Cancer Education Program was funded by NCI in 2011 to recruit and motivate outstanding undergraduate and health professional students to pursue further training and careers in cancer research. Here, we describe the strategy, design, methods, implementation, and accomplishments of our twenty-first century performance-based cancer education program. Our program will meet or exceed all of its 5-year performance goals, including the total number students (n = 156) and under-represented minorities (n = 53) who successfully completed the program under the mentorship of cancer research-intensive faculty members of the James Graham Brown Cancer Center (JGBCC). The mentored research program is complemented with professional development and enhancement activities, including cancer research seminars presented by faculty members actively engaged in research centered on the diagnosis, treatment or prevention of cancer, creation of individual career development plans, exploration of cancer research careers, and acquisition of professionalism skills. Student interests towards cancer research significantly increased after completion of the program compared to baseline (P = 0.02). Based on quantitative and qualitative analysis of various components of the curricula, the trainees favor practical, engaging, and interactive activities aligned within professional career goals and objectives. For instance, the trainees prefer two 30-min small group discussions on "Navigating Careers in Cancer Research" with faculty, professional students, and program alumni. Future updates to the program include new activities that capitalize on the cross-disciplinary background of our mentors and trainees as well as a team-based approach to professional development. Our cancer education program will continue to enhance the professional development of the next generation of cancer scientists and clinicians.

Project description:BackgroundHealth systems globally need to rapidly set and achieve targets for reaching net zero carbon emissions. Virtual consulting (including video- and telephone-based consulting) is regarded as one means by which this might be achieved, largely through reduced patient travel. Little is currently known about the ways in which forms of virtual consulting might contribute to the net zero agenda or how countries may develop and implement programs at scale that can support increased environmental sustainability.ObjectiveIn this paper, we asked, What is the impact of virtual consulting on environmental sustainability in health care? and What can we learn from current evaluations that can inform future reductions in carbon emissions?MethodsWe conducted a systematic review of published literature according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. We searched the MEDLINE, PubMed, and Scopus databases using key terms relating to "carbon footprint," "environmental impact," "telemedicine," and "remote consulting," using citation tracking to identify additional articles. The articles were screened, and full texts that met the inclusion criteria were obtained. Data on the approach to carbon footprinting reported reductions in emissions, and the opportunities and challenges associated with the environmental sustainability of virtual consultations were extracted into a spreadsheet, analyzed thematically, and theorized using the Planning and Evaluating Remote Consultation Services framework to consider the various interacting influences, including environmental sustainability, that shape the adoption of virtual consulting services.ResultsA total of 1672 papers were identified. After removing duplicates and screening for eligibility, 23 papers that focused on a range of virtual consulting equipment and platforms across different clinical conditions and services were included. The focus on the environmental sustainability potential of virtual consulting was unanimously reported through carbon savings achieved by a reduction in travel related to face-to-face appointments. The shortlisted papers used a range of methods and assumptions to determine carbon savings, reporting these using different units and across varied sample sizes. This limited the potential for comparison. Despite methodological inconsistencies, all papers concluded that virtual consulting significantly reduced carbon emissions. However, there was limited consideration of wider factors (eg, patient suitability, clinical indication, and organizational infrastructure) influencing the adoption, use, and spread of virtual consultations and the carbon footprint of the entire clinical pathway in which the virtual consultation was provided (eg, risk of missed diagnoses from virtual consultations that result in the need for subsequent in-person consultations or admissions).ConclusionsThere is overwhelming evidence that virtual consulting can reduce health care carbon emissions, largely through reducing travel related to in-person appointments. However, the current evidence fails to look at system factors associated with implementing virtual health care delivery and wider research into carbon emissions across the entire clinical pathway.

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Developing sustainable trauma care education in Egypt: sequential trauma education program, steps to success.

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Developing sustainable trauma care education in Egypt: sequential trauma education program, steps to success.

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