Piloting a pediatric trauma course in Western Jamaica: Lessons learned and future directions

Hadley K Wesson; Valerie Plant; Marieka Helou; Karen Wharton; Delroy Fray; Jeffrey Haynes; Charles Bagwell

doi:10.1016/j.jpedsurg.2017.01.003

Piloting a pediatric trauma course in Western Jamaica: Lessons learned and future directions

J Pediatr Surg. 2017 Jul;52(7):1173-1176. doi: 10.1016/j.jpedsurg.2017.01.003. Epub 2017 Jan 10.

Authors

Hadley K Wesson¹, Valerie Plant², Marieka Helou³, Karen Wharton⁴, Delroy Fray⁵, Jeffrey Haynes², Charles Bagwell⁶

Affiliations

¹ Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
² Division of Pediatric Surgery, Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA.
³ Department of Pediatrics, Virginia Commonwealth University Health System, Richmond, VA, USA.
⁴ Department of Neonatology, Mednax, Richmond, VA, USA.
⁵ Department of Pediatric Surgery, Cornwall Hospital, Montego Bay, Jamaica.
⁶ Division of Pediatric Surgery, Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA. Electronic address: Charles.bagwell@vcuhealth.org.

PMID: 28132766
DOI: 10.1016/j.jpedsurg.2017.01.003

Abstract

Introduction: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development.

Materials and methods: A pediatric trauma course was conducted at the Cornwall Regional Hospital in Montego Bay, Jamaica sponsored by the Children's Medical Services International, a nonprofit organization. Participants took part in six didactic modules, an infant airway intubation skills session, and three clinical simulation scenarios. Participants completed a postcourse survey at the conclusion of the course.

Results: Twenty-five participants including surgical, pediatric, and emergency medicine residents from regional- and district-level hospitals in Jamaica participated in the course. Participants viewed the course favorably. Strengths included good review of pediatric trauma physiology, short modules, hands-on practice, and applicable clinical scenarios. Using a Likert-type rating scale of 1 to 10, with 1 being minimal and 10 being very knowledgeable, precourse knowledge was ranked as 5.9, which increased to 9.2 after the course. Using a similar scale, the precourse comfort level to run a pediatric trauma was 4.9 and increased to 8.5 following the course.

Discussion: Implementation of this pilot pediatric trauma course was feasible and successful through collaboration with the hosting regional hospital. The lack of formal pediatric training can be overcome by a course such as this which includes both didactics and hands-on clinical patient simulations.

Level of evidence: 4.

Keywords: Jamaica; Low- and middle-income countries (LMICs); Patient simulation; Pediatric trauma; Trauma education.

MeSH terms

Airway Obstruction / therapy
Child
Clinical Competence*
Education, Medical, Continuing / methods
Emergency Medicine / education*
Hospitals, Pediatric
Humans
Intubation, Intratracheal / methods*
Jamaica
Laryngoscopy / education
Physicians
Wounds and Injuries / therapy*