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Technology-Enhanced Trauma Training in Low-Resource Settings: A Scoping Review and Feasibility Analysis of Educational Technologies

  • Minahil Khan
    Affiliations
    Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
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  • Fabio Botelho
    Affiliations
    Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada

    Hospital Das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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  • Laura Pinkham
    Affiliations
    Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
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  • Elena Guadagno
    Affiliations
    Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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  • Dan Poenaru
    Correspondence
    Corresponding author. . The Montreal Children’s Hospital, Room B04.2028, 1001 Decarie Boulevard, Montreal, Quebec, H4A3J1 Tel.: +1 514 412 4498; fax: +1 514 412 4289.
    Affiliations
    Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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      Highlights

      • Lack of adequate trauma training contributes to trauma burden in LMICs.
      • Most technologies represented in trauma training literature are high-fidelity mannequins which are impractical to integrate in low-resource settings; virtual simulation, digital courses and video-assisted debriefing are feasible technologies that show potential to enhance trauma training such settings.

      Summary

      Background

      Lack of training contributes to the burden of trauma-related mortality and morbidity in low- and lower-middle-income countries (LMICs). Educational technologies present a unique opportunity to enhance the quality of trauma training. Therefore, this study reviews current technologies used in trauma courses and evaluates their feasibility for LMICs.

      Methods

      We conducted a scoping review evaluating the learning outcomes of technology-enhanced training in general trauma assessment, team skills or any procedures covered in the 2020 Advanced Trauma Life Support® program. Based on the Technology-Enhanced Learning criteria, we created and applied a feasibility analysis tool to evaluate the technologies for use in LMICs.

      Results

      We screened 6471 articles and included 64. Thirty-four (45%) articles explored training in general trauma assessment, 28 (37%) in team skills, and 24 (32%) in procedures. The most common technologies were high-fidelity mannequins (60%), video-assisted debriefing (19%), and low-fidelity mannequins (13%). Despite their effectiveness, high-fidelity mannequins ranked poorly in production, maintenance, cost, and reusability categories, therefore being poorly suited for LMICs. Virtual simulation and digital courses had the best feasibility scores, but still represented a minority of articles in our review.

      Conclusion

      To our knowledge, this is the first study to perform a feasibility analysis of trauma training technologies in the LMIC context. We identified that the majority of trauma courses in the literature use technologies which are less suitable for LMICs. Given the urgent need for pediatric trauma training, educators must use technologies that optimize learning outcomes and remain feasible for low-resource settings.

      Level of Evidence

      IV.

      Keywords

      Abbreviations:

      LMICs ((low-to middle-income countries)), TEL ((technology-enhanced learning)), ATLS ((Advanced trauma life support))
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