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| REVIEW ARTICLE |
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| Year : 2021 | Volume
: 10
| Issue : 4 | Page : 219-221 |
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Training undergraduate medical students in trauma management skills
Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2
1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
| Date of Submission | 15-May-2021 |
| Date of Decision | 29-May-2021 |
| Date of Acceptance | 04-Jun-2021 |
| Date of Web Publication | 22-Mar-2022 |
Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdrntruhs.jdrntruhs_57_21
Trauma has been ranked as one of the commonest cause accounting for untimely deaths, disabilities, sufferings and impairment in the quality of life. The aim of the review was to explore the status and the ways in which trauma management skills can be taught to undergraduate medical students. An extensive search of all materials related to the topic was carried out in the PubMed search engine and World Health Organization website using the keywords trauma, undergraduate, and medical education. A total of four articles were selected based upon the suitability with the current review objectives. The teaching of trauma evaluation and management has to be regarded as one of the most essential, yet undermined field in the medical institutions. From the medical college perspective, the task of training undergraduate medical students in trauma management is definitely a challenging one. However, considering that the initial time after a trauma is the golden period for saving the life of a person, which is actually being managed by a junior doctor, we have to find out a way for bridging the existing lacuna in the curriculum. In conclusion, trauma management is an essential and integral aspect of undergraduate medical training. However, in the present scenario, it has been neglected in most of the medical institutions due to various reasons. The need of the hour is to formulate specific competencies, go ahead with curriculum mapping and ensure that students are trained and competent before they land into clinical practice.
Keywords: Medical education, trauma, undergraduate
How to cite this article:
Shrivastava SR, Shrivastava PS. Training undergraduate medical students in trauma management skills. J NTR Univ Health Sci 2021;10:219-21 |
| Introduction | |  |
Trauma has been ranked as one of the commonest cause accounting for untimely deaths, disabilities, sufferings and impairment in the quality of life.[1] In-fact, it has been estimated that close to 1.35 million people each year lose their lives due to road accidents worldwide, while on an average 35 million people suffer non-fatal injuries.[1] Apart from the loss of human lives, these injuries also account for the massive economic burden on the individuals and families, and in many ways impact the financial growth of the nation due to the loss of productivity and resources spent in the treatment and care of the injured.[1] The aim of the review was to explore the status and the ways in which trauma management skills can be taught to undergraduate medical students.
| Materials And Methods | | |
An extensive search of all materials related to the topic was carried out in the PubMed search engine and World Health Organization website. Relevant research articles focusing on Trauma management and Undergraduate medical education published in the period 2011 to 2020 were included in the review. A total of six studies similar to current study objectives was identified initially, of which, two were excluded due to the unavailability of the complete version of the articles. Overall, four articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include trauma management AND undergraduate medical education in the title alone. In this review, the articles published in English and conducted among medical students were included. The collected information is presented under the following sub-headings, namely Trauma management and medical students, Necessity to train in trauma management, Existing challenges, Potential recommendations, Simulation-based trauma management, and Lessons from the field.
Trauma management and medical students
It won't be wrong to say that in most of the health care establishments, junior doctors are the one who perform the task of initial assessment and take decisions to provide initial life-saving hospital care.[2] Now, the question arises, are these junior medical doctors competent and well trained during their undergraduate period on these aspects? In reality, most of the medical curriculum across different parts of the world fails to do justice in terms of exposing the undergraduate medical students to the field of training in resuscitation and trauma medicine, and there lies the gap that can significantly influence the outcome in a patient who has met with a trauma.[3]
Necessity to train in trauma management
The teaching of trauma evaluation and management has to be regarded as one of the most essential (considering the incidence of trauma), yet undermined field in the medical institutions. The findings of a study done among the medical undergraduates in the United Kingdom reported that owing to the lack of training in trauma management, the students were forced to initiate trauma conferences on their own so that they can learn better.[3] Also, we must acknowledge that expecting a medical student to learn all about trauma care while they are posted as interns in surgical departments is not correct.[2] This is mainly because of the topics that are covered during such postings or the variation in the pattern of trauma cases, that might lead to disparities in the kinds of exposure.[2]
Existing challenges
From the medical college perspective, the task of training undergraduate medical students in trauma management is definitely a challenging one. This is because of the lack of framework of properly framed competencies (in terms of what all needs to be taught), logistics support, and concerns pertaining to patient safety.[2],[3],[4] Logistical issues are mainly with regard to the presence of students in large numbers and teacher-student ratio. Further, we have to accept that the medical curriculum is already overburdened and thereby identification of an appropriate time within the curriculum is a big ask.[2],[3] In addition, we have to also be ready with who will be teaching, when, how and what will be the prerequisites for having a successful learning outcome.
Potential recommendations
Regardless of these unanswered questions, considering that the initial time after a trauma is the golden period for saving the life of a person, which is actually being managed by a junior doctor, we have to find out a way for bridging the existing lacuna in the curriculum.[2],[3] This has to start with the formulation of the trauma-related competencies, which are must for an undergraduate medical student, and will essentially require support from the faculty members, the Curriculum Committee and the Medical Education Unit of the institution. Once these competencies are framed, we have to go ahead with curriculum mapping to decide about the teaching-learning method, plan of assessment and timing of assessment.
Simulation-based trauma management
Simulation-based medical education has emerged as an important method of teaching trauma management skills (viz. airway management, chest drain insertion, cricothyroidotomy, etc.) to the medical students and the same can be said for a skill lab.[4] The students can be trained in basic and advanced trauma life support, that are also linked with assessments to document the learning. It will be a welcome move to start an elective course on trauma management, wherein the students can learn about the basics of trauma management.[4] The encouraging approach will be to spread the learning opportunities throughout the training period to make it fruitful for the students. The students can be asked to maintain a logbook or record their reflections in the form of a portfolio to monitor their learning.[5]
Lessons from the field
At Shri Sathya Sai Medical College and Research Institute, a constituent college of the Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, a fully functional skill lab is being utilized to impart training to all the interns and postgraduate residents in basic and advanced cardiac life support. The students are being trained in different aspects of life saving skills based on a structured and validated course content and simultaneously also subject to a variety of assessments to assess their learning. This is a welcome step to improve the skills of medical students and postgraduate residents. Finally, we should always devise a mechanism to evaluate the course and be prepared to take remedial measures based on the feedback received about the imparted training from the different stakeholders.
| Conclusion | | |
In conclusion, trauma management is an essential and integral aspect of undergraduate medical training. However, in the present scenario, it has been neglected in most of the medical institutions due to various reasons. The need of the hour is to formulate specific competencies, go ahead with curriculum mapping and ensure that students are trained and competent before they land into clinical practice.
Limitations
One of the limitations in the review articles is lack of accessibility for two papers, which were then removed from the study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | |
| 2. | Lum SK, Subramaniam T. The teaching of trauma management in undergraduate medical education. Med J Malaysia 2016;71:338-40.  |
| 3. | Mastoridis S, Shanmugarajah K, Kneebone R. Undergraduate education in trauma medicine: The students' verdict on current teaching. Med Teach 2011;33:585-7. |
| 4. | Berkenstadt H, Ben-Menachem E, Simon D, Ziv A. Training in trauma management: The role of simulation-based medical education. Anesthesiol Clin 2013;31:167-77. |
| 5. | Froehlich S, Kasch R, Schwanitz P, Schulz AP, Walcher F, Mittelmeier W, et al. Logbook of learning targets for special educational skills in orthopaedic and trauma surgery for undergraduate medical training. Z Orthop Unfall 2013;151:610-31. |
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