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Gavilanes JS, Saengpattrachai M, Rivera-Tutsch AS, Robinson L, Petchkrua W, Gold JA. A Train-the-Trainer Simulation Program Implemented Between Two International Partners. ATS Sch 2024; 5:32-44. [PMID: 38585578 PMCID: PMC10994222 DOI: 10.34197/ats-scholar.2023-0025ps] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 10/10/2023] [Indexed: 04/09/2024] Open
Abstract
With the expansion of global health initiatives focused on healthcare professional training, it is important to ensure that such training is scalable and sustainable. Simulation-based education (SBE) is a highly effective means to achieve these goals. Although SBE is widely used in the United States, its integration globally is limited, which can impact the potential of SBE in many countries. The purpose of this perspective piece is to demonstrate how a train-the-trainer program can help in the development of an international SBE program and specifically what unique issues must be considered in operationalizing this strategy.
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Affiliation(s)
| | | | | | - Lish Robinson
- Oregon Health & Science University, Portland, Oregon; and
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Calder S, Tomczyk B, Cussen ME, Hansen GJ, Hansen TJ, Jensen J, Mossin P, Andersen B, Rasmussen CO, Schliemann P. A Framework for Standardizing Emergency Nursing Education and Training Across a Regional Health Care System: Programming, Planning, and Development via International Collaboration. J Emerg Nurs 2022; 48:104-116. [PMID: 34996572 DOI: 10.1016/j.jen.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/03/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The challenges related to providing continuing education and competence management for emergency nurses are not unique to any one organization, health system, or geographic location. These shared challenges, along with a desire to ensure high-quality practice of emergency nursing, were the catalyst for an international collaboration between emergency nurse leaders in Region Zealand, Denmark, and nurse leaders and educators from a large academic medical center in Boston, Massachusetts. The goal of the collaboration was to design a competency-based education framework to support high-quality emergency nursing care in Region Zealand. The core objectives of the collaboration included the following: (1) elevation of nursing practice, (2) development of a sustainable continuing education framework, and (3) standardization of training and nursing practice across the 4 emergency departments in Region Zealand. METHODS To accomplish the core objectives, a multi-phased strategic approach was implemented. The initial phase, the needs assessment, included semi-structured interviews, a self-evaluation of skills of all regional emergency nurses, and a survey regarding nursing competency completed by emergency nurse leadership. Two hundred ninety emergency nurses completed the self-evaluation. The survey results were utilized to inform the strategic planning and design of a regional competency-based education framework. RESULTS In 18 months, and through an international collaboration, emergency nursing education, training, and evaluation tools were developed and integrated into the 4 regional emergency departments. Initial feedback indicates that the education has had a positive impact. The annual competency day program has continued through 2021 and is now fully institutionalized within the regional emergency nursing continuing education program. Furthermore, use of this innovative education framework has expanded beyond the emergency department to other regional nursing specialties. DISCUSSION AND CONCLUSION Through this unique collaboration with regional and international participants, a sustainable, regional emergency nursing education program was developed that has elevated and standardized the practice of emergency nurses in Region Zealand, Denmark. This program development can serve as a model for region-wide or health care system-wide collaborations in other countries.
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Jackson ME, Ludi EK, Reitz ACW, Moraes Dos Santos G, Helenowski IB, Quiroga LL, Foianini JE, Swaroop M. TRUE-Bolivia (Trauma Responders Unifying to Empower Communities Bolivia) in Santa Cruz, Bolivia. J Surg Res 2022; 273:1-8. [PMID: 34999516 DOI: 10.1016/j.jss.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 10/25/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study is to assess the efficacy of the TRUE-Bolivia (Trauma Responders Unifying to Empower Communities Bolivia) trauma first responder course at improving participant confidence in first responder abilities and increasing knowledge of trauma response skills. METHODS Participants attended the 4-h TRUE-Bolivia course at the municipal department of urban transportation and universities and medical schools in Santa Cruz, Bolivia and completed a demographic survey and pre- and post-course knowledge assessments. All participants who attended the full course and completed both knowledge assessments were included in the study, with 453 people attending at least one portion of the course and 329 completing the full course and assessments. RESULTS A majority of participants were men, had completed high school or attended university, and worked or trained in the fields of transportation or medicine. Participant ratings of confidence on a 5-point Likert scale improved from a median of 3 (interquartile range [IQR] 2) before the course to 5 (IQR 1) after the course (P < 0.01). The median number of correct answers on the pre-course nine-question knowledge assessment was 3 (IQR 3), improving to 7 (IQR 3) on the post-course assessment (P < 0.01). All demographic groups demonstrated improvements in scores from the pre- to post-test. Female gender, higher education level, a background in medicine, and prior training in first aid were associated with higher pre- and post-test scores. CONCLUSIONS The TRUE-Bolivia course increased knowledge of first responder skills and improved confidence in these abilities in participants from a variety of backgrounds. Further study is needed to determine the long-term skill utilization by participants and the course's impact on local trauma morbidity and mortality.
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Affiliation(s)
- Morgan E Jackson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Erica K Ludi
- Department of General Surgery, Emory University, Atlanta, Georgia
| | | | | | | | | | | | - Mamta Swaroop
- Sadanah Trauma and Surgical Initiative, Chicago, Illinois
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Glomb NW, Shah MI, Kosoko AA, Doughty CB, Galapi C, Laba B, Rus MC. Educational impact of a pilot paediatric simulation-based training course in Botswana. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:279-283. [DOI: 10.1136/bmjstel-2019-000501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2019] [Indexed: 11/04/2022]
Abstract
BackgroundAs emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.MethodsThis was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.ResultsThirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.Discussion/ConclusionWe have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.
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Effective teaching and feedback skills for international emergency medicine "train the trainers" programs. J Emerg Med 2013; 45:718-25. [PMID: 23942154 DOI: 10.1016/j.jemermed.2013.04.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 04/08/2013] [Accepted: 04/29/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND As the specialty of Emergency Medicine (EM) develops around the world, it has become common for practitioners from countries with mature EM systems to assist those in regions with developing systems. One effective and frequently used model is "train the trainers," in which a group of consultant teachers instructs a cadre of clinicians in the host region to then become the future teachers of EM in that area. This model has the advantage of overcoming cultural barriers to instruction and can lead to providing a lasting training infrastructure in the region. A key to a successful program is the use of effective and culturally appropriate teaching and feedback skills. OBJECTIVES The goal of this article is to bring together experts in adult education with experts in training in the international setting to present teaching and feedback skills and how they can be applied in different settings and cultures. DISCUSSION Cutting edge instruction and evaluation techniques that can be employed in intercultural "train the trainers" programs will be presented. The characteristics of successful programs, using specifics from actual programs, will also be shared. CONCLUSION Applying the described teaching and evaluation skills with modifications based on local culture will help empower newly trained teachers who will contribute in turn to the longevity of EM in the region and set a high teaching standard that will benefit generations of future colleagues.
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Bhanji F, Gottesman R, de Grave W, Steinert Y, Winer LR. The retrospective pre-post: a practical method to evaluate learning from an educational program. Acad Emerg Med 2012; 19:189-94. [PMID: 22320369 DOI: 10.1111/j.1553-2712.2011.01270.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Program evaluation remains a critical but underutilized step in medical education. This study compared traditional and retrospective pre-post self-assessment methods to objective learning measures to assess which correlated better to actual learning. METHODS Forty-seven medical students participated in a 4-hour pediatric resuscitation course. They completed pre and post self-assessments on pediatric resuscitation and two distracter topics. Postcourse, students also retrospectively rated their understanding as it was precourse (the "retrospective pre" instrument). Changes in traditional and retrospective pre- to postcourse self-assessment measures were compared to an objectives-based multiple-choice exam. RESULTS The traditional pre to post self-assessment means showed an increase from 1.9 of 5 to 3.7 of 5 (p < 0.001); the retrospective pre to post scores also increased from 1.9 of 5 to 3.7 of 5 (p < 0.001). Although the group means were the same, individual participants demonstrated a response shift by either increasing or decreasing their traditional pre to retrospective pre scores. Scores on the 22-item objective multiple choice test also increased, from a median score of 13.0 to 18.0 (p < 0.001). There was no correlation between the change in self-assessments and objective measures as demonstrated by a Spearman correlation of -0.02 and -0.13 for the traditional and retrospective pre-post methods, respectively. Students reported fewer changes on the two distracters using the retrospective pre-post versus the traditional method (11 vs. 29). CONCLUSIONS Students were able to accurately identify, but not quantify, learning using either traditional or retrospective pre-post "self-assessment" measures. Retrospective pre-post self-assessment was more accurate in excluding perceived change in understanding of subject matter that was not taught.
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Affiliation(s)
- Farhan Bhanji
- Montreal Children's Hospital, McGill University, Montreal, Canada
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Lerner EB, Schwartz RB, Coule PL, Pirrallo RG. Use of SALT triage in a simulated mass-casualty incident. PREHOSP EMERG CARE 2010; 14:21-5. [PMID: 19947863 DOI: 10.3109/10903120903349812] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To determine the accuracy of SALT (sort-assess-lifesaving interventions-treatment/transport) triage during a simulated mass-casualty incident, the average time it takes to make triage designations, and providers' opinions of SALT triage. METHODS Seventy-three trainees participating in one of two disaster courses were taught to use SALT triage during a 30-minute lecture. The following day they participated in teams, in one of eight simulated mass-casualty incidents. For each incident trainees were told to assess and prioritize all victims. Each scenario comprised 28 to 30 victims, including 10 to 11 moulaged manikins and 18 to 20 moulaged actors. Each victim had a card that stated the victim's respiratory effort, pulse quality, and ability to follow commands. Initial and final assigned triage categories were recorded and compared with the intended category. Ten of the victims were equipped with stopwatches to measure the triage time interval. Timing began when the trainee approached the victim and ended when the trainee verbalized his or her triage designation. The times were averaged and standard deviations were calculated. After the drill, trainees were asked to complete a survey regarding their experience. RESULTS There were 217 victim observations. The initial triage was correct for 81% of the observations; 8% were overtriaged and 11% were undertriaged. The final triage was correct for 83% of the observations; 6% were overtriaged and 10% were undertriaged. The mean triage interval was 28 seconds (+/- 22; range: 4-94). Nine percent reported that prior to the drill they felt very confident using SALT triage and 33% were not confident. After the drill, no one reported not feeling confident using SALT triage, 26% were at the same level of confidence, 74% felt more confident, and none felt less confident. Before the drill, 53% of the respondents felt SALT triage was easier to use than their current disaster triage protocol, 44% felt it was similar, and 3% felt it was more difficult. After the drill, no one reported that SALT triage was more difficult to use. CONCLUSION We found that assessments using SALT triage were accurate and made quickly during a simulated incident. The accuracy rate was higher than those published for other triage systems and of similar speed. Providers also felt confident using SALT triage and found it was similar or easier to use than their current triage protocol. Using SALT triage during a drill improved confidence.
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Affiliation(s)
- E Brooke Lerner
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
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Weiner SG, Sanchez LD, Rosen P, Lanigra M, Bellesi R, Caneschi A, Galli L, Ban KM. A qualification course in an international emergency medicine intervention. J Emerg Med 2009; 39:234-9. [PMID: 19703741 DOI: 10.1016/j.jemermed.2009.05.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 04/14/2009] [Accepted: 05/31/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Tuscan Emergency Medicine Initiative is a comprehensive training program for physicians designed to create a lasting infrastructure for training in emergency medicine (EM) in a region of Italy. A "Train-the-Trainers" model was utilized to prepare physicians who were working in the emergency department (ED) to become the teachers of EM, and a master's program was created to train the next generation of emergency physicians as well as to put in place a structure into which residency training in EM will be placed. This model has been used in other projects as well; however, the dilemma of what to do with physicians who are already in practice remained an unsolved problem. OBJECTIVES We wished to create a qualification course in EM for this important group of physicians. METHODS Didactic lectures, workshops, simulations, and clinical rotations were utilized to standardize current emergency care delivery in the region's EDs. RESULTS Between 2005 and 2008, 488 physicians completed the program. CONCLUSIONS We propose this model as a way of training and including the physicians caught in the transition to specialty training in any area developing the specialty of EM.
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Affiliation(s)
- Scott G Weiner
- Department of Emergency Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA
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9
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Abstract
OBJECTIVE To measure the effectiveness of a 9-month emergency medicine 'train the trainers' program in Tuscany, Italy. METHODS A total of 81 physicians with emergency department experience completed a training course in Italy. The course included 120 h of didactic lectures, 700 h of clinical rotations and 30 h of practical workshops. The effect of the training course was measured by written multiple-choice and oral case-simulation examinations, and a precourse and postcourse self-assessment instrument using a four-point Likert scale, to describe the ability to care for different types of emergency medicine patients. RESULTS Twenty-four physicians completed the course in 2003-2004 and 57 physicians completed the course in 2004-2005. A comparison of an identical examination given as a posttest to the first group and a pretest to the second group demonstrated significant improvement on a 75-question multiple-choice examination (38.7 vs. 46.2 points, P<0.001). Improvement was also seen in oral case examinations, in pediatrics (17.8 vs. 37.3 points, P<0.001) and neurology (24.8 vs. 34.5, P<0.001). In the self-assessment survey, when asked to describe the ability to diagnose and provide initial treatment for several types of patients before and after the course, significant improvement was reported by 13 of 20 participants (65%). When asked to describe the ability to perform a variety of procedures, significant improvement was seen in seven of sixteen (44%). CONCLUSIONS When measured by written examinations, oral examinations and physician self-assessment, a train the trainers program, designed as part of an international emergency medicine collaboration, was efficacious.
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Ban KM, Pini R, Sanchez LD, Weiner SG, Anderson PD, Grifoni S, Ciottone GR, Edlow JA, Kelly SP, Galli L, Freitas R, Rosen P, Berni GC, Wolfe RE, Gensini G. The Tuscan Emergency Medicine Initiative. Ann Emerg Med 2007; 50:726-32. [PMID: 17766008 DOI: 10.1016/j.annemergmed.2007.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2007] [Revised: 05/17/2007] [Accepted: 05/23/2007] [Indexed: 11/26/2022]
Abstract
Italy lacks standardized specialty training in emergency medicine. There is no system of national or regional accreditation of the knowledge base or skill set of physicians working in regional emergency departments (ED), which results in variability of emergency medical care delivery not only between hospital EDs but also within individual EDs. To address this need, the Tuscan Minister of Health chose to develop a partnership with emergency medicine specialists from the United States to help expedite the growth of the specialty in Tuscany. The collaboration called the Tuscan Emergency Medicine Initiative consists of the regional health care service, the Tuscan university system, Harvard Medical International, and the Beth Israel Deaconess Medical Center Department of Emergency Medicine. We describe that effort and process, with an expectation of more than 625 physicians completing the program by June 2008.
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Affiliation(s)
- Kevin M Ban
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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Weiner SG, Ban KM, Sanchez LD, Tarasco T, Grifoni S, Berni G, Gensini GF. A comparison between the efficacy of lectures given by emergency and non-emergency physicians in an international emergency medicine educational intervention. Intern Emerg Med 2006; 1:67-71. [PMID: 16941817 DOI: 10.1007/bf02934725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The Tuscan Emergency Medicine Initiative is an international collaboration designed to create a sustainable emergency medicine training and qualification process in Tuscany, Italy. Part of the program involves training all emergency physicians currently practicing in the region. This qualification process includes didactic lectures, clinical rotations and practical workshops for those with significant emergency department experience. Lectures in the didactic portion were given by both emergency medicine (EM) and non-EM faculty. We hypothesized that faculty who worked clinically in EM would give more effective lectures than non-EM faculty. METHODS Fifty-one emergency physicians from the hospitals surrounding Florence completed the course, which included 48 one-hour lectures. Twenty lectures were given by practicing emergency physicians and 28 were given by non-EM faculty. Participants completed an evaluation at the end of each session using a 5-point Likert scale describing the pertinence of the lecture to EM, the efficacy and clarity of the presentation, the accuracy of the information and the didactic ability of the lecturer. RESULTS A mean of 38.5 evaluations was completed for each lecture. Every factor was significantly higher for lectures given by EM faculty: the pertinence of the lecture to EM (4.46 vs. 4.16, p < 0.001), the efficacy of the faculty (4.10 vs. 3.91, p < 0.001), the accuracy of the lecture content (4.16 vs 3.96, p < 0.001), and the didactic ability of the instructors (4.02 vs. 3.85, p = 0.001). CONCLUSIONS When teaching EM, evaluations of lectures in this training intervention were higher for lectures given by EM faculty than by non-EM faculty.
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Affiliation(s)
- Scott G Weiner
- Department of Emergency Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
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Arnold JL, Holliman CJ. Lessons learned from international emergency medicine development. Emerg Med Clin North Am 2005; 23:133-47. [PMID: 15663978 DOI: 10.1016/j.emc.2004.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The lessons learned from development of EM around the world span several key areas including general development, systems comparisons, models of EM practice, and education and training. Neither definitive nor exhaustive, these lessons learned are intended to be viewed as sign posts along the road traveled at this point in international EM development. It is hoped that future participants in international EM development can assimilate these lessons learned, adopt the most relevant ones, and add their own insight and wisdom to this growing list. Most importantly, it is hoped that by whichever path future development takes, we all reach the same destination of providing the best possible emergency medical care for the people of the world.
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Affiliation(s)
- Jeffrey L Arnold
- Section of Emergency Medicine, Department of Surgery, Yale University School of Medicine, 464 Congress Avenue New Haven, CT 06519-1315, USA.
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Abstract
EM initiatives are gaining global acceptance as a result of emergency physicians; local advocates; national, transnational, and international EM organizations; and governmental leadership, organizations, and agencies involved in international health and an evolving global health agenda. Spanning the spectrum from basic initiatives to improve acute care services to mature EM specialty development, all countries acknowledge the need for emergency care. The level of EM development in a country is fluid and depends on many variables, including status of health development, burden of disease,resources, advocacy, available expertise, and public demand. Emergency physicians should support the promotion of EM in the context of essential public health and primary care initiatives in these developing countries. Additionally, emergency physicians should work closely with stakeholders, health policy experts, health economics, and international organizations involved in health care to promote the advancement of EM worldwide.
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Affiliation(s)
- Jeffrey Smith
- Department of Emergency Medicine, George Washington University Medical Center, 2300 Eye Street NW, Washington, DC 20037, USA.
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Abstract
In the past two decades, emergency physicians have increasingly looked beyond their national borders to examine how emergency medicine is practised elsewhere in the world. A major result of their efforts is international emergency medicine, which can be defined as the area of emergency medicine concerned with the development and delivery of emergency medical care in the world. Several international trends are currently occurring in emergency medicine, including an increasing number of venues for information exchange, the spread of emergency medicine practice guidelines, an increasing number of international collaborations, and an increasing number of transnational special interest groups in emergency medicine. A closely related trend is the spread of the specialty model of emergency medicine, a key organizational system in which emergency medicine is viewed as a uniquely integrated horizontal body of medical knowledge and skills concerning the acute phases of all types of disease and injury. Multiple challenges await those involved in international emergency medicine, including the need for internationally accepted definitions, a 'systems approach' to analysing emergency medicine systems, and more useful and affordable information. A related challenge is the need for effective consensus-based processes, including international standardization processes. Many of these challenges may be met through the effective leadership of international emergency medicine organizations.
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Affiliation(s)
- Jeffrey L Arnold
- Department of Emergency Medicine, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA, USA.
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Holliman CJ, VanRooyen MJ, Green GB, Kirsch TD, Delooz HH, Clem KJ, Thomas TL, Davis MA, Wang E, Wolfson AB. Planning recommendations for international emergency medicine and out-of-hospital care system development. Acad Emerg Med 2000; 7:911-7. [PMID: 10958132 DOI: 10.1111/j.1553-2712.2000.tb02070.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To present suggestions on planning for development of emergency medicine (EM) and out-of-hospital care in countries that are in an early phase of this process, and to provide basic background information for planners not already familiar with EM. METHODS The techniques and programs used by the authors and others in assisting in EM development in other countries to date are described. CONCLUSIONS Some aspects of EM system development have applicability to most countries, but other aspects must be decided by planners based on country-specific factors. Because of the very recent initiation of many EM system development efforts in other countries, to the authors' knowledge there have not yet been extensive evaluative reports of the efficacy of these efforts. Further studies are needed on the relative effectiveness and cost-benefit of different EM development efforts.
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Affiliation(s)
- C J Holliman
- Center for International Emergency Medicine, Pennsylvania State University, Hershey, USA.
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Affiliation(s)
- P Shayne
- Division of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30303-3219, USA
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Wolff M, Pirrallo RG, Hargarten SW. Strengthening emergency medicine in Poland: a training and partnership model. Acad Emerg Med 1998; 5:1187-92. [PMID: 9864132 DOI: 10.1111/j.1553-2712.1998.tb02694.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report a qualitative evaluation of the Partnerships in Health Care/EMS Project between Poland and the United States. The goal of the partnership was to strengthen the emergency medical services (EMS) system in three Polish cities, Krakow, Bialystok, and Lodz. METHODS The Polish participants were interviewed in Poland approximately eight months after a U.S.-based training program. They were asked to evaluate the effectiveness of the partnership project and discuss their experiences incorporating U.S. emergency medicine (EM) knowledge and technology in the Polish EMS system. RESULTS The Polish physicians identified three major factors that had the greatest impact on the implementation of U.S. EM knowledge in Poland. These factors were the substantive differences between Polish and U.S. EM knowledge and technology, staffing differences in Polish and U.S. ambulances, and the differing role the EMS system plays in the delivery of primary care in the two countries. CONCLUSIONS The Polish physicians succeeded in training EM providers in the three cities, thus strengthening clinical skills of EMS providers. They also were able to adapt the principles of U.S. EM that they had learned to fit the specific circumstances that characterize Polish emergency care. As in the United States, the health care system in Poland is inseparable from the social, political, and economic realities of the nation.
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Affiliation(s)
- M Wolff
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
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Clem KJ, Thomas TL, Wang YT, Bradley D. United States physician assistance in development of emergency medicine in Hangzhou, China. Ann Emerg Med 1998; 32:86-92. [PMID: 9656956 DOI: 10.1016/s0196-0644(98)70103-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Emergency medicine is growing rapidly as a specialty and is beginning to be recognized as an essential component of medicine in China. Traditional Chinese medicine and modern technology exist together. A description of the US authors' experience as consultants at a new emergency department and in establishing an emergency medicine residency program in Hangzhou, China is provided. A total of 7 months were spent in the observation, identification, and development of a basic framework of emergency care at a new hospital. The practice of emergency medicine in China was researched by direct observation at several Chinese cities and by literature review. China is taking the parts of the Western system it can use and implementing its own methods in the overall practice of emergency medicine.
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Affiliation(s)
- K J Clem
- Department of Emergency Medicine, Loma Linda University Medical Center, CA, USA.
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