Z. Aldaher1, K. Dunn1, G. Moore1, C. Jones1, M. Lyon1, A. Kleinheksel1, E. Simmerman Mabes1 1Medical College Of Georgia, Surgery, Augusta, GA, USA
Introduction:
Trauma is a leading cause of death worldwide, with higher mortality rates in rural areas. While the rate of trauma-related deaths increases directly with distance from a trauma center, there also exists an increased relative risk of dying in the emergency department (ED) in rural settings, suggesting a need for enhancing the skills and resources of rural trauma teams. We identified the need to identify training gaps in rural Georgia to facilitate the development of an interactive trauma simulation curriculum.
Methods:
A mixed methods needs assessment was performed. A systematic literature search of databases including PubMed, NLM, Scopus, and ScienceDirect was completed to determine previously identified training needs of rural trauma providers. Articles with endpoints specifically identifying gaps in rural provider training were included. Publications prior to 2010 were excluded. Qualitative analysis of survey data from providers in rural Georgia was performed to identify respondents’ perceived training gaps. Survey participants included physicians, nurses, APPs, and RTs practicing in rural Georgia.
Results:
Literature review identified eleven studies, six full articles were read, and four met criteria. Qualitative data collected from rural providers across the US and worldwide has identified the need for procedural and skill training with providers reporting a lack of training sessions, infrequent exposure to critical scenarios/procedures, and a low level of comfort in handling emergency situations. Our survey data demonstrated gaps in training in the following areas: Infection control, behavioral management, airway/breathing management, trauma management, diagnostic skills, emergency procedures, telemedicine, emergency protocols. We then analyzed the data further, identifying areas specific to trauma and compared the literature with our results (figure 1).
Figure 1: Survey data from providers in rural Georgia indicating training gaps in 6 major categories with total survey responses represented per category in addition to specific training gaps reported matching prior literature
Conclusion:
There is a paucity of literature regarding specific training needs of rural trauma teams, simulation-based training for rural ED providers, and specifically rural trauma simulation-based education. General and targeted needs assessment identified the importance of education and procedural training for our rural outreach initiative. In the process we identified the need for institutional feedback as the receiving hospital and further needs assessment is ongoing to identify areas for improvement in trauma transfers pre-hospital arrival. Upon completion we will use the assessment to design the final interactive curriculum.