Browsing by Author "DeWane, Michael P."

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    Design, implementation and long-term follow-up of a context specific trauma training course in Uganda: Lessons learned and future directions
    (The American Journal of Surgery, 2020) Ullrich, Sarah J.; Kilyewala, Cathy; Lipnick, Michael S.; Cheung, Maija; Namugga, Martha; Muwanguzi, Peter; DeWane, Michael P.; Muzira, Arlene; Tumukunde, Janat; Kabagambe, Monica; Kebba, Naomi; Galukande, Moses; Mabweijano, Jacqueline; Ozgediz, Doruk
    The Kampala Advanced Trauma Course (KATC) was developed in 2007 due to a locally identified need for an advanced trauma training curriculum for the resource-constrained setting. We describe the design, implementation and evaluation of the course.The course has been delivered to over 1,000 interns rotating through surgery at Mulago National Referral Hospital. Participants from 2013 to 2016 were surveyed after completion of the course.The KATC was developed with local faculty and includes didactic and simulation modules. Over 50% of survey respondents reported feeling confident performing and teaching 7 of 11 course skills and felt the most relevant skill was airway management(30.2%). Participants felt least confident managing head trauma(26.4%). Lack of equipment(52.8%) was identified as the most common barrier to providing trauma care.Providers are confident with most skill sets after taking the KATC. Minimal dependence on instructors from high-income countries has kept the course sustainable and maximized local relevance.
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    Development of an Operative Trauma Course in Ugandad - A Report of a Three-Year Experience
    (Journal of Surgical Research, 2020) Ullrich, Sarah J.; DeWane, Michael P.; Cheung, Maija; Fleming, Matthew; Namugga, Martha M.; Kurigamba, Gideon; Kabuye, Ronald; Mabweijano, Jackie; Galukande, Moses; Ozgediz, Doruk; Pei, Kevin Y.
    Trauma is a leading cause of morbidity and mortality in low-income countries. Improved health care systems and training are potential avenues to combat this burden. We detail a collaborative and context-specific operative trauma course taught to postgraduate surgical trainees practicing in a low-resource setting and examine its effect on resident practice. Three classes of second year surgical residents participated in trainings from 2017 to 2019. The course was developed and taught in conjunction with local faculty. The most recent cohort logged cases before and after the course to assess resources used during initial patient evaluation and operative techniques used if the patient was taken to theater. Over the study period, 52 residents participated in the course. Eighteen participated in the case log study and logged 117 cases. There was no statistically significant difference in patient demographics or injury severity precourse and postcourse. Postcourse, penetrating injuries were reported less frequently (40 to 21% P < 0.05) and road traffic crashes were reported more frequently (39 to 60%, P < 0.05). There was no change in the use of bedside interventions or diagnostic imaging, besides head CT. Of patients taken for a laparotomy, there was a nonstatistically significant increase in the use of four-quadrant packing 3.4 to 21.7%) and a decrease in liver repair (20.7 to 4.3%). The course did not change resource utilization; however, it did influence clinical decision-making and operative techniques used during laparotomy. Additional research is indicated to evaluate sustained changes in practice patterns and clinical outcomes after operative skills training.