Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 6 , ISSUE 1 ( January-April, 2017 ) > List of Articles

ORIGINAL ARTICLE

Nonclinical, Observational Trauma Rotations in the United States provide International Students Multidisciplinary Trauma Program and Systems Education

Vicente Gracias, Raj Gupta, Juan CR Silva

Citation Information : Gracias V, Gupta R, Silva JC. Nonclinical, Observational Trauma Rotations in the United States provide International Students Multidisciplinary Trauma Program and Systems Education. Panam J Trauma Crit Care Emerg Surg 2017; 6 (1):8-12.

DOI: 10.5005/jp-journals-10030-1165

License: CC BY 3.0

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To create a non-clinical care education alternative for low-middle-income country (LMIC) medical students in an acute care surgery (ACS) service in the United States.

Materials and methods

An observational 30-day rotation with retrospective evaluation for an international medical student occurred at a level one trauma center in the United States. Trauma morning report was used as an educational model based on some elements of the American College of Surgeons Committee on Trauma, Resources for Optimal Care of the Injured.

Results

Trauma morning report was held daily for the student’s 30-day experience. The trauma patients’ primary and secondary survey, images, trauma bay, and operative management were all reviewed daily. Patients’ prehospital and hospital courses were completely evaluated by the performance improvement team. The functional status, physical therapy, familial support networks, economic and health insurance record, and rehabilitation disposition were reviewed. Prior to discharge, socioeconomic barrier analysis was conducted to provide safe outpatient care plans. Education by attending surgeons for the multidisciplinary team, which was integrated by students, residents, fellows, faculty, social workers, physical therapists, advanced nurse practitioners, performance improvement coordinator, and nurse trauma manager, was conducted daily on a selected topic.

Conclusion

Trauma morning report served as an observational education in multidisciplinary trauma systems (TS) for international students. The experience in the United States provides a new perspective on systems-based trauma care for international students.

Clinical significance

The educational alternative exposed is a pathway for medical students from LMIC to increase their clinical experience, ACS knowledge, and trauma care system-based understanding. The students who opt for this kind of experience may choose a specialization in surgery, increase their research productivity, and improve the development of emergency medical services TS in their respective countries.

How to cite this article

Silva JCR, Gupta R, Gracias V, Peck G. Nonclinical, Observational Trauma Rotations in the United States provide International Students Multidisciplinary Trauma Program and Systems Education. Panam J Trauma Crit Care Emerg Surg 2017;6(1):8-12.

Objetivo

Construir una alternativa de educación para estudiantes de los países de medianos y bajos ingresos(LMIC) mediante una rotación clínica tipo observador (sin contacto directo con el paciente) a través de un servicio de cirugía de emergencia en los Estados Unidos de América (USA).

Materiales y métodos

Un estudiante internacional realizo una rotación tipo observador durante 30 días en un hospital de trauma de primer nivel en USA, donde los reportes de trauma matutinos fueron empleados como modelo de educación, basado en las directrices del comité de trauma del colegio americano de cirugía, la experiencia fue evaluada al final de manera retrospectiva.

Resultados

Los reportes de trauma matutinos fueron presenciados a diario por el estudiante durante la experiencia de 30 días. En estas reuniones se revisó diariamente la valoración primaria y secundaria del paciente traumatizado así como las imágenes diagnósticas y el manejo inicial en la bahía de trauma y el manejo quirúrgico que cada paciente recibió, también se evaluó por el equipo de mejoramiento del desempeño lo ocurrido antes de llegar al hospital y la estancia intrahospitalaria. Al momento del alta, la funcionalidad, el requerimiento de terapia física, la red de soporte familiar, el estado económico y el registro del seguro médico así como las barreras socioeconómicas fueron analizados e integrados para proveer un plan de atención ambulatorio seguro para cada paciente.

 Finalmente cada reunión culminaba con la revisión de un tema en específico llevado a cabo por el cirujano de trauma en turno , para todo el equipo multidisciplinario compuesto por estudiantes de medicina, residentes, fellows, demás cirujanos de trauma, trabajadores sociales, fisioterapeutas, enfermeras practicantes, coordinador de mejoramiento del desempeño y la enfermera gerente del servicio de trauma.

Conclusión:

El reporte matutino de trauma puede ser usado como modelo de educación observacional de los sistemas multidisciplinarios de trauma para los estudiantes internacionales, conjuntamente la experiencia en USA le provee a estos estudiantes una nueva perspectiva respecto a la atención del trauma basada en sistemas integrados.

Significancia clínica

La alternativa en educación expuesta, es una forma por la cual los estudiantes de medicina de los países de medianos- bajos ingresos pueden complementar su experiencia clínica, los conocimientos en la atención de las patologías quirúrgicas agudas, la comprensión de la atención del trauma basada en un sistema integrado. Los estudiantes que escojan llevar a cabo una experiencia de este tipo podrían en el futuro escoger el área quirúrgica como especialización, a la vez que su productividad en investigación puede verse incrementada, como también podrían mejorar el desarrollo de los sistemas de emergencia y sistemas de trauma en sus países de origen.

Palabras clave

Educación medica internacional, cirugía de emergencia, sistemas de atención de trauma.


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