Training in polytrauma management in medical curricula: A scoping review

Abstract

Introduction

Polytrauma (PT) is a leading cause of morbidity and mortality worldwide. However, it is unknown if PT teaching is taught or adequately included in undergraduate medical curricula. We conducted this scoping review to explore the literature on undergraduate PT training.

Methods

Using Arksey and O’Malley’s five stage framework, a scoping review was conducted. Nine medical and educational databases, including PubMed, MEDLINE, Scopus, CINAHL, PsycINFO, and EMBASE were searched using keywords identified by the authors. Eligible studies were limited to the English language, with no set limitations on the year of publication. Studies reporting on PT teaching in undergraduate medical curricula were included.

Results

Nine studies were included. The articles were sub-categorised into three themes: current teaching of PT in medical curricula, trauma management courses and simulation-based trauma education. Four out of five studies on PT teaching in the curriculum were rated as inadequate by current or past students; on the other hand, three out of four trauma management/simulation courses were evaluated and all three were rated positively by students. Three trauma management courses compared students pre- and post-course scores on a written or practical test and reported significant improvement in post-course scores.

Conclusions

There is a relative paucity of literature on undergraduate PT training. There is a need for more research to explore how to deliver effective PT teaching to medical students.

Keywords:

• Polytrauma
• undergraduate
• training
• management
• medical curricula
• scoping review

Glossary

Abbreviated Injury Scale (AIS): ‘Anatomically-based injury severity scoring system that classifies each injury by body region on a 6 point scale. AIS is the system used to determine the Injury Severity Score (ISS) of the multiply injured patient. AIS classifications:

• AIS 1 – Minor

• AIS 2 – Moderate

• AIS 3 – Serious

• AIS 4 – Severe

• AIS 5 – Critical

• AIS 6 – Maximal (currently untreatable)’ (NSW Institute of Trauma and Injury Management (ITIM), 2020).

Injury Severity Score (ISS): ISS assesses the combined effects of the multiply injured patient and is based on the Abbreviated Injury Scale (AIS). ISS is an internationally recognised scoring system which correlates with mortality, morbidity and other measures of severity.

ISS is calculated as the sum of the squares of the highest AIS code in each of the three most severely injured ISS body regions. These body regions are:

• Head or neck

• Face

• Chest

• Abdominal or pelvic contents

• Extremities or pelvic girdle

• External

ISS range from 1 to 75. If an injury is assigned an AIS of 6, the ISS score is automatically assigned 75’ (NSW Institute of Trauma and Injury Management (ITIM), 2020).

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Mohammed Jouda

Mohammed Jouda, MSc, is a general surgeon in the public health service in Ireland. He holds a Master degree in Health Sciences and Clinical Education from the National University of Ireland Galway.

Yvonne Finn

Yvonne Finn, MD, is a Lecturer in the School of Medicine, College of Medicine, Nursing and Health Sciences at the National University of Ireland Galway. She has extensive experience in curricular development and assessment design, and supervises students in the Masters in Clinical Education programme.