Surgical training for burns care in low-income countries: A literature review and critical appraisal. Issue 8 (December 2022) - Borg, Tiffanie-Marie
Abstract: Introduction: Low- and middle-income countries account for over 90% of burns worldwide. Though mission trips, public health interventions and educational strategies have been introduced in recent years, a disparity remains in treatment provided between high- and low -income countries. This analysis aims to review available literature pertaining to strategies for training in burns management, with a focus on those applicable to low-income countries. Methodology: Mesh terms including "burns", "burns care", "burns management", "training", "teaching" and "education" were inputted into Medline and EMBase. Studies were included on the basis that they include an educational intervention to train doctors to provide surgical burns care in low-income countries. Included literature was analysed using scoring tools then a critical appraisal was performed. Results: Fourteen studies were included in this analysis. These describe e-learning (n = 1), video-based teaching (n = 1), lecture-based teaching (n = 1), simulation training (n = 8) and hospital-based training achieved through collaborative efforts between high and low-income countries such as mission trips and fellowship programmes (n = 3). The strategies described have been summarised and presented. Conclusion: Burns care training should be accessible at a global scale and so, involve training methods including simulation, courses and fellowship programmes that are affordable and accessible to surgeons in low-income countries. Highlights: There remains a disparity in treatment provided between high- and low-income countries. E-learning, video-based, lecture-based, simulation and hospital-based training strategies have a role in improving burns care training globally. Consideration must be taken so that training strategies for low-income countries are affordable and can be readily implemented in such resource-limited areas. Implementing burns care training programmes in low-income countries should continue to be supported by surgeons in high-income countries and charities.