ABSTRACTS
Implementing and Evaluating Prehospital Trauma Training Program During the Ukraine–Russia WarAuthor: Kevin Collopy, Brock Jenkins, Javedi Ali, Oleskandra Demeskta, Alona Goncharova, Michelle Gonnet, Katie Murray, Myroslav Mardarevych, Dmytro Pedan, Alexis Schmid, and Sean Kivlehan | | Associate Authors:
Introduction: The 2022 Russian invasion increased trauma-related injuries and deaths throughout Ukraine. It destabilized the prehospital care workforce, leading to an immediate need for trauma education and training among first responders due to the rapidly rising trauma volume and strained prehospital resources. In response, an academic–nongovernmental organizational partnership was formed to develop and deliver in-person prehospital training courses throughout Ukraine. Objective: To assess the impact of needs-based training on first responder knowledge and confidence in managing trauma patients during a humanitarian crisis. Methods: Prehospital Trauma Fundamentals (PHTF) was developed, translated into Ukrainian, and taught in seven Ukrainian oblasts between August 2022 and December 2023. PHTF is a 16-hour course containing lectures, skills stations, and simulations that was developed based on needs assessments and international training standards. Knowledge change and confidence levels were assessed via pre- and postcourse testing and self-assessments. Postcourse follow-up surveys evaluated course impact. Data were analyzed in RStudio using McNemar’s test for paired data and Wilcoxon matched-pairs signed-rank test. This project was determined to not require Institutional Review Board approval by the Mass General Brigham Office of Human Research Affairs. Results: A total of 820 participants completed PHTF. Participants were predominantly female (71.6%); median age of participants was 37.5 years (IQR = 26–48). Knowledge assessment scores increased for 93.6% of participants; scores improved from 53.9% (SD = 13.5%) to 77.0% (SD = 14.2%) (p < .05). Self-confidence surveys demonstrated improved preparedness managing life-threatening conditions(42.6% vs. 70.5%, p < .0001) and increased confidence managing shock (33.8% vs. 62.9%, p < .0001), penetrations (38.9% vs. 76.0%, p < .0001), blunt trauma (41.1% vs. 76.0%, p < .0001), and external hemorrhage (53.4% vs. 82.4%, p < .0001). Participants identified decreases in sense of skill deficit (78.5% vs. 40.4%, p < .001), nervousness managing injured patients (65.1% vs. 58.5%, p < .05), and lack of confidence (58.5% vs. 27.5%, p < .0001). Of the 186 (22.7%) who completed the follow-up survey, 99.5% stated the training has or will have a life-saving effect on their patient management, and 75.3% implemented new skills in their practice. Most used (73.1%) or taught (60.8%) course skills to another clinician. Conclusion: PHTF participants demonstrated increased knowledge and improvements in confidence. Participants applied information taught on war-injured patients, which suggests information taught in educational programs delivered just before or during large-scale events can be retained and used to change patient care. Lessons learned from developing and delivering PHTF can serve as a starting point for delivering just-in-time first responder education in other humanitarian crises or disasters.
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