Improving the spirit – increasing the chances of survival : results of multiprofessional training of medical teams in Iraq and Norway
Year: 2008
Type: dissertation
Abstract: This work is a synthesis of experiences gained during ten years of helping healthcare providers improve their service to victims of injury and acute disease. This work is based on my participation in two programs: The Trauma Care Foundation’s Mine Injury Management Program in Kurdistan, northern Iraq, and the BEST Foundation: Better & Systematic Trauma Care’s trauma team training program in Norwegian hospitals. My experience with both programs took place from 1996 to 2006-7.\n The purpose of the thesis was to: \n 1. Describe and assess the effects of trauma team training in Norway, and summarize health personnel’s experience from implementation, and\n 2. Describe and assess the adaptation and maturation of a pre-hospital trauma care system in northern Iraq, and determine the impact of this system on villagers in mine-affected areas.\n I have summarized these experiences in order to enable health workers with a need for training and system improvement to draw upon our experiences.\n The thesis consists of five papers. In the first paper, the team training method from Norway is described as a solution to the team members’ perceived lack of team skills (communication, leadership, and cooperation). In the second paper, the effects of team training are described in terms of perceived quality of care during multi-trauma resuscitation and individual knowledge and confidence. The feasibility of team training was also assessed. The third study is a follow-up of a program that trained paramedics and first responders in Kurdistan in northern Iraq, with an evaluation of the adaptation and maturation of the trauma system. The fourth study examined the impact of the development of chains of paramedics and first responders on Kurdish villages. Finally, the fifth paper examined how Norwegian healthcare personnel manage to maintain team training in their institutions. \n In these projects, we found that short-term educational activities are effective if they are targeted carefully, which indicates that they should be planned and adapted with cooperation between the local healthcare workers and the external teachers. We found that it is possible to transfer knowledge that continues to live and grow in some organizations, but that this is dependent on support to enthusiasts in the organizations in question. In both locations, the healthcare providers adapted their new knowledge and skills to different patient groups and different medical situations. Treatment quality seemed to remain at a high level. System maturation in northern Iraq resulted in a reduced time interval between injury and the first medical response, and improved physiological function after transportation. In areas where demanding medical challenges, such as severe trauma, occur infrequently, it seems useful to share experiences among health workers. In both settings, we found that health workers take responsibility for further development of their services, and that they are able and willing to apply their experience to other areas of patient care. \n Healthcare providers will act responsibly and employ what they believe are useful training methods provided they receive some sort of support. Responsible health personnel can be a powerful force of change. The training methods described here have great potential for application in similar areas. Medical training in low-income countries is a political act that has implications for the trainees and the societies in which they live that reach beyond the medical arena. In Norway, the decision on where to devote ones energy is also a political matter. However, trauma does not occur indiscriminately, neither should trauma training.
Author: Torben Wisborg
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W101327938