Training Non-Specialists for Craniomaxillofacial Trauma in a Warzone Setting

Abstract

This study investigated a simulated craniomaxillofacial (CMF) trauma training programme for nonspecialist clinicians involved in warfare environments. Many clinicians lack CMF surgical training and the course was designed as a one-day research programme to establish if non-specialists could acquire CMF trauma skills adequate for a warzone. The course consisted of six simulation skills, of which four used sheep heads to teach craniotomy, epistaxis, canthotomy and cantholysis and external pin fixation for mandibular fracture fixation. In addition, two skills utilised plaster dental models designed to enable fixation of mandibular fractures with the Erich arch bar or dental eyelet wiring. This simulation-based programme taught trauma management without the expense of cadavers or risks to patients [1]. The trainees were scored for each of the six skills by hierarchical task analysis (HTA) designed by CMF specialists [2, 3]. The trainee assessment scores improved significantly in all skills post-training, regardless of their medical or surgical deficiencies demonstrating that non-specialists can learn important surgical techniques, valuable for war environments.