Care Training Research Articles

From Simulation to Bedside: The Journey to Provide Equitable Patient Care.

Simulation-based education (SBE) has revolutionized health care training by enhancing skills and addressing systemic issues. This article explores how SBE can bridge the gap between recognizing health care disparities and implementing actionable steps to address them. The immersive nature of SBE, combined with structured debriefing, sets the foundation for a "brave space" that fosters critical discussions on crucial topics, such as health equity. SBE enables health care professionals to develop cultural humility, confront biases, and practice upstander skills. This approach not only addresses hidden curricula but also integrates equity into clinical practice through practical scenarios and community engagement. Despite the potential benefits, challenges such as unintentional harm and the need for thoughtful implementation persist. To maximize effectiveness, SBE initiatives must be aligned with organizational goals and include interdisciplinary team commitment. Ongoing research and robust evaluation are essential to measure SBE's impact on health equity and patient outcomes. [Pediatr Ann. 2024;53(11):e414-e419.].

Early integration of palliative care in haemato-oncology: latest developments.

This review aimed to explore recent progress made in the past five years towards early access to, and integration of palliative care services within the haemato-oncology context to address the unique needs of patients with Haematological malignancies (HMs). We included 14 articles in our review. We identified three themes, namely (i) disparities in the timing of referrals remain, (ii) specialist palliative care and impact on quality of life and (iii) perceptions on early integration. Patients with HM, receive less palliative care services, regardless of their higher symptom burden compared to patients with solid tumours. Structured approaches and models of early integration have shown substantial benefits, including improved pain and symptom management, shorter hospital stays and better end of life planning. Perceptions on existing barriers include the curative treatment focus, haematologists' personal perceptions on timing of palliative care and lack of palliative care training. For early integration to happen, it is crucial to address training gaps, improve communication skills, and foster interdisciplinary collaboration. Standardised organisational pathways can facilitate early and concurrent palliative care integration. System-level flexibility and supportive policies are essential to ensure that patients with HM receive comprehensive and high-quality care.

Content and design of respectful maternity care training packages for health workers in sub-Saharan Africa: Scoping review.

Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear. To explore the content and design of RMC training packages for health workers in sub-Saharan Africa. MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022. There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results. Key data, including training content and methods used, were extracted and summarized. Thirty-two citations from 26 studies/programs were identified (24 journal papers, 5 manuals/guides, 2 reports and 1 PhD thesis), with 27 citations from 22 studies informing the review findings. About half of all conducted studies were from East Africa. The most common topics in RMC trainings were communication, privacy and confidentiality, and human resources. Most trainings were multicomponent and appear to be largely in-service training. Health workers providing direct care to women, compared with non-clinical staff such as receptionists and cleaners, were the only recipients of training in most studies (81.8%). Two broad categories of training methods/tools were identified: workshop-based and action-based. Over 90% of the studies assessed impact of the training, with a majority focused on impacts on maternal health and care; however, half of the latter studies did not appear to have feedback mechanisms in place for implementing change. The content and design of RMC training in sub-Saharan Africa are multifaceted, suggesting the complexity of implementing/promoting RMC. Some progress has been made; however, missed opportunities in training remain with respect to study populations, training topics, cadres, and feedback mechanisms.

Advanced Practice Registered Nurses Student Cross-Specialty Procedural Training: Effective Collaboration and Student Experience.

Intraprofessional simulation and training in acute care nursing specialties can generate synergies that will promote safe, quality patient care. Implementation of multiple intraprofessional simulations across the life span allowed for sharing of faculty and simulation resources. Simulations encompassed both adult and pediatric patients and consisted of airway skills, point-of-care ultrasound, and a multi-skills day encompassing vascular access experiences, chest tube placement, and lumbar puncture. During 5 years, 235 graduate students across three advanced practice nursing specialties participated in the intraprofessional simulation. Learner feedback showed improved confidence, benefit to future practice, and improved clinical judgment via these intraprofessional simulations. Future development of standardized and validated assessments to evaluate each skill will provide quantitative metrics for each clinical skill set and patient population. Further, additional initiatives will include both continuing and expanding intraprofessional simulation offerings, as well as developing interprofessional simulations with physician assistant and perfusionist colleagues. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Neonatal Neurocritical Care Training—The Time Has Come

This Viewpoint describes the advent of neonatal neurocritical care training, the data supporting the need and its efficacy, and the ways this training can optimize outcomes for vulnerable patients and their families.

Fire at Sea: A 70-year Review of Fire-Related Mass Casualty Events on U.S. Aircraft Carriers.

A major fire at sea is among the most devastating events that can occur while a U.S. Navy combatant vessel is underway. Since World War II, no attack on a large U.S. Navy capital ship has occurred during combat operations. However, increasing global tensions raise the threat of future peer adversary naval combat, and shipboard medical caregivers must be prepared for mass casualty events in the deployed maritime environment. To better prepare modern naval caregivers for this possibility, we reviewed mass casualty events from major fires aboard large U.S. Navy aircraft carriers from 1950 through 2020 to summarize available objective data and identify lessons learned. Underway fires from any cause aboard U.S. Navy aircraft carriers and large amphibious assault ships causing more than 10 casualties (injuries + deaths) were reviewed from 1950 through 2020 using available open access sources including literature review, the Naval Safety Command mishap database, and U.S. Navy Judge Advocate Manual reports. Of 246 fires identified, 27 met inclusion criteria resulting in 1,634 casualties with a combined crew mortality of 23% of those injured. In the 16 events with at least 1 death, 2.0% of the total crew was injured with a combined mortality of 28%. All mishaps occurred while underway during routine training or combat operations; none were caused by an enemy combatant attack. Those events affecting more than 5% of the crew were particularly devastating resulting in a mortality rate of 29% of 1,056 total casualties. Given that main medical spaces may be damaged or destroyed during major fires from any cause, identified lessons learned included the need for (1) distributed medical supplies, (2) flexible medical treatment locations throughout the ship, (3) specific training to prepare non-physician caregivers and non-medical first responders to provide burn and hemorrhagic shock resuscitation, airway management, and prolonged care at or near the point of injury, and (4) the prolonged holding capability of critically ill burned and injured patients if evacuation off the ships is unavailable. Shipboard fires underway pose a significant threat to crew safety with a mortality of nearly a quarter of those injured. These fire mass casualty events immediately overwhelm shipboard medical capabilities requiring a complex response from all hands beginning with non-medical first responders. Notably, all events occurred outside of direct enemy combat, potentially underestimating the impact and number of casualties of a shipboard fire during naval combat. Advances in peer weaponry and the threat of future conflict emphasize the need for pre-deployment burn care training for all shipboard medical caregivers as well as advanced airway and resuscitation training for non-physician caregivers. This review underscores the profound impact of shipboard fires on crew safety, highlighting the critical need for enhanced preparedness and response strategies to prepare for fire-related mishaps during routine operations and naval combat.

Expanding the primary care workforce by integrating genetic counselors in multidisciplinary care teams.

Collectively, rare diseases are common, affecting approximately 8% of the population in Canada and the USA. Therefore, the majority of primary care (PC) clinicians will care for patients who are affected or at risk for a genetic disease. Considering the increasing ways in which genetics is being implemented into all areas of healthcare, one way to address these needs and expand the capacity of the PC workforce is through the integration of genetic counselors (GCs) into PC multidisciplinary teams. GCs are Masters-educated allied health professionals with specialized training in molecular genetics, communication, and short-term psychotherapeutic counseling. The current models of GCs in PC mimic other multidisciplinary models. Complex tasks related to genetics, such as pre- and post-test counseling, genetic test selection, and results interpretation, are conducted by GCs, which, in turn, allows physicians, nurse practitioners, and other PC providers to work at the top of their scope of practice. Quality genetics services provided by GCs improve clinical outcomes for patients and their families; the simultaneous provision of genetic education and psychological support by a GC is associated with an increase in patient knowledge, perceived personal control, decrease in distress, and can lead to positive health behavior changes, all of which are aligned with the goals of primary healthcare. With their extensive training in clinical care, medical communication, and psychotherapeutic counseling, integrating GCs into PC care teams will improve the care patients receive and allow PC clinicians to ensure their patients are at the forefront of the personalized medicine revolution.

Spiritual care competences of healthcare workers in emergency and intensive care-aprospective questionnaire study

In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs. What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies? The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence. We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was2.3 (SD 0.4) out of amaximum of 4points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated ahigher level of competence in the area of perception and conversation skills, physicians in documentation skills. Overall, there is aclear need to train healthcare staff in the field of intensive care and emergency medicine.

KNOWLEDGE AND PRACTICE OF NURSES REGARDING TRACHEOSTOMY CARE

Tracheostomy is a common procedure in critical care settings for patients requiring prolonged ventilation or airway management. Nurses play a crucial role in tracheostomy care, which demands comprehensive knowledge and adherence to evidence-based practices to prevent complications. Objective: This study aimed to assess the knowledge and practices of nurses regarding tracheostomy care at Jinnah Hospital Lahore. Methods: A descriptive cross-sectional study was conducted from January 2024 to July 2024 at Jinnah Hospital Lahore. A total of [specify sample size, e.g., 150] registered nurses working in different wards and intensive care units (ICUs) were selected through simple random sampling. Data were collected using a structured questionnaire, which included sections on demographic information, knowledge, and practices. Knowledge and practice scores were categorized as good, moderate, or poor. Data analysis was performed using SPSS version 25.0, employing descriptive statistics and chi-square tests to identify associations between variables. Results: The study revealed that 60% of the nurses had moderate knowledge regarding tracheostomy care, while 25% demonstrated good knowledge, and 15% had poor knowledge. In terms of practice, 54.7% of nurses reported moderate adherence to tracheostomy care protocols, 30% had good practices, and 15.3% demonstrated poor practices. A significant association was found between formal training in tracheostomy care and higher knowledge and practice scores (p < 0.05). Conclusion: The findings indicate that most nurses possess moderate knowledge and practices concerning tracheostomy care, with notable gaps in training and adherence to standardized protocols. The study highlights the need for structured training programs and continuous professional development to enhance nurses' competency in tracheostomy care and improve patient outcomes.

Social connection in long-term care homes: a qualitative study of barriers and facilitators

BackgroundSocial connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents.MethodsWe used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada.ResultsThemes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. ‘Becoming familiar with life in the LTC home to support social connection’ described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. ‘Physical and virtual access beyond the LTC home as strategies to maintain contact’ related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. ‘Getting to know residents to deepen relationships’ related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. ‘Person-centred approaches to build social connection’ included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs.ConclusionsThis study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes.Clinical trial numberclinicaltrials.gov ID NCT05315960.

Palliative care knowledge and self-efficacy: a comparative study between intensive care units and general units nurses

Background and objectivesThe growing number of terminally ill patients has underscored the importance of equipping healthcare workers with adequate palliative care knowledge and self-efficacy. This study aimed to compare the palliative care knowledge and self-efficacy of nurses in intensive care units (ICUs) with those in general wards at hospitals affiliated with Kerman University of Medical Sciences in 2023.MethodsThis descriptive-comparative cross-sectional study involved nurses from intensive care units and general wards of three hospitals affiliated with Kerman University of Medical Sciences, for a total sample size of 300 nurses (150 in each group). The samples were selected using convenience sampling. The data collection tools included a demographic information questionnaire, the Palliative Care Knowledge Test (PCKT), and the Palliative Care Self-Efficacy Scale (PCSES). Convenience Sampling method was used. The data were analyzed using SPSS 23. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, Mann-Whitney U test and multivariate stepwise regression) were employed. Statistical significance was determined by a p-value of ≤ 0.05.FindingsThe mean score for palliative care knowledge was 10.59 (± 2.10) for nurses in intensive care units and 10.43 (± 2.33) for nurses in general wards, with no significant difference between the two groups (P = 0.53). Similarly, the mean score for palliative care self-efficacy was 28.01 (± 10.29) for nurses in intensive care units and 27.98 (± 10.33) for nurses in general wards, with no significant difference between the groups (P = 0.98). Variables such as the history of caring for dying patients in the hospital (P = 0.004) or at home (P = 0.01), workplace (P = 0.002), and work experience (P = 0.03) were identified as the main predictors of palliative care knowledge and palliative care self-efficacy was affected by age (P < 0.001), history of participation in palliative care training courses (P = 0.008), and palliative care knowledge score (P = 0.01).Discussion and conclusionThis study revealed no significant difference in total scores of palliative care knowledge or self-efficacy between nurses in intensive care units and general wards It is suggested that more efforts be made to increase the knowledge and self-efficacy of all nurses, especially nurses in ICU departments, till providing a standard palliative care setting.

Exploring the Factors Related to Knowledge of Palliative Care for Patients with Terminal Cancer Among Nursing Students: A Cross-Sectional Study

Introduction: The inadequate knowledge is the main obstacle of provision of palliative care. This study attempted to examine the association between related factors and knowledge about palliative care for patients with terminal cancer among nursing students in Bangkok, Thailand. Methods: This study was cross-sectional, conducted in June 2024 at Saint Louis College, Bangkok, Thailand. Data were collected through self-administered questionnaires measuring sociodemographic characteristics. We employed the Palliative Care Quiz for Nursing (PCQN) and the Frommelt Attitude Toward Care of the Dying (FATCOD), form B. Descriptive statistics and multiple linear regression were selected to use for analysis. Results: The participants were 111 third-year nursing students. The mean score of knowledge about palliative care for patients with terminal cancer was 8.52 (SD = 1.84. The significant predictors of knowledge about palliative care for patient with terminal cancer were experience of losing close relatives or beloved ones from cancer within 1 year (β = 1.083, p &lt; 0.05), and attitude toward dying (β = 0.041, p &lt; 0.05). Conclusion: This study highlights that nursing students had insufficient palliative care knowledge for patient with end-stage cancer. These findings implies that better attitude toward caring for end-of-life patient associated with improved palliative care knowledge. Therefore, to develop educational program of palliative care for nursing students with psychological and spiritual care training should be embedded in the program for optimum palliative care for patients with terminal cancer.

The interdisciplinary training academy for integrated substance/opioid use disorder prevention and health care: A qualitative look at a new remote field education model.

The opioid syndemic presents a critical need for effective interprofessional training in health care, especially in behavioral health disciplines. Addressing this need, the Interdisciplinary Training Academy for Integrated Substance/Opioid Use Disorder Prevention and Health care (ITA) was developed to provide adaptable educational experiences for emerging behavioral health professionals. This study, reflecting years 2020-2023, explored the experiences and perspectives of ITA fellows regarding interprofessional collaboration and opioid workforce development, focusing on how these elements are integrated. After conducting focus groups, we employed applied thematic analysis to qualitatively analyze the experiences of ITA fellows (11 women and six men; 41% Hispanic/Latino and 59% White; 14 Master of Social Work students and three psychology postdoctoral fellows). This method allowed for a detailed exploration of their perceptions and the nuances of their learning process within the context of opioid workforce development. The findings indicated that fellows' learning processes were adaptive, evolving over time to meet their changing needs. Initially, fellows faced challenges related to role clarity and process understanding. However, they reported significant professional growth as the program progressed, highlighting the effectiveness of the ITA's interprofessional approach in a remote learning setting. The study emphasizes the need for ongoing research to identify and overcome barriers to effective interprofessional collaboration. The results contribute insights into the role of remote field education in preparing future health care professionals to address complex health crises effectively. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adding Life to Years: Comprehensive end-of-life care for all

This study builds upon our 2019 End-of-Life Care (EoLC) research, focusing on enhancing the quality and accessibility of EoLC in Hong Kong. With the introduction of the Advance Decision on Life-sustaining Treatment Bill, we identified the need for a more comprehensive approach to address the full spectrum of care needs beyond medical decisions. Our methodology leveraged insights from diverse stakeholders across various sectors and disciplines. The study revealed critical gaps in the system, service provision, and education related to EoLC. We propose six key recommendations: (1) develop a territory-wide standardised advance care planning (ACP) framework, (2) formulate an EoLC service strategy, (3) establish clear communication pathways to connect EoLC services, (4) promote public life and death education, (5) equip community professionals with ACP training, and (6) enhance university curriculum and on-the-job training in health and social care. These recommendations aim to create a cohesive EoLC ecosystem that respects individual preferences, optimises resource allocation, and addresses the challenges of an aging population. By implementing changes at system, service, and education levels, we envision EoLC in Hong Kong to be delivered in a person-centred, dignified, and coordinated manner, ensuring compassionate care at the final stage of life.

Enhancing trauma-informed care preparation through life story work

ABSTRACT Trauma experience is common and may impact health and health care experiences for older adults. As such, training in trauma-informed care (TIC) is essential for health professions trainees. In this paper, we describe the use of life-story work, in the form of the My Life, My Story (MLMS) program as one platform to enhance TIC competencies. Trainees (N = 74) who were physician (57.0%) and other health professions trainees who did MLMS interviews completed a post-experience survey about trauma disclosures and confidence in responding to these. During these interviews, 36.5% of the patients described a traumatic event and 56.8% described a stressful event, framed by the patient as “ultimately positive” – leading to resilience (42.6%) or “ultimately negative” – leading to negative life outcomes (29.5%), with other responses as not sure or ambivalent. Confidence in responding to trauma disclosures increased following participation in MLMS (t(df = 60) = 5.52, p < .001). Qualitative comments indicated that MLMS helped them recognize the various expressions of trauma and provided insights into possible responses to trauma disclosure, among other TIC competencies. About half (50.8%) of trainees expressed interest in additional resources or training in responding to trauma disclosures. In conclusion, life-story work and MLMS may be one tool to enhance TIC.

Tū Kaha: he mōhio ki ngā Māori o te kōmaoa waewae (Stand Strong: A qualitative study of Māori with venous leg ulcers in Aotearoa New Zealand).

Venous leg ulcers have impact on people's lives far beyond that of a skin lesion but these impacts have not been explored from an Indigenous perspective. We used a Māori-centered narrative approach to interview 13 Māori in Aotearoa New Zealand with venous leg ulcers. Data analysis was informed by a reflexive thematic approach and four themes were identified: Ko waewae ahau (I wear the leg); Ngā mea hōhā (annoying things); Ka tangi te ngākau (heartfelt grief); and Mamae (pain, sore, hurt). Recognizing patients' expertise in their condition, the inclusion of whānau (family) in care planning and provision, while providing consistent advice and resource access, would all enhance the experience of venous ulcer management. Training in venous leg ulcer care needs to move beyond a focus on the leg and toward a more holistic approach that encompasses a broader understanding of patient experiences and cultural contexts when managing venous ulcers.

A qualitative study exploring the experiences of advanced clinical practitioner training in emergency care in the South West of England, United Kingdom

BackgroundAttempting to improve emergency care (EC) advanced clinical practitioner (ACP) training, Health Education England (HEE) South West (SW) implemented a pilot, whereby emergency departments (ED) were provided with enhanced funding...

Infection prevention in home dialysis

Purpose of review Among patients with kidney failure, home dialysis modalities, including peritoneal dialysis (PD) and home hemodialysis (HHD) provide several individual and healthcare system benefits over in-center hemodialysis (HD). Infection remains a major source of morbidity and mortality in this population, and a core outcome of critical importance to patients, caregivers, and kidney health professionals. This narrative review provides evidence-based measures for infection prevention among individuals receiving home dialysis, with a particular emphasis on dialysis and access-related infections. Recent findings Patient and care partner education and training is an important and major theme for infection prevention in home dialysis. In PD, identifying and managing modifiable risk factors for infections such as hypokalemia, constipation, use of gastric acid suppressants, and domestic pets, along with the use of antimicrobial prophylaxis, when indicated, can substantially reduce peritonitis risk. Reducing the use of central venous catheters (CVC), and duration of CVC dependence is the most effective means of prevention of HD access-related bloodstream infections in individuals receiving HHD. For arteriovenous fistula cannulation, rope ladder technique is associated with lower risk of infection compared to buttonhole cannulation. Summary Developing and instituting a well structured and evidence-based patient training and education program within home dialysis units is the most important measure in preventing and reducing dialysis and access-related infections. Kidney care providers should be familiar with different infection risk factors among individuals receiving home dialysis.

Assessing the capacity building programs pursued by university libraries in Meru County, Kenya

Changing user demands require libraries to develop unique capabilities for supporting the delivery of quality teaching, learning, and research. This shift further requires librarians to develop competencies in handling emergent technologies, dissemination of information, scholarly communication, and strategy formulation. Nevertheless, there has been an overreliance on conventional ways that have stifled innovation and creativity in most libraries, raising questions on continuous training programs for information professionals. The purpose of the study was to assess capacity-building programs pursued by university libraries in Meru County. The study used a qualitative approach and employed a case study research design. The Technology Organization Environment Model guided the study. The units of analysis were KeMU and MUST university libraries, and the unit of observation was 15 university library staff, specifically, 2 university library heads and 13 heads of library sections who were selected through the purposive sampling method. The study interviewed university librarians and conducted Focus Group Discussions [FGDs] with library heads of sections. The two FGDs comprised 5 and 7 participants in KeMU and MUST respectively. Validity of the instruments was established by conducting a pretest at Chuka University Library to appraise the dependability of interview and FGDs questions. One librarian and 2 library section heads participated. Data was analysed using content analysis and thematic categorization. The study identified several capacity-building initiatives undertaken by libraries which included leadership training, customer care training, information retrieval skills development and training on reference management systems. This led to a conclusion that library staff were prepared to deliver quality services through a combination of skill enhancement. Notably, the study highlighted opportunities for library personnel to engage in ongoing professional development. It urges library management to organize seminars and workshops periodically to help its staff to keep abreast with latest developments and innovations in the field of library science.

Assessing a tertiary surgical units readiness to offer a fellowship in burn care in Africa

The number of patients presenting with burn injuries in Africa is increasing [1,2], and these injuries can have devastating outcomes [3,4]. One contributing factor to these outcomes is the lack of adequately trained staff in providing expert burn wound care. There is little emphasis on training staff in caring for burn patients in Africa. Our goal was to assess the services offered at a specialized burn unit in South Africa and compare them to the recommendations of the American Burn Association for providing fellowship training in burn care. Establishing such a fellowship program will help train experts who can improve burn care services across Africa.