Emergency medicine education intervention in Rwanda.
OBJECTIVE
To describe the effectiveness of an emergency medical education program in a postwar developing country.


METHODS
A prospective, nonrandomized interrupted time-series study was conducted in an emergency department at a national referral hospital in Rwanda immediately after the 1994 civil war. Participants included 11 medical personnel staffing the ED comprising physicians, nurses, and medical assistants. International medical relief workers in the ED identified deficiencies by directly observing routine clinical practices. On the basis of this assessment, formal training programs in trauma resuscitation, airway management, wound care, and blood/fluid precautions were conducted. Subjects were then observed 1 week and 2 months after the educational programs and scored on a standardized data-collection form. Scores before and after intervention were compared with the use of Fisher's exact test to determine program effectiveness.


RESULTS
Educational interventions with statistically significantly longer term effects included wound management principles and blood/fluid precautions (before versus after intervention, P < .05). Interventions with the least sustained effect included advanced airway interventions and procedures related to trauma resuscitation.


CONCLUSIONS
Educational seminars proved to have the greatest sustained effect on those behaviors requiring minimal equipment and noncomplex medical decisionmaking.
Erickson
T B
TB
Department of Emergency Medicine, University of Illinois, Chicago, USA.
VanRooyen
M J
MJ
Werbiski
P
P
Mycyk
M
M
Levy
P
P
D002983:Clinical Competence; D003422:Critical Care; D004502:Education, Medical, Continuing; D004509:Education, Nursing, Continuing; D004635:Emergency Medicine / Q000193:education*; D016529:Emergency Nursing / Q000193:education; D006801:Humans; D010564:Personnel, Hospital / Q000193:education; D011446:Prospective Studies; D012138:Respiratory Therapy; D012432:Rwanda; D014218:Triage; D014947:Wounds and Injuries / Q000628:therapy