title: Developing sustainable trauma care education in Egypt: sequential trauma education program, steps to success.
abstract: BACKGROUND
  As one of the leading causes of death and disability in the world, human trauma and injury disproportionately affects individuals in developing countries. To meet the need for improved trauma care in Egypt, the Sequential Trauma Emergency/Education ProgramS (STEPS) course was created through the collaborative effort of U.S. and Egyptian physicians. The objective of course development was to create a high-quality, modular, adaptable, and sustainable trauma care course that could be readily adopted by a lower- or middle-income country.
  
  
  METHODS
  We describe the development, transition, and host nation sustainability of a trauma care training course between a high-income Western nation and a lower-middle-income Middle Eastern/Northern African country, including the number of physicians trained and the challenges to program development and sustainability.
  
  
  RESULTS
  STEPS was developed at the University of Maryland, based in part on World Health Organization's Emergency and Trauma Care materials, and introduced to the Egyptian Ministry of Health and Population and Ain Shams University in May 2006. To date, 639 physicians from multiple specialties have taken the 4-day course through the Ministry of Health and Population or public/governmental universities. In 2008, the course transitioned completely to the leadership of Egyptian academic physicians. Multiple Egyptian medical schools and the Egyptian Emergency Medicine Board now require STEPS or its equivalent for physicians in training.
  
  
  CONCLUSIONS
  Success of this collaborative educational program is demonstrated by the numbers of physicians trained, the adoption of STEPS by the Egyptian Emergency Medicine Board, and program continuance after transitioning to in-country leadership and trainers.
authors.affiliation: Department of General Surgery, Ain Shams University, Cairo, Egypt. Electronic address: mohamedshinawi@hotmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Shinawi
authors.affiliation: Department of Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Maureen
authors.initials: M
authors.lastname: McCunn
authors.affiliation: Department of Surgery, Banner Good Samaritan Medical Center, Phoenix, Arizona.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Sisley
authors.affiliation: Department of Community, Environmental and Occupational Health, Ain Shams University, Cairo, Egypt; Substance Abuse Research Center, Jazan University, Jazan, Saudi Arabia.
authors.forename: Maged
authors.initials: M
authors.lastname: El-Setouhy
authors.affiliation: Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland; Charles McC. Mathias Jr. National Study Center for Trauma and EMS, Baltimore, Maryland.
authors.forename: Jon Mark
authors.initials: JM
authors.lastname: Hirshon
mesh_terms: D003479:Curriculum; D003906:Developing Countries; D004534:Egypt; D004635:Emergency Medicine / Q000193:education*; D007391:International Cooperation; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods*; D014481:United States; D014944:World Health Organization; D014947:Wounds and Injuries
keywords: Egypt; Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; developing countries; education; injury; trauma