Alavian Sara, Birkland Bassim, Mwanza Kephas, Mondoux Shawn
Division of Emergency Medicine, Department of Medicine, McMaster University, Canada.
University of Zambia School of Public Health / Seed Global Health, Zambia.
Afr J Emerg Med. 2024 Sep;14(3):218-223. doi: 10.1016/j.afjem.2024.07.003. Epub 2024 Aug 14.
Emergency medicine (EM) is a nascent field in Zambia. While not yet recognized as a medical specialty, there is national interest for developing more robust emergency care systems in this setting. One key element of strengthening EM in Zambia is identifying current gaps in emergency healthcare provision and opportunities for advancement in the field. This research used a modified version of the Emergency Care Assessment Tool to characterize the landscape of EM in Zambia. We collected data on the extent of EM training and teaching engagement among physicians practicing EM in Zambia. The survey assessed three aspects of core EM "signal functions" among the respondents which included; how often they performed the function, how confident they felt with the function, and how important they deemed the function to be in their practice. Finally, we asked respondents to identify barriers to performing the functions in their departments. The majority of respondents were early in their career, all below the age of 50, and participated in some form of teaching and supervision of learners, with minimal access to teaching resources to enhance their work. There was unanimous agreement with the need for formal postgraduate EM training in Zambia. The EM functions performed least often by EM physicians, and in which they felt the least confident, were high-acuity low-occurrence (HALO) procedures such as surgical airway and pericardiocentesis. The most common barrier to performing an EM function was access to supplies, equipment and medication. The second most commonly cited barrier was healthcare worker training. This research identified several critical needs for EM curricula in Zambia, specifically teaching resources for clinicians who supervise learners, directed learning on HALO procedures, and formal postgraduate training in EM based in Zambia.
急诊医学在赞比亚是一个新兴领域。虽然尚未被认定为医学专科,但该国对于在此背景下发展更完善的急诊护理系统存在全国性的兴趣。在赞比亚加强急诊医学的一个关键要素是确定当前急诊医疗服务提供方面的差距以及该领域的发展机会。本研究使用了急诊护理评估工具的一个修改版本来描述赞比亚急诊医学的现状。我们收集了在赞比亚从事急诊医学工作的医生的急诊医学培训和教学参与程度的数据。该调查评估了受访者核心急诊医学“信号功能”的三个方面,包括:他们执行该功能的频率、对该功能的自信程度以及他们认为该功能在其实践中的重要性。最后,我们要求受访者指出在其科室执行这些功能的障碍。大多数受访者处于职业生涯早期,均未满50岁,参与了某种形式的对学习者的教学和监督,但获得的用于提升工作的教学资源极少。对于赞比亚开展正规的急诊医学研究生培训的必要性,大家达成了一致意见。急诊医生执行频率最低且自信程度最低的急诊医学功能是高敏锐度低发生率(HALO)程序,如手术气道建立和心包穿刺术。执行急诊医学功能最常见的障碍是获取物资、设备和药品。第二常见的障碍是医护人员培训。本研究确定了赞比亚急诊医学课程的几个关键需求,特别是为监督学习者的临床医生提供教学资源、针对HALO程序的定向学习以及基于赞比亚的正规急诊医学研究生培训。