Anatomy of Gun Violence: Contextualized Curriculum to Train Surgical Residents in Both Technical and Non-Technical Skills in the Management of Gun Violence

Onufer, Emily J.; Andrade, Erin G.; Cullinan, Darren R.; Kramer, Jessica B.; Leonard, Jennifer; Stewart, Melissa; Vallar, Kelly; Wise, Paul E.; Klingensmith, Mary E.; Punch, L

doi:10.1016/j.jamcollsurg.2020.09.025

Cited by 4 publications

(3 citation statements)

References 31 publications

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Section: Discussionmentioning

confidence: 99%

“…Although we reported findings from a single medical center, it is possible that similar increases in orthopaedic consultations for firearm injuries are being seen in other communities within the United States. Any potential increase in firearm violence should be noted by surgeons, other health-care professionals, and policymakers, given the growing recognition of firearm violence as a public health crisis 18 and a marker of social inequity 19,20 . The observational nature and relatively short time frame of our study, as well as the evolving impact of the pandemic, limited our ability to rigorously examine the association between firearm injuries and the onset of the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Epidemic Amidst a Pandemic: Musculoskeletal Firearm Injuries During the COVID-19 Pandemic

Inclan

Velicki

Christ

et al. 2021

Journal of Bone and Joint Surgery

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Background:The COVID-19 pandemic has substantially impacted the delivery of health care, both through direct care associated with COVID-19 and through more pervasive effects. Our goal was to evaluate whether the number of orthopaedic consultations for firearm injuries differed during the early months of the COVID-19 pandemic compared with the same period in prior years. We hypothesized that the initial months of the COVID-19 pandemic, compared with the same period in prior years, would have a higher number of orthopaedic consultations for firearm injuries and a lower rate of outpatient follow-up after consultations.Methods: A prospectively collected database of orthopaedic trauma consultations at a level-I trauma center was queried for firearm injuries. We compared the number of orthopaedic consultations for firearm injury during the initial months of the COVID-19 pandemic (March 23, 2020, to September 30, 2020, referred to as the pandemic group) with identical dates from 2017 to 2019 (referred to as the pre-pandemic group). Outpatient follow-up rates, ZIP codes (and associated Area Deprivation Index), and demographic data were compared between the pandemic group and the pre-pandemic group.Results: During the entire study period, 552 orthopaedic consultations for firearm injuries were identified. There was a 63% increase in the daily mean number of firearm injury consultations in the pandemic group, to 1.01, compared with the pre-pandemic group, 0.62 (p < 0.001). There was no difference in the rate of outpatient follow-up: 66% for the pandemic group and 72% for the pre-pandemic group. There was no difference in the percentage of patients from the most socially deprived decile: 45.3% in the pandemic group and 49.5% in the pre-pandemic group. Patients presenting during the pandemic were more often uninsured (75.8%) relative to the pre-pandemic group (67.9%), with a lack of health insurance significantly decreasing the likelihood of outpatient follow-up (p < 0.01).Conclusions: Compared with the same period in prior years, there was a significant increase in the number of orthopaedic consultations for firearm injuries during the early months of the COVID-19 pandemic in our community. Patient race, socioeconomic status, and outpatient follow-up were similar between the pandemic group and the pre-pandemic group. There was a higher proportion of uninsured patients within the pandemic group and a lower rate of follow-up among those without insurance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

An Epidemic Amidst a Pandemic: Musculoskeletal Firearm Injuries During the COVID-19 Pandemic

Inclan

Velicki

Christ

et al. 2021

Journal of Bone and Joint Surgery

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“…Homma [45] 2017 Japan Surgeons (all levels) Assesses the efficacy of a cadaver-based trauma surgical skills course designed to avoid the prohibitive expense associated with other existing courses. Participant self-assessed confidence scores increased in all skill domains but showed some degree of decay at 6 months Homma [46] 2019 Japan Senior surgeons Evaluates and advanced version of the original CESTS for senior surgeons Measures the efficacy of a course for the surgical management of penetrating torso trauma, finding improvement in knowledge and skill of junior residents (PGY1-3) but not senior residents (PGY5) participant in the course Onufer [56] 2020 USA Surgery residents Assesses changes in participant knowledge after a course for the surgical management of penetrating firearm injury, finding that residents had on average a * 7.5% improvement in post-course knowledge scores with a larger effect among junior residents Surgical Techniques and Repairs in Trauma for the Low-resource Environment (STaRTLE)…”

Section: Implementation Evaluation and Credentialingmentioning

confidence: 99%

Operative Trauma Courses: A Scoping Review to Inform the Development of a Trauma Surgery Course for Low‐Resource Settings

et al. 2023

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Background A multitude of operative trauma courses exist, most of which are designed for and conducted in high‐resource settings. There are numerous barriers to adapting such courses to low‐ and low‐middle‐income countries (LMICs), including resource constraints and contextual variations in trauma care. Approaches to implementing operative trauma courses in LMICs have not been evaluated in a structured manner. Methods We conducted a scoping review of the literature including databases (e.g., PubMed, Web of Science, EMBASE), grey literature repositories, and structured queries of publicly available course materials to identify records that described operative trauma courses offered since 2000. Results The search identified 3,518 non‐duplicative records, of which 48 relevant reports were included in analysis. These reports represented 23 named and 11 unnamed operative trauma courses offered in 12 countries. Variability existed in course format and resource requirements, ranging from USD 40 to 3,000 per participant. Courses incorporated didactic and laboratory components, which utilized simulations, cadavers, or live animals. Course content overlapped significantly but was not standardized. Data were lacking on course implementation and promulgation, credentialing of instructors, and standardized evaluation metrics. Conclusions While many operative trauma courses have been described, most are not directly relatable to LMICs. Barriers include cost‐prohibitive fees, lack of resources, limited data collection, and contextual variability that renders certain surgical care inappropriate in LMICs. Gaps exist in standardization of course content as well as transparency of credentialing and course implementation strategies. These issues can be addressed through developing an open‐access operative trauma course for low‐resource settings.

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Non-fatal gun violence and community health behaviors: A neighborhood analysis in Philadelphia

Semenza

Stansfield

2021

J Behav Med

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Anatomy of Gun Violence: Contextualized Curriculum to Train Surgical Residents in Both Technical and Non-Technical Skills in the Management of Gun Violence

Cited by 4 publications

References 31 publications

An Epidemic Amidst a Pandemic: Musculoskeletal Firearm Injuries During the COVID-19 Pandemic

An Epidemic Amidst a Pandemic: Musculoskeletal Firearm Injuries During the COVID-19 Pandemic

Operative Trauma Courses: A Scoping Review to Inform the Development of a Trauma Surgery Course for Low‐Resource Settings

Non-fatal gun violence and community health behaviors: A neighborhood analysis in Philadelphia

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