| dc.description.abstract | This thesis comprises the design and validation of a simulation training course for the management of craniomaxillofacial trauma by non-specialists which arose from the evident lack of sufficient surgical expertise in war zones. Although it focuses on austere war zones, a comparison with war in peaceful urban zones and in terrorist attacks on civilian populations is essential. It has two principal components, the clinical and the educational.HistoricallyCMF surgery was catalysed by the two World Wars and developed through an integration of Dental & Oral Surgery with Ear Nose & Throat Surgery to become Maxillofacial Surgery and Plastic Surgery. This CMF integration now includesall related specialties.Craniomaxillofacial trauma isanincreasing problem internationally [4]. The differences between CMF trauma cases in Austere War (AW) and Wealth and Peace (WP) conflict are not readily differentiated by their titles. Austere and War (AW) and Wealth and Peace (WP) are more socio-economic terms rather than demographic classifications of conflict especially with increasing terrorism which warrants the title of: Terrorist Aggression in Peace (TAP). The clinical study compares four conflict areas: (i) The AW in Libya, (ii) WP mafia gunshot and physical trauma injuries in Catanzaro (Italy), (iii) CMF trauma cases arising from interpersonal violence in urban East London and (iv) terrorist attacks which represent aggressive racial or religious discrimination by unprovoked hostile conflict. All four conflicts areas require emergency training to manage both physical injuries and psychiatric disorders from witnessing civilian injury and death [5, 6]. This study began with the analysis of 154 cases of injuries from the AW in Misrata, Libya, and compared with cohorts of 35 cases from the mafia violence of Catanzaro, Italy, and 418 cases of CMF interpersonal violence in East London. From this a curriculum was built following Kern and Khamis's structural steps, which utilised two Delphi consensus syllabuses created by trauma experts. By this method, 5 training programmes were developed utilising simulated components which were supervised and validated by experienced experts. The outcome was achieved in less time and with considerably less costs [7, 8] [9]. The course confirmed that innovative education and simulation exercises can reliably improve the skills of non-specialists in diverse CMF trauma management regardless of the environment. Development of the course and in particular the assessment tools, paves the way to creating a training programme for postgraduates. | en_US |
