Enhancing Emergency Trauma Management Skills Through Simulation: A Quality Improvement Initiative in Ghana

Abstract

Introduction: In Ghana, persistent gaps in emergency and trauma care are linked to limited training opportunities and uneven workforce distribution. This pilot program evaluated the feasibility and outcomes of a regional, simulation-based quality improvement initiative for emergency trauma care in the Central Region of Ghana. Methods: A pre- and post-test pilot was conducted as part of a regional quality improvement effort among multidisciplinary clinicians of various facilities. Two simulation-based continuous professional development (CPD) modules, Basic Emergency and Trauma Management and Suture Techniques & Wound Care, were delivered. Quantitative data were analyzed using chi-square tests (p<0.05), and open-ended responses were analyzed thematically. Results: The majority of participants were nurses (51.1%, n=24) and from district hospitals (61.7%, n=29). Additionally, 53.2% (n=25) of facilities reported functional resuscitation areas, and 27.7% (n=13) had access to blood transfusion services. Knowledge scores improved significantly across all domains, from a mean of 52.6% pre-training to 85.9% post-training (p<0.001). The largest gains were in spinal precautions, focused abdominal sonography in trauma (FAST) interpretation, and bite wound management. All participants expressed high satisfaction, citing the realism and interactivity of the simulation as major strengths, and recommended integrating simulation into regular CPD. Key challenges reported included limited trauma equipment (76.6%, n=36), staffing shortages (66.0%, n=31), and weak referral systems (51.1%, n=24). Conclusion: This pilot demonstrated that simulation-based training is both feasible and effective for building emergency and trauma care competence in resource-limited settings. Embedding simulation-based CPD within regional quality improvement frameworks offers a scalable strategy for workforce development and health system strengthening in Ghana.