Bio
Peter Acker is a Clinical Associate Professor in the Department of Emergency Medicine at the Stanford University School of Medicine. Dr. Acker holds an MD and an MPH from the Tufts University School of Medicine in Boston, Massachusetts, USA. He completed his emergency medicine training at the University of Chicago, where he served as chief resident. He completed a fellowship in International Emergency Medicine at Stanford University. He currently holds the rank of Clinical Associate Professor in the Department of Emergency Medicine and is a Faculty Fellow with the Center for Innovation in Global Health (CIGH) at Stanford University School of Medicine.
Dr. Acker’s academic work in global health has focused on strengthening health systems, particularly emergency referral systems, to increase access to emergency care for vulnerable populations, including mothers and newborns. He has explored this work in many countries, with a focus in South and Southeast Asia as well as Sub-Saharan Africa, working to improve health facility's abilities to identify sick patients, coordinate safe and effective transport and improve the emergency care they receive upon arriving at a definitive care location. He has also worked extensively with the GVK EMRI ambulance service in India, currently the world’s largest prehospital care system, and the Nepal Ambulance Service to increase the quality and reach of prehospital care and effective emergency referral systems in both of these regions. He is currently involved in a number of efforts focused in improving the measurement and effectiveness of emergency referral systems, supporting the revision of the Averting Maternal Death and Disability tool. Most recently he has been working to create new partnerships in Sri Lanka to better understand current patterns of road traffic accident injuries and outcomes and how existing prehospital care and emergency care resources can be leveraged to optimize outcomes.
Clinical Focus
- Emergency Medicine
- Global Health
- Health System Strengthening
- Maternal and Child Health
- Emergency Referral Systems
- Maternal and Obstetric Emergencies
- Medical Education
- Prehospital Emergency Care
- Emergency Ultrasonography
Administrative Appointments
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Alternate, Stanford Clinical Assistant Professor Appointments And Promotions Committee (2024 - Present)
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Editorial Board Member, The Sri Lanka Journal of Trauma (2024 - Present)
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Faculty Mentor, Stanford Department of Emergency Medicine (2024 - Present)
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Mentor, Stanford Immersion in Medicine Series (2023 - Present)
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Mentor, Stanford Early Clinical Engagement Course (2022 - Present)
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Management Committee Member, USAID Health Care Seeking Behavior and Referrals Community of Practice (2021 - Present)
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EMED 313A Medical Student Coach, Stanford University School of Medicine (2020 - Present)
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Member, Centers for Medicare and Medicaid Services Rural Obstetric Readiness Workgroup (2020 - 2021)
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Faculty Senator, Stanford University School of Medicine (2019 - Present)
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Affiliated Faculty, Stanford Medicine Center for Asian Health Research and Education (2018 - Present)
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Co-Clerkship Director, EMED 313 Emergency Medicine Student Clerkship (2017 - 2018)
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Ambassador, Stanford Digital Medic (2016 - Present)
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Faculty Fellow, Center for Innovation in Global Health (CIGH) at Stanford University School of Medicine (2015 - Present)
Honors & Awards
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SHC Excellence in Service Award-Nominee, Stanford Health Care Awards (2024)
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Bedside Teacher of the Year, Stanford Emergency Medicine Residency (2023)
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James BD Mark Award for Excellence in Patient Care-Nominee, Stanford University School of Medicine (2023)
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MD Program Teaching Award-Nominee, Stanford University School of Medicine (2020)
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Humanitarian Award, American College of Emergency Physicians - California Chapter (2019)
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Outstanding Interdepartmental Faculty Professor, Resident Staff of the Stanford Department of Obstetrics and Gynecology (2017-2018)
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Stanford Emergency Medicine Residency Faculty of the Year, Honorable Mention, Stanford Emergency Medicine Residency (2014-2015)
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Chief Resident, Emergency Medicine, University of Chicago Emergency Medicine Residency (2012-2013)
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Emergency Medicine Ambassador Award, University of Chicago Emergency Medicine Residency (2012-2013)
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PGY-3 Resident of the Year, University of Chicago Emergency Medicine Residency (2012-2013)
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Professionalism in Emergency Medicine Award, University of Chicago Emergency Medicine Residency (2012-2013)
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PGY-2 Resident of the Year, University of Chicago Emergency Medicine Residency (2011-2012)
Boards, Advisory Committees, Professional Organizations
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Steering Committee Member, Global Center on Urban Maternal and Perinatal Health (2023 - Present)
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Advisor, Project Urban Birth (2022 - Present)
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Steering Committee Member, Health Care Seeking and Referrals Community of Practice (2021 - Present)
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Member, Centers for Medicare and Medicaid Services Rural Obstetric Readiness Workgroup (2020 - 2021)
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Member, USAID Healthcare Seeking Behaviors and Referrals Community of Practice (2019 - Present)
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Fellow, American College of Emergency Physicians (2017 - Present)
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Deputy Ambassador to Cambodia, American College of Emergency Physicians (2015 - 2022)
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Technical Advisor for Emergency Medicine and Referrals, USAID Quality Health Services Project-Cambodia (2014 - 2019)
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Member, American College of Emergency Physicians (2010 - Present)
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Member, Society for Academic Emergency Medicine (2010 - Present)
Professional Education
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Residency: University of Chicago Hospitals Internal Medicine Residency (2013) IL
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Medical Education: Tufts University School of Medicine (2010) MA
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Masters in Public Health, Tufts University School of Medicine, Public Health and Global Health (2010)
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Fellowship, Stanford University School of Medicine, International Emergency Medicine (2014)
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Board Certification: American Board of Emergency Medicine, Emergency Medicine (2014)
Community and International Work
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Characterizing road traffic injuries and their associated healthcare and financial burdens, Sri Lanka
Topic
Road Traffic Accidents and Trauma
Partnering Organization(s)
University of Peradeniya and University of Colombo
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Prehospital Maternal Emergency Obstetric Warning Score Development, Tamil Nadu, India
Topic
Maternal Emergency Referrals
Partnering Organization(s)
GVK EMRI
Populations Served
Pregnant Women and Newbors
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Improving Newborn and Maternal Outcomes by Strengthening Emergency Care Gujarat, Gujarat, India
Topic
Emergency Referral Systems
Partnering Organization(s)
GVK EMRI India
Location
International
Ongoing Project
No
Opportunities for Student Involvement
No
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Assessing and Strengthening the Indian Neonatal Care and Referral System, Gujarat, India
Topic
Evaluation of neonatal care resources and referral systems
Partnering Organization(s)
Stanford Department of Pediatrics
Ongoing Project
No
Opportunities for Student Involvement
No
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Diploma Course in Emergency Medicine, Yangon, Myanmar
Topic
Emergency Medicine
Partnering Organization(s)
Parami Hospital
Location
International
Ongoing Project
No
Opportunities for Student Involvement
No
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Digital Medic Emergency Medicine Content Development, India, South Africa, Philippines, Rwanda and others
Populations Served
Medical Students
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Medical student curriculum development in Emergency Medicine, Uganda
Partnering Organization(s)
Makerere University
Populations Served
Medical Students
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Prehospital Care Guideline Development and Dissemination, Nepal
Partnering Organization(s)
Nepal Ambulance Service
Populations Served
Urban and Rural Nepalis suffering from emergency conditions
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Prehospital Care Provide Mobile Application Decision Aid Creation, Nepal
Topic
Pre-hospital care in resource limited settings
Partnering Organization(s)
Nepal Ambulance Service
Populations Served
Emergently ill and injured Nepalese
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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Emergency Medicine Education and Development, Myanmar
Topic
Assessing baseline EM knowledge and designing educational internvetions
Populations Served
All levels of healthcare professionals
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
No
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2014 Nepal Ambulance Service EMT Refresher Training, Nepal
Topic
Critical EMT refresher course
Partnering Organization(s)
Nepal Ambulance Service
Populations Served
EMT's
Location
International
Ongoing Project
No
Opportunities for Student Involvement
No
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2014 VPOL Course: Managing Emergencies: What Every Doctor Needs to Know, Uganda
Topic
Online emergency medicine skills course
Partnering Organization(s)
Makerere University
Populations Served
Medical Students
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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2013-2016 Stanford Essential Prehospital Care Course, India
Topic
EMT refresher training courses
Partnering Organization(s)
GVK-EMRI
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
Yes
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2014-2019 USAID Quality Health Services Project, Cambodia
Topic
Improving access to emergency care services
Partnering Organization(s)
URC, MTI
Location
International
Ongoing Project
Yes
Opportunities for Student Involvement
No
Current Research and Scholarly Interests
My research and work focus on optimizing the use of health system data to create intelligent and accurate emergency referral systems to ensure vulnerable populations receive the care they require as efficiently as possible. I am interested in increasing our understanding of currently available health infrastructure in resource limited settings, and pairing that knowledge with technology tools to help identify patient's true needs and match those needs with health system capacity in real-time.
Projects
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USAID Quality Health ServIces project in Cambodia, Stanford University, University Research Consortium (8/1/2013 - Present)
A multifaceted project working to improve maternal and neonatal health throughout Cambodia. Our area of concentration involves creation of an integrated system for efficient identification, initial assessment and immediate care, referral and transfer of ill neonates and mothers.
Location
Cambodia
Collaborators
- Matthew Strehlow, Professor, Stanford University Department of Emergency Medicine
- S. Mahadevan, Stanford University Department of Emergency Medicine
- Ayesha Khan, Clinical Associate Professor, Emergency Medicine
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Stanford Essential Prehospital Care Course, Stanford University, University Research Consortium
Designing and implementing a series of novel, focused EMT refresher training courses with our Indian partner GVK EMRI. These training programs are being utilized to provided updated, evidence based care training to their group of over 10,000 EMTs.
Location
India
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Prehospital Care Provider Training and Mobile Decision Aid Application Creation
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Saving Mother's and Infant's Lives via Emergency Care (SMILE), Stanford University Department of Emergency Medicine and GVK Emergency Research and Management Institute, India (8/15/2019)
Location
Gujarat, India
Collaborators
- Matthew Strehlow, Professor, Stanford University Department of Emergency Medicine
- S. Mahadevan, Stanford University Department of Emergency Medicine
- Jennifer Newberry, Stanford University Department of Emergency Medicine
- Benjamin Lindquist, Clinical Assistant Professor, Emergency Medicine
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Prehospital Maternal Emergency Obstetric Warning Score Development, Stanford University Department of Emergency Medicine (June 1, 2021 - Present)
Through prospective data collection we will be deriving and validating a prehospital maternal early warning score to help rapidly identify women in the prehospital setting who will require higher levels of care, which can then be used to accurately inform receiving facility selection
Location
Tamil Nadu, India
Collaborators
- Matthew Strehlow, Professor, Stanford University Department of Emergency Medicine
- Brian Rice, Mr, Stanford University Department of Emergency Medicine
- Jennifer Newberry, Stanford University Department of Emergency Medicine
- Enoch Akuffo Obeng, Clinical Assistant Professor, Stanford University Department of Emergency Medicine
- Jennifer Emily Jones, Clinical Instructor, Stanford University Department of Emergency Medicine
All Publications
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Spontaneous coronary artery dissection: An uncommon cause of cardiac arrest in the young.
Journal of the American College of Emergency Physicians open
2023; 4 (4): e13000
Abstract
Spontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndrome that frequently goes undiagnosed due to its rarity and variable presentation. Additionally, patients with SCAD are frequently young and relatively healthy; factors that may inadvertently lower clinical suspicion of serious pathology, thereby causing delayed or missed diagnosis and inadequate management. Our case report describes a young female who presents after cardiac arrest with inconclusive initial labs and diagnostic tests who was ultimately diagnosed with SCAD. Additionally, we briefly review the pathogenesis and risk factors, as well as the diagnostic and management recommendations for SCAD.
View details for DOI 10.1002/emp2.13000
View details for PubMedID 37397183
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Paediatric use of emergency medical services in India: A retrospective cohort study of one million children.
Journal of global health
2022; 12: 04080
Abstract
Millions of children in low- and middle-income countries (LMICs) experience illness or trauma amenable to emergency medical interventions, but local resources are not sufficient to treat them. Emergency medical services (EMS), including ambulance transport, bridge the gap between local services and higher-level hospital care, and data collected by EMS could be used to elucidate patterns of paediatric health care need and use. Here we conducted a retrospective observational study of patterns of paediatric use of EMS services by children who used EMS in India, a leader in maternal and child EMS development, to inform public health needs and system interventions to improve EMS effectiveness.We analysed three years (2013-2015) of data from patients <18 years of age from a large prehospital EMS system in India, including 1 101 970 prehospital care records across 11 states and a union territory.Overall, 38.3% of calls were for girls (n = 422 370), 40.5% were for adolescents (n = 445 753), 65.9% were from rural areas (n = 726 154), and most families were from a socially disadvantaged caste or lower economic status (n = 834 973, 75.8%). The most common chief complaints were fever (n = 247 594, 22.5%), trauma (n = 231 533, 21.0%), and respiratory difficulty (n = 161 120, 14.6%). However, transport patterns, including patient sex and age and type of destination hospital, varied by state, as did data collection.EMS in India widely transports children with symptoms of the leading causes of child mortality and provides access to higher levels of care for geographically and socioeconomically vulnerable populations, including care for critically ill neonates, mental health and burn care for girls, and trauma care for adolescents. EMS in India is an important mechanism for overcoming transport and cost as barriers to access, and for reducing the urban-rural gap found across causes of child mortality. Further standardisation of data collection will provide the foundation for assessing disparities and identifying targets for quality improvement of paediatric care.
View details for DOI 10.7189/jogh.12.04080
View details for PubMedID 36243953
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A qualitative study of an undergraduate online emergency medicine education program at a teaching Hospital in Kampala, Uganda.
BMC medical education
2022; 22 (1): 84
Abstract
BACKGROUND: Globally, half of all years of life lost is due to emergency medical conditions, with low- and middle-income countries (LMICs) facing a disproportionate burden of these conditions. There is an urgent need to train the future physicians in LMICs in the identification and stabilization of patients with emergency medical conditions. Little research focuses on the development of effective emergency medicine (EM) medical education resources in LMICs and the perspectives of the students themselves. One emerging tool is the use of electronic learning (e-learning) and blended learning courses. We aimed to understand Uganda medical trainees' use of learning materials, perception of current e-learning resources, and perceived needs regarding EM skills acquisition during participation in an app-based EM course.METHODS: We conducted semi-structured interviews and focus groups of medical students and EM residents. Participants were recruited using convenience sampling. All sessions were audio recorded and transcribed verbatim. The final codebook was approved by three separate investigators, transcripts were coded after reaching consensus by all members of the coding team, and coded data were thematically analyzed.RESULTS: Twenty-six medical trainees were included in the study. Analysis of the transcripts revealed three major themes: [1] medical trainees want education in EM and actively seek EM training opportunities; [2] although the e-learning course supplements knowledge acquisition, medical students are most interested in hands-on EM-related training experiences; and [3] medical students want increased time with local physician educators that blended courses provide.CONCLUSIONS: Our findings show that while students lack access to structured EM education, they actively seek EM knowledge and practice experiences through self-identified, unstructured learning opportunities. Students value high quality, easily accessible EM education resources and employ e-learning resources to bridge gaps in their learning opportunities. However, students desire that these resources be complemented by in-person educational sessions and executed in collaboration with local EM experts who are able to contextualize materials, offer mentorship, and help students develop their interest in EM to continue the growth of the EM specialty.
View details for DOI 10.1186/s12909-022-03157-5
View details for PubMedID 35135519
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When Stirrups Aren’t Available: Product Evaluation of a Novel Low- Cost Pelvic Lift Cushion
Human Factors in Healthcare
2022; 2
View details for DOI 10.1016/j.hfh.2022.100020
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Developing Emergency Triage Systems in Cambodia.
Cureus
2020; 12 (10): e11233
Abstract
As Cambodia works to rebuild its public health system, an area of focus has been improving the quality of emergency services. After a needs assessment in 2011, project partners identified the implementation of a patient triage system as the first target for development efforts. A context-specific triage system was created using the input of a spectrum of local stakeholders. It was tailored to fit the needs and resources available within the Cambodian health system. The system was implemented through a series of educational interventions at 35 public hospitals throughout nine Cambodian provinces. Follow-up quality improvement visits occurred on a quarterly basis between February 2016 and September 2018, during which feedback on the system was gathered using both quantitative and qualitative methods, and additional system updates were implemented. In this technical report we aim to describe the triage system design, implementation and quality improvement processes utilized with the hope of informing and supporting colleagues working to address similar challenges in other areas of the world. Through this assessment process a number of key observations were made: 1) Establishment of context-specific emergency triage systems is feasible in low resource settings; 2) Development of new triage processes requires an iterative approach; 3) Successful uptake of new practice systems requires flexibility from both the implementers and end-users in the development relationship; 4) Process improvement requires consistent retraining and reinforcement.
View details for DOI 10.7759/cureus.11233
View details for PubMedID 33269161
View details for PubMedCentralID PMC7706145
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Continuing Education for Prehospital Healthcare Providers in India - A Novel Course and Concept.
Open access emergency medicine : OAEM
2020; 12: 201–10
Abstract
Emergency medical services (EMS) in India face enormous challenges in providing care to a geographically expansive and diverse patient population. Over the last decade, the public-private-partnership GVK EMRI (Emergency Management and Research Institute) has trained over 100,000 emergency medical technicians (EMTs), with greater than 21,000 currently practicing, to address this critical gap in the healthcare workforce. With the rapid development and expansion of EMS, certain aspects of specialty development have lagged behind, including continuing education requirements. To date, there have been no substantial continuing education EMT skills and training efforts. We report lessons learned during development and implementation of a continuing education course (CEC) for EMTs in India.From 2014 to 2017, we employed an iterative process to design and launch a novel CEC focused on five core emergency competency areas (medicine and cardiology, obstetrics, trauma, pediatrics, and leadership and communication). Indian EMT instructors and providers partnered in design and content, and instructors were trained to independently deliver the CEC. Many challenges had to be overcome: scale (>21,000 EMTs), standardization (highly variable skill levels among providers and instructors), culture (educational emphasis on rote memorization rather than practical application), and translation (22 major languages and a few hundred local dialects spoken nationwide).During the assessment and development phases, we identified five key strategies for success: (1) use icon-based video instruction to ensure consistent quality and allow voice-over for easy translation; (2) incorporate workbooks during didactic videos and (3) employ low-cost simulation and case discussions to emphasize active learning; (4) focus on non-technical skills; (5) integrate a formal training-of-trainers prior to delivery of materials.These key strategies can be combined with innovation and flexibility to address unique challenges of language, system resources, and cultural differences when developing impactful continuing educational initiatives in bourgeoning prehospital care systems in low- and middle-income countries.
View details for DOI 10.2147/OAEM.S249447
View details for PubMedID 32982494
View details for PubMedCentralID PMC7505709
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Strengthening the Emergency Referral System in Cambodia for Women and Children Under Five: A Description of Interventions and Impact Analysis.
Journal of Global Health Reports
2020
View details for DOI 10.29392/joghr.3.e2019079
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Comparing Teaching Methods in Resource-Limited Countries.
AEM education and training
2018; 2 (3): 238
View details for PubMedID 30051096
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Comparing Teaching Methods in Resource-Limited Countries
AEM EDUCATION AND TRAINING
2018; 2 (3): 238
View details for DOI 10.1002/aet2.10100
View details for Web of Science ID 000770023600008
- Anaphylaxis Progressive Cases in Emergency Medicine McGraw-Hill Education. 2018; 1
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Comparison of Online and Classroom-based Formats for Teaching Emergency Medicine to Medical Students in Uganda.
AEM education and training
2018; 2 (1): 5-9
Abstract
Severe global shortages in the health care workforce sector have made improving access to essential emergency care challenging. The paucity of trained specialists in low- and middle-income countries translates to large swathes of the population receiving inadequate care. Efforts to expand emergency medicine (EM) education are similarly impeded by a lack of available and appropriate teaching faculty. The development of comprehensive, online medical education courses offers a potentially economical, scalable, and lasting solution for universities experiencing professional shortages.An EM course addressing core concepts and patient management was developed for medical students enrolled at Makerere University College of Health Sciences in Kampala, Uganda. Material was presented to students in two comparable formats: online video modules and traditional classroom-based lectures. Following completion of the course, students were assessed for knowledge gains.Forty-two and 48 students enrolled and completed all testing in the online and classroom courses, respectively. Student knowledge gains were equivalent (classroom 25 ± 8.7% vs. online 23 ± 6.5%, p = 0.18), regardless of the method of course delivery.A summative evaluation of Ugandan medical students demonstrated that online teaching modules are effectively equivalent and offer a viable alternative to traditional classroom-based lectures delivered by on-site, visiting faculty in their efficacy to teach expertise in EM. Web-based curriculum can help alleviate the burden on universities in developing nations struggling with a critical shortage of health care educators while simultaneously satisfying the growing community demand for access to emergency medical care. Future studies assessing the long-term retention of course material could gauge its incorporation into clinical practice.
View details for DOI 10.1002/aet2.10066
View details for PubMedID 30051058
View details for PubMedCentralID PMC6001592
- Procedural Sedation in Resource Limited Settings Critical Decisions in Emergency Medicine 2017; 31 (4): 3-13
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Implementing an Innovative Prehospital Care Provider Training Course in Nine Cambodian Provinces
Cureus
2016; 8 (6)
View details for DOI 10.7759/cureus.656
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Efficacy of a novel two-day EMT refresher training program focused on essential EMS knowledge and skills
International Summit on Emergency Medicine and Trauma
2014
View details for DOI 10.1186/1865-1380-7-S1-P5