World Journal of Surgery

, Volume 42, Issue 11, pp 3514–3519 | Cite as

Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings

  • David A. ShayeEmail author
  • Travis Tollefson
  • Irfan Shah
  • Gopal Krishnan
  • Damir Matic
  • Marcelo Figari
  • Thiam Chye Lim
  • Sunil Aniruth
  • Warren Schubert
Original Scientific Report



Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of craniomaxillofacial (CMF) trauma education.


CMF trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency.


A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed.


Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.



Special thanks to the AO Alliance Foundation and AO Foundation, including Michael Cunningham, PhD, Chitra Subramanian, PhD and Diana Greiner.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • David A. Shaye
    • 1
    • 2
    Email author
  • Travis Tollefson
    • 3
  • Irfan Shah
    • 4
  • Gopal Krishnan
    • 5
  • Damir Matic
    • 6
  • Marcelo Figari
    • 7
  • Thiam Chye Lim
    • 8
  • Sunil Aniruth
    • 9
  • Warren Schubert
    • 10
    • 11
  1. 1.Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical SchoolBostonUSA
  2. 2.Department of OtolaryngologyCentral University Teaching HospitalKigaliRwanda
  3. 3.Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck SurgeryUniversity of California, DavisSacramentoUSA
  4. 4.Armed Forces Institute of Dentistry/Army Medical CollegeNational University of Medical Sciences (NUMS)IslamabadPakistan
  5. 5.Department of Maxillofacial SurgerySDM College of Dental Sciences and HospitalDharwadIndia
  6. 6.Plastic and Reconstructive Surgery, Department of SurgeryWestern UniversityLondonCanada
  7. 7.Section of Head and Neck Surgery, Department of SurgeryHospital Italiano de Buenos AiresBuenos AiresArgentina
  8. 8.Plastic, Reconstructive and Aesthetic Surgery, Department of SurgeryNational University HospitalSingaporeSingapore
  9. 9.Department of Maxillo-Facial and Oral SurgeryUniversity of the Western CapeCape TownSouth Africa
  10. 10.Department of Plastic & Hand SurgeryUniversity of Minnesota and Regions HospitalSt. PaulUSA
  11. 11.AO FoundationAOCMFDavosSwitzerland

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