{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:35:21Z","timestamp":1786714521486,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n This study reports the implementation of the Nunavik Trauma Course (NTC), a simulation-based curriculum developed in collaboration with rural physicians in Nunavik.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A needs-assessment pilot questionnaire was distributed to rural physicians in Nunavik through snowball sampling. In response to the questionnaire, an 8-h trauma course was developed, incorporating hands-on and scenario-based training sessions. The curriculum prioritised the unique challenges and training requirements identified by the participants of the pilot survey. A simulation centre hosted the course to replicate realistic, high-stakes scenarios, providing participants an opportunity to enhance their procedural skills and decision-making abilities in a supportive atmosphere. In-training surveys assessed participants\u2019 knowledge, confidence and skills pre\/post-course.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of the 13 participants, 11 completed the pre-course survey (85% response rate). Most were employed full-time (\n n<\/jats:italic>\n = 8; 73%) and had >5 years of experience (\n n<\/jats:italic>\n = 6; 55%). Among them, 36% managed critically injured people once per week (\n n<\/jats:italic>\n = 4), whereas 64% were involved once every 1\u20133 months (\n n<\/jats:italic>\n = 7). Following the course, physicians endorsed significantly greater comfort with bougie-assisted endotracheal intubation (\n P<\/jats:italic>\n = 0.014), cricothyroidotomy (\n P<\/jats:italic>\n = 0.003), pleural pigtail insertion (\n P<\/jats:italic>\n = 0.003), pelvic binder application (\n P<\/jats:italic>\n = 0.003), tourniquet placement (\n P<\/jats:italic>\n < 0.001) and increased intracranial pressure management (\n P<\/jats:italic>\n = 0.007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The NTC represents a targeted educational initiative addressing the needs of physicians in remote resource-limited settings. By prioritising contextual relevance and procedural proficiency, the NTC is a model for adaptable, physician-informed rural trauma training.<\/jats:p>\n <\/jats:sec>\n \n \n Am\u00e9liorer les soins en traumatologie dans les r\u00e9gions \u00e9loign\u00e9es: Une formation en traumatologie destin\u00e9e aux m\u00e9decins du Nord canadien<\/jats:p>\n <\/jats:sec>\n \n Introduction:<\/jats:title>\n Cette \u00e9tude pr\u00e9sente la mise en \u0153uvre du Nunavik Trauma Course (NTC), un programme de formation par simulation \u00e9labor\u00e9 en collaboration avec des m\u00e9decins ruraux du Nunavik.<\/jats:p>\n <\/jats:sec>\n \n M\u00e9thodes:<\/jats:title>\n Un questionnaire pilote d\u2019\u00e9valuation des besoins a \u00e9t\u00e9 distribu\u00e9 \u00e0 des m\u00e9decins ruraux du Nunavik au moyen d\u2019un \u00e9chantillonnage boule de neige. \u00c0 la suite des r\u00e9ponses obtenues, une formation de huit heures en traumatologie a \u00e9t\u00e9 con\u00e7ue, combinant des ateliers pratiques et des mises en situation. Le contenu de la formation a \u00e9t\u00e9 \u00e9tabli en fonction des d\u00e9fis particuliers et des besoins de formation soulev\u00e9s par les participants au sondage pilote. La formation s\u2019est d\u00e9roul\u00e9e dans un centre de simulation afin de recr\u00e9er des sc\u00e9narios r\u00e9alistes \u00e0 haut niveau d\u2019enjeu, permettant aux participants de renforcer leurs habilet\u00e9s techniques et leur prise de d\u00e9cision dans un environnement encadrant. Des questionnaires administr\u00e9s pendant la formation ont permis d\u2019\u00e9valuer les connaissances, la confiance et les comp\u00e9tences des participants avant et apr\u00e8s le cours.<\/jats:p>\n <\/jats:sec>\n \n R\u00e9sultats:<\/jats:title>\n \n Parmi les 13 participants, 11 ont rempli le questionnaire pr\u00e9alable \u00e0 la formation, pour un taux de r\u00e9ponse de 85%. La majorit\u00e9 travaillait \u00e0 temps plein (\n n<\/jats:italic>\n = 8; 73%) et comptait plus de cinq ans d\u2019exp\u00e9rience (\n n<\/jats:italic>\n = 6; 55%). Parmi eux, 36% prenaient en charge des personnes gravement bless\u00e9es une fois par semaine (\n n<\/jats:italic>\n = 4), tandis que 64% y \u00e9taient expos\u00e9s une fois tous les un \u00e0 trois mois (\n n<\/jats:italic>\n = 7). Apr\u00e8s la formation, les m\u00e9decins ont rapport\u00e9 un niveau de confort significativement plus \u00e9lev\u00e9 pour l\u2019intubation endotrach\u00e9ale assist\u00e9e par bougie (\n P<\/jats:italic>\n = 0,014), la cricothyro\u00efdotomie (\n P<\/jats:italic>\n = 0,003), l\u2019insertion d\u2019un drain pleural de type pigtail (\n P<\/jats:italic>\n = 0,003), l\u2019application d\u2019une ceinture pelvienne (\n P<\/jats:italic>\n = 0,003), la pose d\u2019un garrot (\n P<\/jats:italic>\n < 0,001) et la prise en charge d\u2019une hypertension intracr\u00e2nienne (\n P<\/jats:italic>\n = 0,007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Le NTC constitue une initiative de formation cibl\u00e9e qui r\u00e9pond aux besoins des m\u00e9decins pratiquant en r\u00e9gions \u00e9loign\u00e9es et \u00e0 ressources limit\u00e9es. En misant sur la pertinence du contexte et la ma\u00eetrise des gestes techniques, le NTC offre un mod\u00e8le adaptable de formation en traumatologie rurale, con\u00e7u \u00e0 partir de l\u2019exp\u00e9rience et des besoins des m\u00e9decins sur le terrain.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/cjrm.cjrm_56_25","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T12:00:45Z","timestamp":1786104045000},"page":"93-102","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing trauma care in remote regions: A trauma training course for physicians in Northern Canada"],"prefix":"10.4103","volume":"31","author":[{"given":"Alexander","family":"Laskaris","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesaan","family":"Kandasamy","sequence":"additional","affiliation":[{"name":"Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerneja","family":"Stare","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Howse","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha G.","family":"Caminsky","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven Di","family":"Marco","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Boulanger","sequence":"additional","affiliation":[{"name":"Ungava Tulattavik Health Centre, Kuujjuaq, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Messier-Maynard","sequence":"additional","affiliation":[{"name":"Ungava Tulattavik Health Centre, Kuujjuaq, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ababacar","family":"Thorpe","sequence":"additional","affiliation":[{"name":"Ungava Tulattavik Health Centre, Kuujjuaq, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Grushka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Deckelbaum","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosar","family":"Khwaja","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan G.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Trauma and General Surgery, McGill University Health Centre, Montreal General Hospital Site, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"R3-20260814","doi-asserted-by":"crossref","first-page":"e2322310","DOI":"10.1001\/jamanetworkopen.2023.22310","article-title":"Mapping health disparities in 11 high-income nations","volume":"6","author":"MacKinnon","year":"2023","journal-title":"JAMA Netw Open"},{"key":"R4-20260814","first-page":"3","article-title":"Does geography matter in mortality? 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