trauma.org – moulage

The trauma.org website attempts to 'promote and disseminate the knowledge and practice of injury prevention and trauma care throughout the world'. The website contains a wealth of information regarding the management of trauma victims, as well as news about upcoming conferences and events in the field. The present review will focus on the 'moulage' link, which can be reached from the main trauma.org homepage.

The 'moulage' section of the site contains numerous clinical scenarios that focus on various topics in trauma care. These scenarios are subdivided into the broad categories: initial assessment of the trauma patient, prehospital care, cervical spine clearance, pediatric trauma, neurotrauma and trauma team leader decision scenarios.

Each 'moulage' is interactive and begins with a description of a trauma. The user is then confronted with a management issue and several possible diagnostic or therapeutic options. If the correct treatment strategy is chosen, the scenario progresses and new clinical dilemmas and management choices involving the same patient are presented. If the user makes a catastrophic or an obviously incorrect choice, the 'moulage' is terminated (typically this is indicated by the demise of the hypothetical patient) and the user must return to the beginning of the scenario. If the user makes an incorrect but not fatal choice, the error in judgment is highlighted by the program but the user is still allowed to work through the remainder of the case.

I was very impressed by the scenarios that have been developed in each of the topic areas. The process of working through a 'moulage' is certainly educational, and the designers of the website have done an outstanding job in ensuring that the material presented is relevant and current. The photographs (typically of trauma pathology) and radiology images are also excellent, and add significantly to the experience of navigating through a case.

The narratives for each scenario are presented in a conversational manner, but often slip into melodrama. The authors obviously have a keen sense of humor, but after completing several of the 'moulages' I became impatient with the unnecessary prose and editorial comments. Similar sentiments were echoed by several of the other individuals that were used as a test audience.

I demonstrated the site to a wide audience including a layperson, a medical student and several intensive care residents. All of these test subjects were very impressed by the site, and found it useful and educational. The medical student seemed to derive the most pleasure and educational value from the site. However, the residents also indicated that the scenarios had contributed to their understanding of trauma practice. They were disappointed that some of the explanations provided were not more detailed.

The 'trauma team leader decision scenarios' were uniformly given the highest ratings. All users appreciated the succinctness of these scenarios and the more focused nature of the questions. The explanations given for both correct and incorrect answers in these scenarios were more comprehensive than in the other sections.

To properly maneuver the site, users must have either Netscape Navigator 2.0+, Internet Explorer 3.01+ or another internet browser that supports frames and Javascript.

Overall, I found the trauma scenarios to be well presented and educational. More importantly, they were actually fun to work through, and seemed to be appreciated by a diverse group of medical users. I would highly recommend a visit to this site to anyone with an interest in trauma care.

Best feature

Interactive nature of the clinical scenarios.

Worst feature

Several of the vignettes contain unnecessary text that becomes a nuisance to skim through.

Wish list

More scenarios in the format of the 'trauma team leader decision scenarios'.

Other links

MDchoice.com – http://www.MDchoice.com

This website contains two interactive scenarios for each of the topic areas of advanced cardiac life support, of acute leg swelling and of acute coronary syndrome. The cases are detailed and well presented. Each 'decision point' has several correct answers, and I found that this made the scenarios slightly less challenging than they might have been if only one correct response had been presented. Medical students and residents are likely to gain the most benefit from working through the cases on this website, which is free.

ACLS.net – http://www.ACLS.net

This free website contains two interactive scenarios that concentrate on basic life support and advanced cardiac life support algorithms. Many clinicians may find these scenarios somewhat simplistic, but individuals who have recently completed the basic life support course or the advanced cardiac life support course may find them useful for reviewing important resuscitation principles.