{
  "abstract": "IMPORTANCE/OBJECTIVE:: Neurologic emergencies contribute disproportionately to morbidity and mortality in sub-Saharan Africa, yet structured neurocritical care training remains limited. Emergency Neurologic Life Support (ENLS) standardizes early management of neurologic emergencies, but implementation in resource-limited settings requires contextual adaptation. Limited access to neuroimaging and monitoring compounds diagnostic uncertainty. Portable neuroultrasound (NeuroUS) offers a feasible bedside adjunct. We developed, implemented, and evaluated Tanzania’s first resource-adapted neurocritical care educational program, including hands-on NeuroUS training in a low- and middle-income country (LMIC) setting.\n\nDESIGN, SETTING, PARTICIPANTS, MAIN OUTCOMES, AND MEASURES:: We conducted a prospective observational study during a 2-day in-person training program (October 2025). Multidisciplinary healthcare professionals caring for neurocritical care patients completed pre- and postcourse assessments evaluating medical knowledge, self-reported knowledge, and confidence across ENLS and NeuroUS domains (5-point Likert scale). Ordinal Likert outcomes were summarized using median and interquartile range (IQR) and compared using two-sided Mann-Whitney U tests. Correct-response proportions were compared using Fisher exact tests. Benjamini-Hochberg false-discovery-rate adjustment was applied within each outcome family.\n\nRESULTS:: Twenty-two participants completed precourse assessments; 17 completed postcourse assessments. Self-reported medical knowledge improved across 15 of 16 domains. The largest effects were observed for NeuroUS knowledge, which increased from a median of 1.5 (IQR, 1–2) to 4 (IQR, 4–5; rank-biserial, r = 0.85; 95% CI, 0.64–1.00; q < 0.001); Broad-Reaching Acute Interventions in Neurocritical Care, from 3 (IQR, 2–3) to 4 (IQR, 4–5; r = 0.73; 95% CI, 0.48–0.93; q < 0.001); and intracranial hypertension and herniation, from 3 (IQR, 3–4) to 5 (IQR, 4–5; r = 0.70; 95% CI, 0.45–0.89; q < 0.001). Confidence scores were higher in eight of 16 domains after adjustment. Both NeuroUS diagnostic-application items demonstrated large postcourse differences (q < 0.001). Correct-response proportions increased across all six exploratory knowledge items, but none remained statistically significant after adjustment for multiple comparisons. Ninety-four percent found the program relevant to their practice.\n\nCONCLUSIONS AND RELEVANCE:: Implementation of resource-limited ENLS integrated with structured neuroultrasound is feasible and significantly improved knowledge and confidence. This hybrid approach represents a scalable education model for LMICs.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, Cooper University Hospital, Camden, NJ.",
    "Department of Neurology, Temple University Hospital, Philadelphia, PA.",
    "Department of Critical Care Medicine, Cooper University Hospital, Camden, NJ.",
    "Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Swarna Rajagopalan",
      "orcid": "0000-0002-0490-503X"
    },
    {
      "affs": [
        1
      ],
      "name": "Lauren Koffman"
    },
    {
      "affs": [
        0
      ],
      "name": "Fred Rincon"
    },
    {
      "affs": [
        2
      ],
      "name": "Nitin Puri"
    },
    {
      "affs": [
        3
      ],
      "name": "Sibtain Moledina"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fa3qqkg2yt7my.bib",
  "cited_by": 0,
  "doi": "10.1097/cce.0000000000001501",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13716409/",
  "id": "fa3qqkg2yt7my",
  "issns": [
    "2639-8028"
  ],
  "landing_url": "https://doi.org/10.1097/cce.0000000000001501",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Observational Study"
    ],
    [
      "openalex",
      "2711|Emergency Medicine Education and Research"
    ]
  ],
  "openalex": "W7224849144",
  "pdf_url": null,
  "pmcid": "PMC13716409",
  "pmid": "42953567",
  "published": "2026-11-01",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/fa3qqkg2yt7my.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:23:24Z",
      "native_id": "PMC13716409",
      "source": "pmc",
      "url": "https://doi.org/10.1097/cce.0000000000001501"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2711|Emergency Medicine Education and Research",
      "subfield": "general"
    }
  ],
  "title": "A Novel Resource-Adapted Neurocritical Care Education Program in Tanzania: Implementation, Outcomes, and a Framework for Sustainable Training",
  "title_text": "A Novel Resource-Adapted Neurocritical Care Education Program in Tanzania: Implementation, Outcomes, and a Framework for Sustainable Training",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:11Z",
  "url": "https://research.draconitic.com/paper/fa3qqkg2yt7my",
  "venue": "Critical Care Explorations",
  "versions": []
}