Delivering hybrid digital trauma training to rural Kenya
Ronald Lett, MD, FRCSC, is leading a three-year trauma training program in Kenya to reduce injury-related morbidity and mortality.
For more than 40 years, Dr. Lett has worked to improve the quality of surgical services in developing countries. Dr. Lett’s work has been done primarily through the Canadian Network for International Surgery (CNIS), an organization he co-founded in 1995 that has trained over 60,000 health professionals in 10 African countries.

Trauma Team Training hybrid course participants at Machakos County, Kenya in July 2022 – Dr. Ronald Lett is third from right, second row (submitted photo)
Hybrid trauma training
Dr. Lett’s International Development, Aid and Collaboration-funded training project builds on the CNIS Trauma Team Training (TTT) course first developed in 1997 in Uganda to address training gaps for clinical associates in under-resourced settings.
“The difference with this project is that we’re delivering training on a digital platform so that we are more efficient, effective and accessible,” says Dr. Lett. By delivering a hybrid course that uses digital as well as hands-on training techniques, the CNIS can significantly improve the course’s productivity.
After two successful standard TTT training pilot programs at community centres in Kenya, the CNIS and the Kenyan Ministry of Health are using the hybrid digital course in nine counties.
For the next three years, one Kenyan instructor team and six providers teams will be trained annually in three Kenyan counties. In July, the first hybrid TTT course was implemented and, starting this November, two courses per month will be rolled out. In October, a remote TTT instructors’ course was conducted to orient instructors in the use of the TTT digital platform.
A trauma registry is also being established to help reduce injury-related morbidity and mortality, with Kenya’s Ministry of Health supporting its maintenance.

Team training exercise in 2022 (submitted photo)
Creating sustainable training
Sustainability is a key element of the CNIS’s work. The TTT course includes training for instructors and providers, delivers the pedagogical equipment needed for effective training and supports the implementation of a trauma registry.
The coursework consists of interactive lectures, skills sessions, clinical team exercises and case studies targeting trauma patients in under-resourced facilities. These assets are accessed via laptops or mobile phones on the CNIS’ YouTube channel, website or learning management systems.
The training incorporates remote and digital methodologies that have been used successfully for clinical training in Nigeria, Tanzania and South Sudan – countries where Dr. Lett has worked extensively.
“Canadian and Kenyan instructors will teach jointly, with some instructors (including Royal College Fellows) working on-site in Kenya and some teaching remotely from Canada,” said Dr. Lett. “This hybrid strategy allows us to use resources in the most efficient way.”
The digital TTT course will contribute to sustainable capacity building and will result in critical front-line care for millions of Kenyans.
Volunteer opportunity
Dr. Lett is interested in recruiting volunteers. For this work, he needs clinical editors and proofreaders who can help support the course’s digitization, as well as instructors for hands-on training. “If Royal College Fellows have a specific interest in helping, they should let us know,” he said.
If you are interested in volunteering, please email idac@royalcollege.ca (subject: Dr. Lett’s project in Kenya) with some details about yourself. Your email will be passed on to the project lead.