Cara Swain

I am a surgical registrar employed by the Royal Navy. My specialist interests are in trauma and emergency general surgery, with a dual interest in medical education, particularly the use of simulation. I am the lead for Surgical Education within the Defence Medical Services' Academic Department of Military Surgery & Trauma (ADMST). 

I completed my doctoral research period as a full-time student in Stockholm in September 2024 and returned to clinical work in the UK. I am expecting to defend my thesis later in 2025. 

The overall aim of my research project is to contribute to the understanding of the utility of live tissue training for developing competence in the
surgical management of complex, combat-related traumatic injuries.
Live tissue training is an example of simulation-based learning used in the practice of trauma management. Complex surgical skills are taught using
anaesthetised animals, deliberately wounded to reflect various types and severity of injuries, in order to simulate tissue handling, dissection of
structures and attendant bleeding. On completion of the period of training, animals are euthanised without regaining consciousness. The continuing use of this training modality within medical education is controversial due to increasing public scrutiny, focus on animal welfare/ethical concerns and the availability of alternative simulator technology.

My Doctoral research is qualitative, using observational methods among others, to explore how live animals are being used as human patient
substitutes and enhance understanding of how competence is developed via this educational practice.
The PhD is comprised of four studies reported in five manuscripts, which are currently in various stages of completion. 

1) Systematic review of educational use of live tissue training - published in Journal of Surgical Education

2) Literature review of the ethical arguments associated with live tissue training - publishing in Journal of Medical Ethics 

3) A focus group study exploring the perceptions of UK military medical professionals in relation to live tissue training - manuscript submitted, undergoing peer review

4) An international, multi-site ethnographic study of learning, observing courses (military and civilian) which use live animal models to train 
competence and management of surgical trauma - manuscript submitted, undergoing peer review

5) An interview study exploring perceptions of learners, educations and commissioners of live tissue training events and courses - manuscript drafted, pending submission

Publications associated with my Doctoral research:

Swain CS*, Cohen HM, Helgesson G, Rickard RF, Karlgren K. A Systematic Review of Live Animal Use as a Simulation Modality (“Live Tissue
Training”) in the Emergency Management of Trauma. Journal of Surgical Education. 2023 Sep 1;80(9):1320-39.

Swain CS*, Karlgren K. Comment on: “A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage”. Annals of
Surgery Open. 2023 Sep 1;4(3):e305.

Swain C*, Stathakarou N, Alzuguren P, Lemarteleur V, Moffatt R, Karlgren K. Trauma surgical simulation: discussing the replacement of live animals used as human patient simulators. Advances in Simulation. 2024 Feb 12;9(1):7.

Swain CS*, Cohen HM, Helgesson G, Rickard RF, Karlgren K. Exploring the Scientific Conversation Regarding Live Tissue Training in Trauma Surgery: A Bibliometric Analysis. Journal of Surgical Education. 2024 Dec 1;81(12):103295.

I have undertaken pedagogical courses including Teach the Teacher and have previously completed an Advanced Certificate in Clinical Education. The majority of my teaching experience is clinical in nature, with involvement in simulation courses for both military and civilian learners. 

I am a faculty member for the international Advanced Trauma Life Support (ATLS) course and was appointed to the UK national ATLS Steering Group committee in March 2025 (4 year term).

I have delivered individual seminars on Undergraduate, Masters and Doctoral-level courses - relating my clinical and research experiences to wider fields - and I am actively looking for opportunities to contribute more fulsomely to programmes.