Cara Swain

Cara Swain

Phd Student
Visiting address: Tomtebodavägen 18A, 17177 Stockholm
Postal address: C7 Lärande, Informatik, Management och Etik, C7 Informatik Koch Karlgren, 171 77 Stockholm

About me

  • I am a surgical registrar employed by the Royal Navy and currently a full-time Doctoral student. My specialist interests are in trauma and
    emergency general surgery, with a secondary interest in medical education, particularly the use of simulation.


  • 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, 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) A focus group study exploring the perceptions of UK military medical professionals in relation to live tissue training - manuscript complete, awaiting submission to journal

    3) 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 - preliminary analysis in progress

    4) An interview study exploring perceptions of learners, educations and commissioners of live tissue training events and courses - data analysis in progress

    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 Jul 27.

    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.


  • I have undertaken pedagogical courses including Teach the Teacher and completed an /Advanced Certificate in Clinical Education/. I am a faculty
    member for the international Advanced Trauma Life Support (ATLS) course and have also taught on the Royal College of Surgeons (England) Basic Surgical Skills course. The majority of my teaching experience is clinical in nature, with involvement in simulation courses for both military and civilian


All other publications


  • Phd Student, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 2022-2024

Editorial work

  • BMJ Military Health, Editorial board member, 2024

News from KI

Events from KI