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.  

Research description

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 - analysis in progress 

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 - data collection phase

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


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.

Teaching portfolio

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 learners. 


Bachelor of Medicine & Bachelor of Surgery (MBChB), University of Bristol, UK - 2012 

Postgraduate Diploma in Global & Remote Healthcare, University of Plymouth, UK - 2018 

Intercollegiate Membership of the Royal College of Surgeons of England (MRCS) - 2018 

Academic honours, awards and prizes

Royal College of Surgeons of England Research Fellowship 2021