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| Highlights | Description | Test Results | Contact | References |
| Highlights | |
| Gave rural EMTs access to expert instructor in another state | |
| Videotaped performance skill allowed EMTs to critique themselves | |
| Remote instructor reviewed tapes and critiqued via E-mail | |
| EMTs and instructor considered the videotaping the strongest component of the program | |
| Desktop video conference allowed remote instructor and EMTs to discuss self-study materials and written performance critiques | |
| Self-study didactic materials decreased required classroom time | |
| Self-study was not well used | |
| Students need good support system for self-study | |
This pilot test was designed to improve the pediatric airway management and positioning knowledge and skills for emergency medical technicians working in a rural ambulance service. Problems with pediatric airway management and positioning are well documented in the literature. Rural EMTs typically receive some training in pediatric care, but low call volumes, especially in rural areas, provide few opportunities to practice their skills or use their knowledge.1,2 Knowledge and skill deterioration is well documented in EMS.3,4,5 Although training is often advocated to retain knowledge and skills,6,7,8, 9 high-quality local training is not always available.
The Pediatric Emergency distance learning program
included self-study materials contained on an Internet World Wide Web site, in
published textbooks, and on interactive CD-ROM programs. The training was
conducted by an instructor in Salt Lake City, UT, who communicated with 9
prehospital providers, aged 20-59, in Fort Benton, MT, using E-mail and desktop
video conferencing. The instructor reviewed and critiqued videotapes of the
ambulance crew members’ performance skills taped before the training began.
The performance skill required participants to assess and provide care for a
pediatric trauma patient in a simulated emergency.
The
providers took a written test, filled out a questionnaire to measure
self-confidence, and completed the performance test before and after the
training.
Quantitative
data showed statistically significant improvement in performance but no change
in either written knowledge or self-confidence.
During a focus group meeting and personal interviews, the ambulance crew members identified the chance to review their own performance on videotape and to have access to an expert instructor as the most valuable components of the training program. The lack of improvement on the written test may have been because ambulance crew members concentrated on the performance test, making little use of the self-study materials.
The pilot program shows promise for making high quality training, including performance skills training, available to all prehospital providers, regardless of their location.
Pretest performance scores range: 19.67 – 47 (median 38)
[60 points possible]
Total scores significantly higher at posttest (M = 42.4) than pretest (M = 36.7), t (2.357), p = .025 (one-tailed)
|
Written test [20 possible points] |
|
| Pretest scores range: 12 - 19 (mean 15.6) | Posttest scores range: 13-18 (mean 15.5) |
| Change was not statistically significant | |
| Rating
of confidence in self skills (Scale of 1 to 5 with 1 being Not-at-all Confident and 5 being Completely Confident) |
|
| Pretest rating range: 2.9 - 4.5 (mean 3.8) | Posttest rating range: 3.3 - 4.9 (mean 3.9) |
|
Change was not statistically significant |
|
| Rating
of confidence in ambulance service skills (Scale of 1 to 5 with 1 being Not-at-all Confident and 5 being Completely Confident) |
|
| Pretest rating range: 3.3 - 5 (mean 4.2) | Posttest rating range: 2.9 - 5 (mean 3.7) |
| Change was not statistically significant | |
| Jeri Pullum Critical Illness & Trauma Foundation Bozeman MT | Great Falls MT jpullum@citmt.org |
D. Breck Rushton Utah Bureau of EMS Salt Lake City, UT brushton@doh.state.ut.us |
1.
Glaeser PW, Linzer J, Tunik MG, Henderson DP, Ball J. Survey of nationally
registered emergency medical services providers: Pediatric education. Annals
of Emergency Medicine 2000;16:33-38.
2.
Seidel JS, Henderson DP, Ward P, Wayland BW, Ness B. Pediatric prehospital
care in urban and rural areas. Pediatrics
1991;4:681-690.
3.
Skelton MB, McSwain NE. A study of cognitive and technical skill
deterioration among trained paramedics. Journal
of the American College of Emergency Physicians 1977;6:436-438.
4.
Latman NS, Wooley K. Knowledge and skill retention of emergency care
attendants, EMT-As, and EMT-Ps. Annals of
Emergency Medicine 1980;9:183-189.
5.
Zautcke JL, Lee RW, Ethington NA. Paramedic skill decay. Journal of Emergency Medicine 1987;5:505-512.
6.
Eichelberger MR, Stossel-Pratsch G, Mangubat EA. A pediatric emergencies
training program for emergency medical services. Pediatric Emergency Care 1985;1:177-179.
7.
Hobbs GD, Moshinskie JF, Roden SK, Jarvis JL. A comparison of classroom and
distance learning techniques for rural EMT-I instruction. Prehospital Emergency Care 1998;2:189-191.
8.
Larmon B, Schriger DL, Snelling R, Morgan MT. Results of a 4-hour
endotracheal intubation class for EMT-basics. Annals
of Emergency Medicine 1998;31:224-7.
9.
Stewart RD, Paris PM, Pelton GH, Garretson D. Effect of varied training
techniques on field endotracheal intubation success rates. Annals of Emergency Medicine 1984;13:1032-1036.