The effectiveness of a formal curriculum in teaching mass casualty management.

OBJECTIVE: To improve knowledge, skills, and confidence in mass casualty management through design and im-plementation of a formal educational curriculum. DESIGN: Observational study using a mixed-methods formal educational training curriculum. SETTING: Rural Emergency Medical Services (EMS) system in Pennsylvania. Subjects/participants: Convenience sample of 141 licensed EMS providers. INTERVENTIONS: Formal educational curriculum using a computerized mass casualty scenario, lectures, hands-on skill stations, post-intervention participant satisfaction survey, knowledge retention at three- and six-month post curriculum. RESULTS: The formal curriculum resulted in an improvement in scene size-up, incident command system (ICS) set-up, and medical management of 12 percent, 27 percent, and 26 percent, respectively. Average scores on the written component evaluating mass casualty incident (MCI) management and knowledge of test patient triage were 84 percent and 74 percent, respectively. Knowledge recall at three- and six-month post-training was highly retained as test scores were generally unchanged from the time of the educational session. Course and instructor evaluations by participants reflected a high degree of satisfaction (scoring five on a five-point Likert scale). CONCLUSIONS: The formal curriculum was effective in improving the knowledge, skills, and confidence of mass casualty management. Although traditional educational methods tend to show decreases in long-term knowledge retention, the mixed active learning strategies used in this curriculum resulted in high level retention since short and long-term test scores were similar and unchanged over time. Additionally, this curriculum was perceived by participants as highly satisfactory toward their knowledge and skill development.

Prehospital mass-casualty triage training-written versus moulage scenarios: how much do EMS providers retain?

INTRODUCTION: The aim of this study was to assess the effectiveness of written and moulage scenarios using video instruction for mass-casualty triage by evaluating skill retention at six months post intervention. METHODS: Prehospital personnel were instructed in the START method of mass-casualty triage using a video. Moulage and written testing were completed by each participant immediately after instruction and at six months post instruction. RESULTS: There was a significant decrease in performance between initial and six-month testing, indicating skill decay and loss of retention of triage skills after an extended nonuse period. There were no statistically significant differences between written and moulage testing results at either initial testing or at six months. Prior skill level did not influence test performance on the type of testing conducted or long-term retention of triage skills. CONCLUSION: These data confirm the skill deterioration associated with an infrequently used triage method. Further research to more precisely define triage criteria, as well as the ability to apply the criteria in a clinical setting and to rapidly identify patients at risk for morbidity/mortality is needed.