title: Analysis of an international emergency medical service train-the-trainer program.
abstract: OBJECTIVE
  To assess the effectiveness of an international emergency medical services (EMS) train-the-trainer program.
  
  
  METHODS
  Seven bilingual Polish physicians attended a 350-hour US-based EMS training program. The physicians returned to Poland to train Polish-speaking EMS personnel.
  
  
  METHODS
  The Polish training was assessed by means of a pretest, a final examination, a series of skill stations, and a retrospective self-assessment instrument created by the authors. The retrospective self-assessment instrument, using a six-point Likert scale, measured the degree of self-reported competence before and after training in three areas: basic trauma, advanced medical, and basic medical.
  
  
  RESULTS
  One hundred seventy-nine Polish students were assessed. Pretest scores ranged from 17% to 100% (mean, 74% +/- 11%). Ninety-one percent passed the final examination (mean, 91% +/- 4.0%; range, 74% to 99%). All students passed all skill stations. The before-and-after instrument indicated that the Polish students' prior competence ranged from not competent (Likert score 1) to fully competent (Likert score 6). Mean scores were: basic trauma, 2.6 +/- 4; advanced medical, 2.5 +/- 7; and basic medical, 2.8 +/- 7. After-course scores demonstrated improved competence. Before-and-after instrument score differences were significant for each area (P < .0001).
  
  
  CONCLUSIONS
  Despite differences in language, culture, technology, and resources, an international train-the-trainer program can be evaluated. In addition to standard testing, a retrospective before-and-after self-assessment instrument provides corroborative evidence of program success.
authors.affiliation: Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Pirrallo
authors.forename: M
authors.initials: M
authors.lastname: Wolff
authors.forename: D E
authors.initials: DE
authors.lastname: Simpson
authors.forename: S W
authors.initials: SW
authors.lastname: Hargarten
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000592:standards*; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007393:International Educational Exchange; D011044:Poland; D015397:Program Evaluation; D012189:Retrospective Studies; D012655:Self-Evaluation Programs; D014922:Wisconsin