title: Training for rural prehospital providers: a retrospective analysis from Montana.
abstract: OBJECTIVE
  This paper provides a retrospective analysis of training methods used by rural Montana's prehospital care providers. Drawn from both published and unpublished sources and spanning the past 25 years, it examines the origins of training in this vast rural state and aims to shed light on successful, nontraditional training delivery methods currently being used. Because volunteer personnel traditionally provide prehospital emergency care in rural areas, development and implementation of effective training programs are generally considered important to helping these practitioners maintain the knowledge and skills they use in their lifesaving work.
  
  
  METHODS
  Five different training programs used in Montana were assessed: Train-the-trainer; Local Cluster with videotape and guided practicals; Circuit Rider training with interactive videodisc; interactive video teleconference; and the TENKIDS statewide electronic infrastructure. Strengths and weaknesses of each training program were analyzed.
  
  
  RESULTS
  Traditional train-the-trainer methods make training readily accessible, but it is difficult to ensure consistent, top-quality delivery of the materials. Electronic training is popular and effective but can be expensive and difficult to develop and distribute. Establishing an electronic infrastructure allows for easy delivery of high-quality electronic instruction. However, it remains somewhat expensive to develop.
  
  
  CONCLUSIONS
  Efforts to improve capabilities of instructors in Montana have had varied success. Studies illustrate that remote training methods that train the providers directly are effective and popular. The application of electronic media and other distance learning techniques have demonstrated a positive impact on the frequency, quality, and standardization of training for volunteer prehospital EMTs.
authors.affiliation: Critical Illness and Trauma Foundation, Bozeman, Montana 59715, USA. jpullum@citmt.org
authors.forename: J D
authors.initials: JD
authors.lastname: Pullum
authors.forename: N D
authors.initials: ND
authors.lastname: Sanddal
authors.forename: K
authors.initials: K
authors.lastname: Obbink
mesh_terms: D004521:Educational Measurement; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education*; D005069:Evaluation Studies as Topic; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D009009:Montana; D016730:Program Development; D019114:Remote Consultation / Q000592:standards*; D012189:Retrospective Studies; D012424:Rural Population; D013663:Teaching / Q000379:methods; D013685:Telecommunications; D014741:Video Recording; D000078329:Workforce