title: Teaching ACLS stroke objectives to prehospital providers: a case-based approach.
abstract: OBJECTIVE
  To determine whether a case-based educational module would increase prehospital care providers' short-term and long-term knowledge about stroke and to compare the educational impact when the module was moderated by a physician versus an advanced cardiac life support (ACLS) instructor.
  
  
  METHODS
  A stroke module consisting of two case-based scenarios was administered to emergency medical services (EMS) personnel by either an ACLS instructor or a physician. Identical 25-question tests (based on 1997 ACLS prehospital stroke objectives) were administered before and after the module. Descriptive statistics were calculated by groups, and Wilcoxon tests were used to assess the significance of improvement in scores based on the paired data.
  
  
  RESULTS
  Two hundred six EMS personnel [112 (54%) emergency medical technician (EMT)-P, 91 (44%) EMT-B/EMT-I, and three (2%) other training levels] participated in the module, of whom 74 [30 (41%) EMT-P, 42 (57%) EMT-B/EMT-I, and two (2%) other training levels] participated in follow-up testing between six and seven months. Overall, there was a 32% improvement in test scores immediately after completion of the module (p < 0.001) and an 18% improvement at six months (p < 0.001). No significant difference in pretest scores existed between the physician-led and ACLS instructor-led groups (mean EMT-P pretest scores 69% versus 70% and EMT-B/EMT-I scores 55% versus 54%, respectively). There was no significant difference in short-term (p = 0.36) or long-term (p = 0.074) score improvements between the two groups.
  
  
  CONCLUSIONS
  This case-based approach to EMS stroke education is effective and can achieve equal benefit when administered by a physician or an ACLS instructor.
authors.affiliation: University of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio, USA. todd.crocco@hsc.wvu.edu
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Crocco
authors.forename: Raymond
authors.initials: R
authors.lastname: Moreno
authors.forename: Edward C
authors.initials: EC
authors.lastname: Jauch
authors.forename: Amie N
authors.initials: AN
authors.lastname: Racine
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Pio
authors.forename: Tiepu
authors.initials: T
authors.lastname: Liu
authors.forename: Rashmikant U
authors.initials: RU
authors.lastname: Kothari
mesh_terms: D022561:Advanced Cardiac Life Support / Q000193:education* / Q000379:methods; D003657:Decision Making; D004496:Education, Continuing / Q000379:methods*; D004521:Educational Measurement; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D015146:Midwestern United States; D018794:Problem-Based Learning; D015397:Program Evaluation; D013663:Teaching / Q000379:methods