title: Effect of a focused and directed continuing education program on prehospital skill maintenance in key resuscitation areas.
abstract: US Army Medics (formerly MOS 91B) received training similar to EMT-B level but were not required to be certified. Medics additionally received training in such skills as intravenous (i.v.) line insertion and fluid resuscitation. Continuing education, although encouraged, was not required. The objective of this study was to determine the effectiveness of a focused and directed psychomotor skills continuing education program in maintaining skills performance over a 6-month period in four key resuscitation areas. The education effect was the focus of the analysis. The study population was a convenience sample of medics with 1-4 years experience assigned to field units at Ft. Hood, TX. Subjects received a pretest evaluation of skills performance in four key areas using standard NREMT skill sheets. Scores on skill evaluations represent the percentage of steps correctly performed. After pretest evaluations, subjects were required to complete a comprehensive and focused continuing education program that emphasized skill practice. After the 6-month pretest, a post-test was conducted. Pre- and post-test scores for each student were matched. A one-tailed Student's t-test was used to compare results before and after the intervention, with statistical significance set at p < 0.05. The total sample of subjects available for the post-test (n =107) was compared to the initial pretest sample (n = 127) and shown to be accurately representative. The pretest performance for the skills of i.v. insertion, airway management, patient assessment, and bleeding control was 79 +/- 11, 73 +/- 14, 44 +/- 22, and 57 +/- 13, respectively. The post-test performance for these same skills increased (p < 0.05) in all cases when compared to pretest scores: 87 +/- 9, 76 +/- 15, 73 +/- 19, and 62 +/- 14, respectively. A focused and directed continuing education program that emphasizes skill practice in key resuscitation areas can improve skills performance.
authors.affiliation: Department of Emergency Medicine, Army Medical Department Center and School, Fort Sam Houston, Texas, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: De Lorenzo
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Abbott
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D004496:Education, Continuing / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D015397:Program Evaluation; D012151:Resuscitation / Q000193:education*; D014481:United States