title: Evaluation of an international emergency medicine intervention in Tuscany.
abstract: OBJECTIVE
  To measure the effectiveness of a 9-month emergency medicine 'train the trainers' program in Tuscany, Italy.
  
  
  METHODS
  A total of 81 physicians with emergency department experience completed a training course in Italy. The course included 120 h of didactic lectures, 700 h of clinical rotations and 30 h of practical workshops. The effect of the training course was measured by written multiple-choice and oral case-simulation examinations, and a precourse and postcourse self-assessment instrument using a four-point Likert scale, to describe the ability to care for different types of emergency medicine patients.
  
  
  RESULTS
  Twenty-four physicians completed the course in 2003-2004 and 57 physicians completed the course in 2004-2005. A comparison of an identical examination given as a posttest to the first group and a pretest to the second group demonstrated significant improvement on a 75-question multiple-choice examination (38.7 vs. 46.2 points, P<0.001). Improvement was also seen in oral case examinations, in pediatrics (17.8 vs. 37.3 points, P<0.001) and neurology (24.8 vs. 34.5, P<0.001). In the self-assessment survey, when asked to describe the ability to diagnose and provide initial treatment for several types of patients before and after the course, significant improvement was reported by 13 of 20 participants (65%). When asked to describe the ability to perform a variety of procedures, significant improvement was seen in seven of sixteen (44%).
  
  
  CONCLUSIONS
  When measured by written examinations, oral examinations and physician self-assessment, a train the trainers program, designed as part of an international emergency medicine collaboration, was efficacious.
authors.affiliation: Department of Emergency Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. sweiner@tufts-nemc.org
authors.forename: Scott G
authors.initials: SG
authors.lastname: Weiner
authors.forename: Philip D
authors.initials: PD
authors.lastname: Anderson
authors.forename: Leon D
authors.initials: LD
authors.lastname: Sanchez
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Berni
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Peter
authors.initials: P
authors.lastname: Rosen
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Ban
mesh_terms: D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D005060:Europe; D005180:Faculty, Medical; D006801:Humans; D007393:International Educational Exchange; D007558:Italy; D015397:Program Evaluation; D012015:Reference Standards; D014481:United States