title: A first aid training course for primary health care providers in Nagorno Karabagh: assessing knowledge retention.
abstract: BACKGROUND
  Conflict in the South Caucasus' Nagorno Karabagh region has damaged health facilities and disrupted the delivery of services and supplies as well as led to depletion of human and fixed capital and weakened the de facto government's ability to provide training for health care providers.
  
  
  OBJECTIVE
  In response to documented medical training deficits, the American University of Armenia organized a first aid training course (FATC) for primary health care providers within the scope of the USAID-funded Humanitarian Assistance Project in Nagorno Karabagh. This paper reports the follow-up assessments conducted to inform policy makers regarding FATC knowledge and skill retention and the potential need for periodic refresher training.
  
  
  METHODS
  Follow-up assessments were conducted six months and 18 months following the FATC to assess the retention of knowledge, attitudes, and self-reported practices. Eighty-four providers participated in the first follow-up and 210 in the second. The assessment tool contained items addressing the use and quality of the first aid skills, trainee's evaluation of the course, and randomly selected test questions to assess knowledge retention.
  
  
  RESULTS
  At both follow-up points, the participants' assessment of the course was positive. More than 85% of the trainees self-assessed their skills as "excellent" or "good" and noted that skills were frequently practiced. Scores of approximately 58% on knowledge tests at both the first and second follow-ups indicated no knowledge decay between the first and second survey waves, but substantial decline from the immediate post-test assessment in the classroom.
  
  
  CONCLUSIONS
  The trainees assessed the FATC as effective, and the skills covered as important and well utilized. Knowledge retention was modest, but stable. Refresher courses are necessary to reverse the decay of technical knowledge and to ensure proper application in the field.
authors.affiliation: College of Health Sciences, American University of Armenia, Yerevan, Armenia. methomp1@uncc.edu
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thompson
authors.forename: Tsovinar L
authors.initials: TL
authors.lastname: Harutyunyan
authors.forename: Alina H
authors.initials: AH
authors.lastname: Dorian
mesh_terms: D001136:Armenia; D002983:Clinical Competence; D005392:First Aid; D006801:Humans; D007318:Inservice Training; D011320:Primary Health Care; D012153:Retention, Psychology