title: Evaluation of a training curriculum for prehospital trauma ultrasound.
abstract: BACKGROUND
  In the United States, ultrasound has rarely been incorporated into prehospital care, and scant descriptions of the processes used to train prehospital providers are available.
  
  
  OBJECTIVE
  Our objective was to evaluate the effectiveness of an extended focused assessment with sonography for trauma (EFAST) training curriculum that incorporated multiple educational modalities. We also aimed to determine if certain demographic factors predicted successful completion.
  
  
  METHODS
  All aeromedical prehospital providers (APPs) for a Level I trauma center took a 25-question computer-based test to ascertain baseline knowledge. Questions were categorized by content and format. Training over a 2-month period included a didactic course, a hands-on training session, proctored scanning sessions in the Emergency Department, six Internet-based training modules, pocket flashcards, a review session, and remedial training. At the conclusion of the training curriculum, the same test and an objective structured clinical examination were administered to evaluate knowledge gained.
  
  
  RESULTS
  Thirty-three of 34 APPs completed training. The overall pre-test and post-test means and all content and format subsets showed significant improvement (p < 0.0001 for all). No APP passed the pre-test, and 28 of 33 passed the post-test with a mean score of 78%. No demographic variable predicted passing the post-test. Twenty-seven of 33 APPs passed the objective structured clinical examination, and the only predictive variable was passing the post-test (odds ratio 1.21, 95% confidence interval 1.00-1.25, p = 0.045).
  
  
  CONCLUSIONS
  The implementation of a multifaceted EFAST prehospital training program is feasible. Significant improvement in overall and subset testing scores suggests that the test instrument was internally consistent and sufficiently sensitive to capture knowledge gained as a result of the training. Demographic variables were not predictive of test success.
authors.affiliation: Department of Emergency Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Press
authors.forename: Sara K
authors.initials: SK
authors.lastname: Miller
authors.forename: Iman A
authors.initials: IA
authors.lastname: Hassan
authors.forename: Robert
authors.initials: R
authors.lastname: Blankenship
authors.forename: Deborah
authors.initials: D
authors.lastname: del Junco
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Camp
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003479:Curriculum / Q000592:standards*; D004501:Education, Medical / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000379:methods; D004521:Educational Measurement; D004634:Emergency Medical Technicians / Q000193:education*; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011446:Prospective Studies; D014463:Ultrasonography; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*
keywords: EFAST; helicopter; prehospital; trauma; ultrasound