Developing and Assessing a Training Program in Prehospital Care of Behavioral Emergencies

Did we achieve our training objectives? The written test suggested that significant learning did occur. However, these results should be viewed with caution. We attempted to do a three-month follow-up posttest, but our rate of return was too small to analyze. Also, the resuits of the field performance study indicate a significant improvement in only two skills: EMTs commenting on the patients' problems and saying goodbye to patients.

Because of the large numbers of participants at the Boston workshop, it consisted primarily of lectunes and large-group discussions and minimal interaction between the trainees and faculty. Also, there were few opportunities to practice the skills discussed in the workshop. However, in Essex Junction, the smaller numbers helped to correct these deficiencies. Although this did not change the overall results of the test scores, it probably accounted for the higher posttest scores in Essex Junction.

As a result of our findings, we revised the pilot course to emphasize a small-group seminar format with opportunities for practicing skills through role-playing exercises and small-group discussions. Our experience suggests that intensive training of this type can help prehospital caretakers provide more effective care to acutely distressed emergency patients.