Baghdassarian Aline, Best Al M, Virabyan Anushavan, Alexanian Claire, Shekherdimian Shant, Santen Sally A, Simonyan Hambartzum
Department of Emergency Medicine Richmond, Virginia Commonwealth University School of Medicine, 1250 East Marshall Street, Main Hospital, 2nd Floor, Suite-600, POBOX: 980401, Richmond, VA, 23298, USA.
Department of Emergency Medicine Inova Fairfax Campus, 3300 Gallows Road, Falls Church, VA, 22042, USA.
Int J Emerg Med. 2021 Jan 6;14(1):1. doi: 10.1186/s12245-020-00320-x.
Emergency pediatric care curriculum (EPCC) was developed to address the need for pediatric rapid assessment and resuscitation skills among out-of-hospital emergency providers in Armenia. This study was designed to evaluate the effectiveness of EPCC in increasing physicians' knowledge when instruction transitioned to local instructors. We hypothesize that (1) EPCC will have a positive impact on post-test knowledge, (2) this effect will be maintained when local trainers teach the course, and (3) curriculum will satisfy participants.
This is a quasi-experimental, pre-test/post-test study over a 4-year period from October 2014‑November 2017. Train-the-trainer model was used. Primary outcomes are immediate knowledge acquisition each year and comparison of knowledge acquisition between two cohorts based on North American vs local instructors. Descriptive statistics was used to summarize results. Pre-post change and differences across years were analyzed using repeated measures mixed models.
Test scores improved from pretest mean of 51% (95% CI 49.6 to 53.0%) to post-test mean of 78% (95% CI 77.0 to 79.6%, p < 0.001). Average increase from pre- to post-test each year was 27% (95% CI 25.3 to 28.7%). Improvement was sustained when local instructors taught the course (p = 0.74). There was no difference in improvement when experience in critical care, EMS, and other specialties were compared (p = 0.23). Participants reported satisfaction and wanted the course repeated. In 2017, EPCC was integrated within the Emergency Medicine residency program in Armenia.
This program was effective at impacting immediate knowledge as well as participant satisfaction and intentions to change practice. This knowledge acquisition and reported satisfaction remained constant even when the instruction was transitioned to the local instructors after 2 years. Through a partnership between the USA and Armenia, we provided OH-EPs in Armenia with an intensive educational experience to attain knowledge and skills necessary to manage acutely ill or injured children in the out-of-hospital setting.
EPCC resulted in significant improvement in knowledge and was well received by participants. This is a viable and sustainable model to train providers who have otherwise not had formal education in this field.
制定紧急儿科护理课程（EPCC）是为了满足亚美尼亚院外急救人员对儿科快速评估和复苏技能的需求。本研究旨在评估当教学工作转交给当地教员时，EPCC在增加医生知识方面的有效性。我们假设：（1）EPCC将对测试后知识产生积极影响；（2）当当地培训师授课时，这种效果将得以维持；（3）课程将令参与者满意。
这是一项从2014年10月至2017年11月为期4年的准实验性、测试前/测试后研究。采用培训培训师模式。主要结果是每年即时知识获取情况以及基于北美教员与当地教员的两个队列之间的知识获取比较。使用描述性统计来总结结果。使用重复测量混合模型分析测试前后的变化以及多年间的差异。
测试分数从前测平均分51%（95%置信区间49.6至53.0%）提高到后测平均分78%（95%置信区间77.0至79.6%，p < 0.001）。每年从前测到后测的平均增幅为27%（95%置信区间25.3至28.7%）。当当地教员授课时，进步得以维持（p = 0.74）。比较重症监护、急诊医疗服务及其他专科的经验时，进步情况没有差异（p = 0.23）。参与者表示满意，并希望重复开设该课程。2017年，EPCC被纳入亚美尼亚急诊医学住院医师培训项目。
该项目在影响即时知识以及参与者满意度和改变实践的意愿方面是有效的。即使在两年后教学工作转交给当地教员，这种知识获取和报告的满意度仍保持不变。通过美国和亚美尼亚之间的合作，我们为亚美尼亚的院外急救人员提供了强化教育体验，以获取在院外环境中管理急病或受伤儿童所需的知识和技能。
EPCC使知识有显著提高，并受到参与者的好评。这是一种可行且可持续的模式，用于培训那些在该领域未接受过正规教育的人员。
