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of the world. Methods: A dual phase evaluation process is proposed. In the first phase (precurriculum), prospective students will identify patients with an acute illness or injury most likely to benefit from field interventions with a standardized, validated case severity scale (CSS). The CSS categorizes patients on their initial level of severity and their interval status change upon arrival at the emergency department. The second phase (postcurriculum) would combine the CSS with a structured patient encounter data collection (quality assessment) tool, which would document clinical data and serve as a prompt for critical interventions. A cohort will be followed prospectively for 12 months to evaluate changes in CSS based on clinical interventions. Observed interventions will be controlled for a given locale's resources and prehospital infrastructure. The curriculum and quality assessment tool will be implemented in staggered intervals throughout the each center's jurisdiction allowing for comparisons between pre-and postcurriculum cohorts. Conclusion: A combination severity scale and quality assessment instrument may be useful in measuring patient outcomes, and in addition, have universal applications for improving and reinforcing the performance of prehospital providers.

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