<p>Continuing Education for Prehospital Healthcare Providers in India – A Novel Course and Concept</p>

Abstract

Background Emergency medical services (EMS) in India face enormous challenges in providing care to a geographically expansive and diverse patient population. Over the last decade, the public–private-partnership GVK EMRI (Emergency Management and Research Institute) has trained over 100,000 emergency medical technicians (EMTs), with greater than 21,000 currently practicing, to address this critical gap in the healthcare workforce. With the rapid development and expansion of EMS, certain aspects of specialty development have lagged behind, including continuing education requirements. To date, there have been no substantial continuing education EMT skills and training efforts. We report lessons learned during development and implementation of a continuing education course (CEC) for EMTs in India. Methods From 2014 to 2017, we employed an iterative process to design and launch a novel CEC focused on five core emergency competency areas (medicine and cardiology, obstetrics, trauma, pediatrics, and leadership and communication). Indian EMT instructors and providers partnered in design and content, and instructors were trained to independently deliver the CEC. Many challenges had to be overcome: scale (>21,000 EMTs), standardization (highly variable skill levels among providers and instructors), culture (educational emphasis on rote memorization rather than practical application), and translation (22 major languages and a few hundred local dialects spoken nationwide). Lessons Learned During the assessment and development phases, we identified five key strategies for success: (1) use icon-based video instruction to ensure consistent quality and allow voice-over for easy translation; (2) incorporate workbooks during didactic videos and (3) employ low-cost simulation and case discussions to emphasize active learning; (4) focus on non-technical skills; (5) integrate a formal training-of-trainers prior to delivery of materials. Conclusion These key strategies can be combined with innovation and flexibility to address unique challenges of language, system resources, and cultural differences when developing impactful continuing educational initiatives in bourgeoning prehospital care systems in low- and middle-income countries.

Lack of Public Awareness and Prehospital Care in Severe Trauma Patients: The Weakest Link in the Indian Healthcare System

“…In 2005, 108 was introduced as a toll-free telephone number for emergency response services. It is a national emergency number for emergency medical services [ 15 ]. Also, private hospitals have their own telephone numbers for ambulance services, unlike developed countries [ 7 ].…”

Outcomes of out of hospital sudden cardiac arrest in India: A review and proposed reforms

“… 10 , 11 Furthermore, emergency medical services (EMS) expansion is needed to ensure shorter wait and ambulance-to-emergency department transfer times. 12 We address the current trends and suggest nationwide reforms that can improve the survival rates of patients that have experienced an OHCA.…”

Health Workforce Development Policies in Iran: A Study of In-service Training Policies

“…In-service training is one of the requirements for developing health workforce skills (1)(2)(3) and providing quality services to patients (4)(5)(6). In developing countries where the shortage of human resources in the health system is one of their constant problems (7,8), having a capable workforce can contribute to the productivity (9) and resilience of the health system (10,11). Moreover, due to the rapid growth of knowledge and technology and the development of medical equipment, the need to update the technical knowledge of the health system workforce is felt in accordance with the progress made (12), and the health workforce needs to develop their personal skills and abilities (13) Accordingly, the need for in-service training is felt worldwide (14).…”