1. Comparing the Efficacy of Video Versus Live Delivery of an EMT Training Course in India
Peter C Acker, MD, MPH
Aditya Mantha, MS
Elizabeth Pirrotta, PHD
Matthew Strehlow, MD
Swaminatha V. Mahadevan, MD*

2. Financial Disclosures
None

3. EMS Development in India: 2005
GVK EMRI:
1 state
14 ambulances
GVK EMRI began in 2005
-1 state and 14 ambulances

4. Educational Collaboration: 2007
In 2007 GVK EMRI partnered with Stanford
Since then Stanford has had the opportunity to provide technical expertise in the creation of educational materials, curriculum, and training pedagogy for GVK EMRI’s growing cohort of providers.

5. EMS Development in India: 2015
GVK EMRI:
15 states
2 union territories
10,000 ambulances
20,000 EMTs
Rapid growth, driven by recognition (by both public and gov’t) of the essential nature of quality prehospital care
By 2015: 15 states + 2 union territories
>10,000 ambulances and EMT’s

6. Knowledge Dissemination
As new content was created, knowledge dissemination often occurred using a TOT model. Trainers from a number of states would gather, receive new knowledge from a content expert (often from the US). Updated trainers would then return to their home states and teach their EMT’s.

7. Barriers to Knowledge Dissemination
Cost
Geography
Distribution logistics
Regional teaching + practice variations
This style has many challenges, particularly as the size and spread of the service increased.

8. Barriers to Knowledge Dissemination
Overcoming Barriers
Video-based lectures
One potential means of overcoming these barrier would be use of video based lectures
The hope being that video based lectures would increase the fidelity of the teaching material, and enhance the speed with which dissemination and updates could occur.

9. Objective
Compare the impact on knowledge of two EMT training presentation formats:
Traditional live lectures
Video-based lectures

10. Methods Participants EMT’s attending two-day Basic EMT training course
-Convenience sample of EMT’s attending a two day EMT refresher training course in one of three states
-Gujarat
-Andhra Pradesh
-Tamil Nadu

11. Methods 30 MCQ Pre-Test Quasi-randomization
Video Lecture Presentations
Live Lecture Presentations
-All participants took a 30 MCQ pre-test
-At each site, participants were quasi-randomized by alternate allocation to video-based lecture lectures or traditional live lectures group.
-content focused on basic EMT skills and was identical for both groups.
-Video-based lecture group was shown video’s of lecture content, pre-recorded by three Stanford faculty in English, with facilitation by local instructors in the preferred local language
-Live Participant group viewed the same lecture slides, in English, but taught by local trainers in the preferred local language.
-All participants took a 60-multiple choice question post-test.
-Data was analyzed using analysis of variance (ANOVA).
60 MCQ Post-Test

12. Demographics 191 Participants Video: 99 Live: 92 AP: 42 GJ: 47 TN: 102
Break down of participants
AP=Andhra Pradesh
GJ=Gujarat
TN=Tamil Nadu
LOE=length of employment
No statistically significant differences between groups when comparing gender, age, or LOE
Female: 29% Female: 23% p=0.158
Age: yrs Age: p=0.235
LOE: mo LOE: mo p=0.310

13. Observations Pre-Test Results Video= 63.3 +/- 11.1%
Live= /- 11.5%
p= 0.086
Video
Live
No statistically significant difference between pre-test scores when comparing exposure groups

14. Observations Score Change Video= +9.4 +/- 8.4% p= < 0.001
Live= /- 9.8% p= < 0.001
Video
Live
Video
When comparing each exposure group to itself, significant changes in score were noted between pre and post test
Live

15. Observations Score Change Video= +9.4 +/- 8.4% Live= +12.2 +/- 9.8%
p= < 0.013
Video
Live
Video
When comparing score change between group, there was a statistically significant difference in score improvement favoring the live presentation method
Live

16. Observations Post-Test Results Video= 72.6 +/- 7.2%
Live= /- 7.0%
p= 0.58
Video
Live
Video
Live
No statistically significant difference between post-test scores when comparing exposure groups

17. Limitations Incomplete randomization
Regional variation in teaching format

18. Conclusions
Both methods demonstrated positive impact on immediate knowledge of EMTs
Live > Video
Both methods had a positive impact on scores with scores improving to a greater degree in the live groups

19. Conclusions
Video based EMT trainings may be an effective alternative to live trainings
May offer others benefits not measured in this study
Although live training may have had a larger impact on scores, both groups had a positive impact, and perhaps there may be other benefits of video based trainings, not measured in this study (time, cost, ease of dissemination, etc) that may make it an effective alternative

20. Conclusions
Identifying optimal teaching method will require further investigation into alternate factors influencing EMT training effectiveness in this context

21. Thank You