Context and setting Communication skills are largely acknowledged as a core component of health care providers' competence. Over the past 20 years, many medical schools have included them in their curricula. Among health care providers, first aid professionals have a pivotal impact on society and individuals due to their daily involvement in critical health situations. However, few studies have assessed first aid curricula with regard to communication skills. Why the idea was necessary Italian first aid professionals receive only a technical training. Communication skills are not part of the curricula. Our work represents the first attempt to assess first aid professionals' educational needs in order to improve their curriculum. What was done A research intervention was carried out with all the team leaders of a first aid association in Milan, with the 2-fold objective of performing a needs assessment and offering participants an opportunity to reflect on their experiences in a supportive environment. In-depth interviews regarding a first aid situation that struck the participants were collected. The interviews followed a simplified version of debriefing in order to offer participants an opportunity to process their experiences. Facts, emotions and thoughts were solicited. One week after the interviews, participants were given a telephone questionnaire which included questions to be answered on a 5-point Likert scale on ease of narrating, well-being after the narration and how positive the narrative experience was, as well as an open-ended question. Interview transcripts were analysed through content analysis. Upon completion of analysis, a 2-hour meeting with all participants was organised. Selected quotes from interviews were presented by theme for group discussion. This helped participants become more aware of their strengths as well as the areas in which they needed to improve and allowed for the building of a shared map of educational needs. Evaluation of results and impact Of the 30 team leaders approached, 27 volunteered to participate in the project. The content analysis highlighted a sense of inadequacy in 2 areas: communication with patients and management of emotions. Communication with the patient or family was described as among the most difficult aspects of dealing with an emergency. The need to acquire skills for managing difficult conversations with patients and their families emerged. Strong personal emotions were also perceived as a source of difficulty because of the lack of tools with which to manage them. The need to manage personal emotions during an emergency in order to be fully present and provide competent first aid was identified. The need to process those emotions after the emergency was described as a ‘matter of surviving’. So far, this need has been met by discussing the medical aspects of the intervention with the team or by talking with friends and family. Questionnaire results showed that the narrative experience was perceived on average as being very positive, but not easy (ease 2.9 points, well-being 3.5, positivity 4.2). In the open-ended question, 9 respondents described the interview as providing relief and as useful for organising feelings and thoughts; 8 expressed a generally positive opinion; 5 underlined the difficulty of narrating; 3 addressed the interview's educational value, and 2 underlined the pleasure of being listened to. The positive evaluation of the research intervention might be due to the fact that the intervention fulfilled the participants' needs to process difficult experiences. Results call for the development of a first aid curriculum that includes training in communication skills and emotion management.
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Jun 15, 2007
Graciela Risco De Dominguez 
Open Access
