Patient Care Skills Research Articles

Road traffic-related injuries need to develop capacity building to provide comprehensive care

Every year around the world, millions die on road generally from preventable causes and are major public health threat in current times with soaring figures of unnecessary and unacceptable burden of morbidity and disability. We attempted an extensive collection of published literature with specific inclusion criteria in PubMed, Cochrane, Web of Science, and WHO Global Health Library including additional search in indexed literature and website-based population survey reports. Ten percent of road accident fatalities worldwide occur in India, and in addition, more than a million are grievously injured every year. Moreover, victims with nonfatal injuries are forced to live with a range of physical and emotional disabilities with a colossal social and economic impact. In addition, the health-care costs allied with these injuries also create an immense threat to the already stretched out curative health-care load particularly in resource-poor settings of the developing third world countries. Notwithstanding such sobering data, road traffic injuries received less than optimal interest from national health planners to provide comprehensive care from primary health-care levels where maximum injuries come as first contact intervention. Injuries are not accidents and they do not occur by chance alone; like morbidity, they follow a classical model of epidemiological triad of agent-host-environment. Hence, by classifying the risk factors for injury as modifiable and nonmodifiable, it is most likely to forecast and prevent by models. There is a great need to validate brain injury biofluid biomarkers in the acute care setting such as in the emergency departments. The following core competencies are addressed in this article: Medical knowledge, Patient care and procedural skills, and Systems-based practice.

A novel treatment option for patients suffering from migraine: Erenumab

Migraine is one of the common disabling neurological disorders. It is conventionally treated by antihypertensives, antidepressants, and antiepileptics for prophylaxis. In spite of all these treatment options available, physicians were always in search of an ideal drug molecule with more target-specific drug action with lesser side effects and which may improve patient compliance. This exhaustive search led to the discovery of a new molecule in the pathophysiology of migraine that is calcitonin gene-related peptide (CGRP) and which in turn led to discovery of specific CGRP antagonists such as gepants and monoclonal antibodies such as erenumab. A systematic literature search was carried out on the internet using databases such as PubMed, Cochrane Reviews, Google Scholar, and Wikipedia using keywords such as migraine, erenumab, and CGRP receptor. Detailed information about pathophysiology of migraine, CGRP, and erenumab was gathered. Erenumab is the first human monoclonal antibody approved by the Food and Drug Administration in May 2018. It is marketed under the trade name “Aimovig.” It acts as an antagonist of CGRP receptors, which plays a key role in the pathophysiology of migraine. In spite of being macromolecular human monoclonal antibodies, it has very few side effects as compared to gepants. Erenumab may offer promising role in the preventive treatment of episodic and chronic migraine. The present study describes the mechanism of action, efficacy, and side effects as documented in three completed clinical trial findings of erenumab. The following core competencies are addressed in this article: Medical knowledge, Patient care and procedural skills.

Simulating a disaster: Preparing responders in India

Objective: This study evaluates the effectiveness of a novel modality created by our team to teach disaster preparedness consisting of tabletop drills and disaster simulation. Based on the Incident Command System (ICS) framework, our system prepares medical providers to respond independently to country-level disasters. Background: Disaster response remains an important component of emergency preparedness internationally. To this end, the ICS provides a standardized approach to the command, control, and coordination of emergency response. Methods: A 2-day workshop was conducted with medical providers in Bangalore, India, that used serial disaster simulations to improve disaster response using the ICS. Through increasing responsibility and self-directed tabletops, the participants (doctors, medical students, nurses, and police) gained the skills to respond independently to a simulated countrywide disaster. After the exercise, they were asked to grade the usefulness of simulation and lectures. Results: Forty-four providers responded to the questionnaire, all of which (n = 44, 100%) recommended the course. They graded the final disaster drill as most useful (n = 36, 82%) and also graded lectures from topic experts as useful (n = 36, 83%). Based on qualitative written feedback, participants felt drills helped them in communication and leadership. Conclusion: This novel teaching modality, using simulation and tabletop drills, is an effective tool to teach the ICS to medical providers. Participants felt that they benefitted from training and would respond better to future disasters. The following core competencies are addressed in this article: Systems-based practice, Patient care, Interpersonal and communication skills.

Complex necrotizing soft-tissue infections managed with extra-corporeal membrane oxygenation: 10-year follow-up

The use of extracorporeal membrane oxygenation (ECMO) was initially used to support patients in acute cardiopulmonary failure, but its utility has expanded to include a broadspectrum of patients with complex medical conditions. As a growing number of cases continue to mount to prove its successes, ECMO has emerged as a versatile treatment modality in a wide range of clinical scenarios. While the literature documents many successes regarding short-term outcomes, long-term data are lacking. We previously reported two separate cases of profound septic shock where ECMO was implemented as rescue therapy and both patients were able to be successfully discharged. We now provide an update to one of those cases to demonstrate long-term meaningful outcomes in a case where ECMO was utilized successfully. The following core competencies are addressed in this article: Medical knowledge, Patient care and procedural skills, and Systems-based practice.

Ensuring Student Competence in Essential Dental Consultation Communication Skills for Patient Care: Developing, Validating and Piloting a Comprehensive Checklist

Ensuring Student Competence in Essential Dental Consultation Communication Skills for Patient Care: Developing, Validating and Piloting a Comprehensive Checklist

Impact on confidence and practice: How the ADAPT online patient care skills program made a difference for pharmacists.

The ADAPT "ADapting pharmacists' skills and Approaches to maximize Patients' drug Therapy effectiveness" online education program was developed to enable pharmacists to overcome a lack of confidence in patient care and collaborative skills, enabling successful adoption of expanded scope of pharmacist practice. This study examined responses of ADAPT participants, to determine if acquisition of knowledge, skill, and confidence is retained and translated into adoption of expanded scope of practice and billable services, perceived improvement in quality of patient care, and increased professional satisfaction. A sequential exploratory mixed methods approach was used for this study. Fifty-four surveys were completed and 13 interviews were conducted. Greater than 86% agreed or strongly agreed that their confidence in their ability to perform ADAPT skills had improved. Billing for services varied based on province. Four themes emerged through the interview process: confidence, change, impact and barriers/facilitators. Respondents described confidence in their ability to use ADAPT skills to make changes in personal practice activities, and this appeared to lead to taking on new roles that provided both professional satisfaction and improved patient care and professional relations. However, some barriers remained in providing or billing for certain practice activities.

Effective and Feasible Simulation-Based Procedural Training for Medical Students: Instructional Video-Guided Deliberate Practice Versus Training with Expert Feedback.

Limited opportunity for teaching patient-care skills in clinical settings has increased the need for simulation training in medical education. However, this modality may be hard to sustain because of extensive time requirements and potential scheduling conflicts. The authors conducted a pilot randomized study to compare the immediate and long-term effects of using instructional video with self-directed practice to those of using simulation training with expert feedback. The results are promising for the use of instructional video-guided, self-directed deliberate practice; however, future studies with a larger sample from multiple institutions should replicate this study to confirm these results.

Effectiveness of the Malnutrition eLearning Course for Global Capacity Building in the Management of Malnutrition: Cross-Country Interrupted Time-Series Study.

BackgroundScaling up improved management of severe acute malnutrition has been identified as the nutrition intervention with the largest potential to reduce child mortality, but lack of operational capacity at all levels of the health system constrains scale-up. We therefore developed an interactive malnutrition eLearning course that is accessible at scale to build capacity of the health sector workforce to manage severely malnourished children according to the guidelines of the World Health Organization.ObjectiveThe aim of this study was to test whether the malnutrition eLearning course improves knowledge and skills of in-service and preservice health professionals in managing children with severe acute malnutrition and enables them to apply the gained knowledge and skills in patient care.MethodsThis 2-year prospective, longitudinal, cross-country, interrupted time-series study took place in Ghana, Guatemala, El Salvador, and Colombia between January 2015 and February 2017. A subset of 354 in-service health personnel from 12 hospitals and 2 Ministries of Health, 703 preservice trainees from 9 academic institutions, and 204 online users participated. Knowledge gained after training and retention over time was measured through pre- and postassessments comprising questions pertaining to screening, diagnosis, pathophysiology and treatment, and prevention of malnutrition. Comprehension, application, and integration of knowledge were tested. Changes in perception, confidence, and clinical practice were assessed through questionnaires and interviews.ResultsBefore the course, awareness of the World Health Organization guidelines was 36.73% (389/1059) overall, and 26.3% (94/358) among in-service professionals. The mean score gain in knowledge after access to the course in 606 participants who had pre- and postassessment data was 11.8 (95% CI 10.8-12.9; P<.001)—a relative increase of 41.5%. The proportion of participants who achieved a score above the pass mark posttraining was 58.7% (356/606), compared with 18.2% (110/606) in pretraining. Of the in-service professionals, 85.9% (128/149) reported applying their knowledge by changing their clinical practice in screening, assessment, diagnosis, and management. This group demonstrated significantly increased retained knowledge 6 months after training (mean difference [SD] from preassessment of 12.1 [11.8]), retaining 65.8% (12.1/18.4) of gained knowledge from the training. Changes in the management of malnutrition were reported by trained participants, and institutional, operational, and policy changes were also found.ConclusionsThe malnutrition eLearning course improved knowledge, understanding, and skills of health professionals in the diagnosis and management of children with severe acute malnutrition, and changes in clinical practice and confidence were reported following the completion of the course.

Use of non-technical skills can predict medical student performance in acute care simulated scenarios

BackgroundThough the importance of physician non-technical (NT) skills for safe patient care is recognized, NT skills of medical students, our future physicians, has received little attention. This study aims to investigate the relationship of medical student NT skills and clinical performance during acute care team simulation (ACTS). MethodsForty-one medical students participated in ACTS. A nurse confederate facilitated and evaluated clinical performance. Two raters assessed participants’ NT skills using an adapted NT assessment tool and overall NT skills score was calculated. Regressions predicting clinical performance using NT constructs were conducted. ResultsOverall NT skills score significantly predicted students’ clinical performance (r2 = 0.178, p = 0.006). Four of the five individual NT constructs also significantly predicted performance: communication (r2 = 0.120, p = 0.027), situation awareness (r2 = 0.323, p < 0.001), leadership (r2 = 0.133, p = 0.019), and decision making (r2 = 0.163, p = 0.009). ConclusionsMedical student NT skills can predict clinical performance during ACTS. NT skills assessments can be used for targeted education for better feedback to students.

TF-15 Wilderness Medicine: Foundations in Leadership and Austere Medical Care

Wilderness medicine is a growing subspecialty within emergency medicine. Increasingly, academic departments are developing robust programming through research initiatives, undergraduate to postgraduate curricula, and community outreach offerings. Wilderness medicine, defined as the delivery of medical care in resource-limited and austere environments, requires a knowledge base and skill set essential in general emergency medicine. Furthermore, the organized delivery of care in this context relies on non-technical skills in team leadership and communication critical to highly reliable systems across the contemporary health care landscape. We developed an experiential 4-week credit bearing elective for senior medical students, leveraging their personal passion for the outside world to drive a foundational introduction to the medical subspecialty. This senior medical student elective in wilderness and environmental medicine will serve as a comprehensive introduction to the subspecialty covering foundational content related to pathophysiology, epidemiology, therapeutics, and social factors in the human interaction with austere environments; develop skills in operational team leadership related to expedition medicine and search and rescue operations; and provide valuable space to combine students’ personal and professional passions. Our 4-week immersive curriculum includes a 17-day didactic portion followed by a 10-day field practicum. Knowledge base and skill concepts are first introduced through lecture, discussion, and interactive workshops. Content selection is curated from the Wilderness Medical Society’s requirements for the Fellow of the Academy of Wilderness Medicine (FAWM) and expert input. Knowledge acquisition is reinforced through application in high-fidelity simulation in the outdoor environment. Assessment of leadership skills and medical care is through direct observation. Group debriefing following each simulation further anchors learning. The didactic portion builds toward a 10-day field expedition largely planned by the students under direct guidance of course faculty. Each student has an opportunity to serve as expedition leader of the day. Additional medical simulation and skills workshops are utilized during in the field. A summative written exam assesses student retention of content. An observed and self-assessment tool for team leadership skills is used to appraise development and identify areas for further growth. We hope that participation in the course will introduce students to the subspecialty of wilderness medicine through an engaging, comprehensive and interactive experience. We believe this course will provide a non-traditional platform for refining essential skills in patient care, team-based operations, and the human factors influencing judgement, risk and error— all tools that will serve students well throughout their careers.

Pharmacists' learning needs in the era of expanding scopes of practice: Evolving practices and changing needs.

Continuing professional development fosters advancement in knowledge and skills and can support changes in practice. Research suggests that pharmacists perceive the need for additional training to take on expanded roles. However, the types of professional development and preferred learning methods are unclear. To identify pharmacists' professional learning needs in order to support expanded roles in practice. A mixed-methods approach was used. In focus groups made up of pharmacists and pharmacy students, learning needs associated with their perceptions of pharmacists' roles were examined. A web-based survey of Albertan pharmacists determined the knowledge, experience, and confidence required to engage in professional activities, preferred learning methods, and professional development needed to support pharmacists currently and in future. Analysis of data obtained from 5 focus groups (n = 42) revealed learning needs related to changes in pharmacists' roles. Pharmacists valued the social aspect of learning as well as the role of certification in building confidence. Survey data (n = 416) indicated that a high proportion of pharmacists reported training needs in the areas of physical assessment, interpreting laboratory tests, and making decisions about complex drug therapy. Community pharmacists and those with bachelor degrees were more likely to indicate a need for additional training in various patient care skills. Pharmacists reported a preference for learning with peers and learning at work within teams. Meeting various learning needs will foster pharmacists in their current and future professional roles, including situated learning in the workplace. These findings will be of interest to employers and educators in supporting pharmacists' evolving roles in practice.

Pharmacy Student Knowledge, Confidence and Attitudes Toward Medical Cannabis and Curricular Coverage

Objective. To assess pharmacy student confidence in their knowledge of qualifying conditions for medical cannabis use in the US and their attitudes toward curricular coverage of medical cannabis. Methods. Students were asked to complete an electronic survey to measure knowledge and confidence in various domains of medical cannabis treatment, including qualifying conditions, adverse effects, and other patient care skills. Results. There were 238 students who completed the survey. Responses to all domains and their corresponding confidence levels displayed a lack in confidence. The only domain wherein students had confidence in was their ability to retrieve related drug information. Nearly 80% of students felt that the topic of medical cannabis should be added to existing curricula within the next five years. Conclusion. With the prevalence of cannabis programs and knowledge gap, pharmacy schools should consider coverage of medical cannabis in the curricula.

Progressive disclosure cases: The design and evaluation of use in multiple therapeutics courses

Background and purposeCase-based learning is used frequently throughout pharmacy education. Although beneficial, stand-alone cases may result in segmented learning that does not simulate realistic longitudinal patient care. We report the development, implementation, and evaluation of a longitudinal progressive disclosure case surrounding a single patient spanning two different therapeutics courses. Educational activity and settingA patient case was developed surrounding topics in two third professional year therapeutics courses occurring sequentially in the same semester. Changes to the patient's status were provided to students longitudinally via “disclosures.” Students were assessed via quizzes and written assessment and plans. Students completed four perceptions of confidence surveys via a four-point Likert Scale. Surveys included questions surrounding confidence in areas of the pharmacists’ patient care process (PPCP) before and after courses utilizing the progressive disclosure case. Case assessment grades were used to evaluate the impact on student performance on course examinations. Students also completed a survey on final perceptions of the activity. FindingsSeventy students were enrolled in the two courses participating in the progressive disclosure case and there were 50 (71.4%) matched, completed surveys completed for analysis. Significant improvements were seen in several questions surrounding confidence in the areas of the PPCP between the beginning and conclusion of courses that contained the progressive disclosure case. No correlation between case activity grades and examination performance was found. Discussion and conclusionOverall, student confidence in patient care skills associated with information collection, assessment, plan design, and monitoring improved with the use of progressive disclosure cases within two sequential therapeutics courses.

Design of a 15-month interprofessional workplace learning program to expand the added value of clinical pharmacists in primary care

Background and purposeClinical pharmacists who work in the general practice settings bring an improvement to patient care and outcomes. Postgraduate training for an independent clinical role does not often occur in the primary health care setting. When it does, the design of the curriculum is infrequently based on interprofessional workplace learning principles and it does not always integrate practical experience with classroom-based learning activities. This could lead to situations where clinical pharmacists are insufficiently trained to apply clinical reasoning skills and direct patient care in the general practice setting. Educational activity and settingA program was designed, including competencies and learning objectives, based on results from focus group interviews with stakeholders and the literature on interprofessional workplace learning. Ten participants were selected for a pilot run of the program and were asked several times for their opinion about the program. FindingsA 15-month training program was offered to pharmacists who became clinical pharmacists with the responsibility to perform patient consultations in general practice. The program was based on interprofessional workplace learning principles and facilitated the participants’ skill in connecting the evidence, the patients’ perspective and their own professional perspective. The 10 participating pharmacists were satisfied with the program. Discussion and summaryThe training program provided increased opportunities to clinical pharmacists to add value in general practice. The training program enabled pharmacists to advance their skills in direct patient care and to improve the alignment between different professionals in the primary care domain.

Efficacy of an Interactive E-Learning curriculum in the NICU (INTERN) compared to traditional instruction as a method to improve pediatric resident education - a randomized controlled trial

Introduction: The American Board of Pediatrics (ABP) Residency Review and Redesign in Pediatrics program (R3P) encourages the development of skills for life-long learning and patient care through innovative approaches such as simulation and computer-assisted learning (CAL). CAL caters to adult learning theory and transforms a passive learning experience into an active one with improved retention and application of knowledge. Studies show that CAL appears more effective than no intervention although a developing infrastructure to support e-learning within medical education is needed. Hypothesis: An interactive e-learning curriculum combined with traditional instruction in the …

Analyzing the Knowing‐Doing Gap of Pedagogy Implementation by Near‐Peer Pre‐Professional Anatomy Lab Teachers

Training pre‐professional Teaching Assistants (TA's) in the art of pedagogy is a first step toward mastery of the ACGME Core Competencies of Patient Care, and Interpersonal and Communication Skills. The Knowing‐Doing Gap (KDG) of implementing training into practice is a common problem in the field of medical education. We wanted to identify the specific factors that contributed to the KDG for near‐peer pre‐professional Gross Anatomy TA's toward implementing new teaching strategies. A 6‐week pedagogy training program was implemented in which Anatomy Lecture TA's instructed peer Lab TA's on a variety of teaching strategies applicable for any of the three different lab classroom formats: Didactic Lab (DL), Open Lab (OL), unsupervised Free Lab (FL). The goal of the program was to improve the teaching skills of the Lab TA's and identify barriers to pedagogy implementation. Following the completion of the training program, we asked lab TA's to complete an IRB approved reflection through Qualtrics that assessed their implementation of teaching strategies. Questions included both Likert and free response formats. Likert data were expressed as percentage of respondents. Free response data were analyzed using a grounded theory approach, beginning with constructing a word cloud to reveal the most frequent words used in responses that informed subsequent detailed thematic qualitative analysis. Of our 63 Lab TA's, 46 responded (73%) to the survey. We analyzed the use of six teaching strategies. Flipped classroom style and facilitating justification reasoning were used most frequently in DL (17.2%, 48.78%). Peer teaching and gamification were used most frequently in OL (24%, 18.4%). Second order questions and case‐study methods were used most frequently in FL (48.75%, 20.73%). Lab TA's reported that gamification was the most difficult to implement. Across pedagogies, inadequate time to implement, student under‐preparation and/or disinterest in the pedagogical technique as a help for learning the material, were the principal factors that contributed to the KDG in the Anatomy Lab. Future studies will examine methods to overcome barriers toward implementing novel pedagogical techniques.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Assessment of knowledge and skills of nursing staff working in a tertiary care hospital of Western Uttar Pradesh

Background: Nurses are the most vital part of the health system. Having adequate knowledge, awareness and desired clinical skills among them can decrease the risk of infection or complications, can shorten the stay of patients in hospital, decrease the morbidity and mortality of patients and decrease the disease burden.Material &amp; Methods- Nursing staff from the wards of a private tertiary care hospital were interviewed for knowledge and observed for skill assessment. Aim &amp; Objective: To assess the knowledge, skills and practices of nursing staff working in a tertiary care hospital. Results: Knowledge of nurses is good regarding routine investigations, universal precautions, work ethics but poor in pharmacovigilance. Nurses are found to be good having skills in patient care, clinical skills but are poor in practice of biomedical waste management and vital monitoring. Nurses are having good communication with patient &amp;doctors but response time on patients’ call is more.Conclusion: Retraining of nursing staff at regular intervals to upgrade their knowledge regarding universal precautions, work ethics, bio medical waste management and improve upon clinical skills should be made mandatory in a hospital setting.

Confidence in skills applied to patient care among PharmD students in telehealth medication management programs versus other settings

IntroductionExposure to medication therapy management (MTM) courses has demonstrated to increase student pharmacist's confidence in the application of patient care skills. The purpose of this study was to evaluate the effects of student pharmacists’ work experience in a telehealth MTM program, versus hospital or community settings, on their confidence in skills applied in patient care. MethodsThis was a cross-sectional multicenter survey. Confidence in patient care among student pharmacists was assessed between those who worked in a telehealth MTM program versus other settings. The data was evaluated using Chi-Square, Fisher exact, unpaired-t, Kruskal-Wallis, and Mann-Whitney U tests. Results282 surveys were completed. First-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a comprehensive medication review (CMR) (p < .001), interviewing patients (p < .001), identifying medication errors (p < .001), and making therapeutic recommendations to patients (p = .04) and prescribers (p = .04). Second and third-year student pharmacists who worked in telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p ≤ .005). Fourth-year student pharmacists who worked in the telehealth MTM programs, versus other settings, were more confident in the provision of a CMR (p = .003), interviewing patients (p = .02), and identifying medication errors (p = .04). ConclusionStudent pharmacists’ participation in a telehealth MTM program may markedly increase their confidence in skills applied in patient care. MTM work experience should be offered to student pharmacists during their PharmD programs to enhance their confidence in the provision of patient care.

Using an Inflammatory Bowel Disease Objective Structured Clinical Examination to Assess ACGME Milestones in Gastroenterology Fellows

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) has identified six core competencies in which trainees are expected to demonstrate proficiency. Milestones have been developed to provide a framework for evaluating trainee performance within these competencies. We used an objective structured clinical examination (OSCE) focused on inflammatory bowel disease (IBD) to assess the milestones in gastroenterology (GI) fellows. METHODS: Ten second-year fellows from six GI fellowship programs participated in a four case OSCE. In the “Transition of Care” case the fellow was to assess a patient's readiness on the planned transition from child-centered to adult-centered care. In the “Shared Decision Making” case the fellow was to evaluate a patient with Crohn's disease who would benefit from combination therapy. In the “ER Flare” case the fellow was to triage and suggest management of a flaring ulcerative colitis patient. In the “IBS in IBD” case the fellow was asked to discuss irritable bowel syndrome in the context of quiescent IBD. Previously validated OSCE checklists were used to assess the GI fellows' performance using a 3- and 5-point behaviorally-anchored Likert Scale. Checklists were scored by the standardized patient. Checklist items were mapped to appropriate ACGME milestones by a GI medical educator. Scores within each milestone were normalized on a scale from 0-9 as utilized by the ACGME in the Next Accreditation System milestone initiative. Fellows were provided feedback on their performance. RESULTS: The majority of fellows scored between 6 and 9 in the milestones assessing patient care (PC), medical knowledge (MK), interpersonal and communication skills (ICS), professionalism (Prof), and systems-based practice (SBP). Composite average scores for all participants were as follows: PC1 7. 7, PC2 6. 9, MK1 6. 9, MK2 7. 0, ICS1 7. 4, Prof1 7. 6, Prof3 6. 9, and SBP4 6. 4. Fellows scored highest in the “Shared Decision Making” case and scored lowest in the “Transitions of Care” case. CONCLUSION(S): In this OSCE GI fellows performed well in the majority of milestones evaluated, however areas of less optimal performance were identified, providing areas for future focus in fellow training. The OSCE is a well-validated standardized tool for evaluating trainees, and with appropriate mapping of checklists to ACGME milestones, it can serve as an objective method to assess GI fellows' progress in the core competencies.

The impact of an Emergency Medical Technician basic course prior to medical school on medical students

ABSTRACTBackground: Previous research on Emergency Medical Technician (EMT) programs as an early clinical experience indicates that medical students’ confidence in patient care and team-building skills increases with participation. However, very little is known about the unplanned, long-term effects of EMT courses on medical students once they enter medical school.Objectives: This study examined the immediate outcomes produced by the month-long summer EMT course and the unplanned outcomes that students reported 1 year later.Methods: Pre/postsurveys were collected on all 25 students who graduated from the EMT course offered before their first year. These survey data were analyzed using a paired-samples t test. A subset of students (N = 14) consented to taking a survey and be interviewed on the lasting impact of their EMT experience. Interviews were conducted 10 months after the 2016 cohort completed the EMT course and at 22 months for the 2015 cohort. They were audio-recorded, transcribed, and analyzed using inductive content analysis.Results: Survey results indicated that students’ confidence in patient care and team-building skills increased significantly for all identified skills at the P < 0.05 level. Overall confidence in patient care increased 1.5 points (P = 0.001) on 1–4 Likert-type scale. Overall confidence in team-building skills increased at 0.7 points (P = 0.01). Qualitative analysis of interviews discovered four themes, including the retention and transferability of practical skills, a developed understanding of team communication, comfort with patient interactions, and the development of a framework for assessing patients’ needs. Students applied the EMT skills in various extracurricular volunteering experiences and in clinical skills courses.Conclusions: This study concludes that EMT programs have both immediate and lasting effects that seem to assist students with making sense of and navigating other learning opportunities. Specifically, EMT courses offered to students prior to their entry into medical school may help orient them to team-based health care and triaging patient care.