Palliative care staff often report that they lack the skills and confidence to provide support during an existential crisis. Consequently, there is a definite need for a training program in this area.

Our aim was to investigate whether a training model could give palliative care staff increased knowledge, awareness, and preparedness—all useful tools for providing support.

A mixed-methods research design was used. Data were collected in four hospital-based palliative homecare teams in the Stockholm area. In total, 34 staff participated, representing different palliative care team professions. Before and after the intervention, a questionnaire with a 9-point Likert-type scale was completed (n = 34). Qualitative focus group discussions were conducted a month after the intervention (25 participants). These were recorded, transcribed, and analyzed using qualitative content analysis with a manifest focus.

In the quantitative part of our study, the participants showed significantly increased perceived knowledge, awareness, and preparedness in every aspect (p < 0.001 for all items). The focus group discussions revealed a process that made it possible to apply new knowledge and insight. The process began with theoretical knowledge and, through care-related reflection and self-reflection, the knowledge base gradually developed and provided useful skills and increased job satisfaction.

The team-based “TrainingModel Sand/TER” can be performed without excessive effort and contribute to improved competence in providing support during an existential crisis. It is particularly useful for staff working in clinical palliative care.

Emergency medicine continues to grow as an international specialty. With >30 countries developing emergency medicine training, supporting international physician education is imperative. The proposed Emergency Medicine International (EMI) observational fellowship is a systematic model for the academic and experiential training of future leaders.

This program is a result of interest in academic emergency medicine and the responsibility of the educational institution. A literature review on the international development of emergency medicine was performed and the weaknesses were assessed. Based on this review, the goals for EMI are providing: (1) leadership; (2) exposure to education training models; and (3) research instruction. The EMI structure consists of four blocks: (1) emergency medicine clinical rotations; (2) emergency medical services (EMS) experience; (3) medical toxicology exposure; and (4) emergency medicine operations/administration. All blocks are tailored to the training background and interests of participants such as focusing on education methodology (conference organization, simulation) or departmental operations (quality improvement, faculty development). Overlapping all blocks is crucial to education in research methodology and evidence-based practice of medicine.

Assessment of the program includes pre-/post-survey completion by participants and yearly post-fellowship contact tracking the development of emergency medicine in their country.

While different types of organizations can assist in other ways, only academic emergency medicine can help grow and mentor faculty to expand the specialty worldwide.

The Glasgow Coma Scale (GCS) is the standard measure used to quantify the level of consciousness of patients who have sustained head injuries. Rapid and accurate GCS scoring is essential.

To evaluate the effectiveness of a GCS teaching video shown to prehospital emergency medical services (EMS) providers.

Participants and setting—United States, Mid-Atlantic region EMS providers. Intervention—Each participant scored all of the three components of the GCS for each of four scenarios provided before and after viewing a video-tape recording containing four scenarios. Design—Before-and-after single (Phase I) and parallel Cohort (Phase II). Analysis— Proportions of correct scores were compared using chi-square, and relative risk was calculated to measure the strength of the association.

75 participants were included in Phase I. In Phase II, 46 participants participated in a parallel cohort design: 20 used GCS reference cards and 26 did not use the cards. Before observing the instructional video, only 14.7% score all of the scenarios correctly, where as after viewing the video, 64.0% scored the scenarios results were observed after viewing the video for those who used the GCS cards (p = 0.001; RR = 2.0; 95% CI = 1.29 to 3.10) than for those not using the cards (p <0.0001; RR = 10.0; 95% CI = 2.60 to 38.50).

Post-video viewing scores were better than those observed before the video presentation. Ongoing evaluations include analysis of longterm skill retention and scoring accuracy in the clinical environment.