The impact of intense airway management training on paramedic knowledge and confidence measured before, immediately after and at 6 and 12 months after training

Emergency Medicine Journal, 06/08/2012

Walker M et al. – Significant improvement in confidence and knowledge was found after paramedics completed an intense airway management course. Knowledge at 6 and 12months remained significantly better compared with pre–course.


  • An identical written survey (measuring demographics and confidence) and multiple-choice examination (measuring knowledge) was administered at the start and end of a 10h airway course.
  • At 6 and 12months after the course, paramedics took the knowledge examination.
  • Paired confidence and written knowledge examination scores before and immediately after the course were compared.
  • Differences between knowledge examination scores at all four time points (before, immediately after and at 6 and 12months) were tested using analysis of variance and Tukey's test.


  • 299 ALS paramedics were enrolled in the study.
  • 209 (69%) reported 6 or more years of ALS experience.
  • The mean pre-course confidence score was 2.74/4 and the mean post-course confidence score was 3.39/4; a difference of 0.7 points (95% CI 0.61 to 0.71).
  • Post-course examination scores improved by 4.9 points (95% CI 4.58 to 5.20), from 7.7 to 12.6/20.
  • At 6months the mean score was 10.3/20, and at 12months 10.2/20.
  • Post-course scores were significantly better than pre-course scores.
  • Scores at 6 and 12months did not differ significantly and remained significantly improved from pre-course scores.

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