Evaluating the impact of peer-led pre-hospital trauma care training on pre-hospital healthcare provider competencies: a pilot study

Effective pre-hospital trauma care is crucial for improving patient outcomes. However, limited institutional support and access to structured trauma training, such as the Pre-Hospital Trauma Life Support (PHTLS) course, remain significant challenges for pre-hospital healthcare providers (PHPs) in many regions. Therefore, this study evaluates a peer-led training program, taught by Emergency Medical Technician (EMT) instructors, to enhance trauma care competencies among PHPs. A controlled before-and-after study was conducted among PHPs (EMTs and nurses) in Gwangju, South Korea, during their 2022/2023 continuing education program. In total, 122 participants underwent trauma care training led by peer EMT instructors under certified faculty supervision. The program included didactic sessions and scenario-based skills training, based on the PHTLS framework and Peyton’s four-step approach. Performance was assessed at three time points: pre-test (T0), post-test (T1), and follow-up (T2, 6–12 months later). Post-training, mean performance scores significantly increased from 42.6 ± 20.7 (T0) to 88.9 ± 8.9 (T1, p < 0.001). At T2, scores declined to 63.3 ± 13.8 but remained significantly above baseline (p < 0.001). Skills such as tourniquet application and scene assessment showed sustained improvement, while primary and secondary assessment scores returned to baseline over time. Most participants were highly satisfied: 86.1% rated the program excellent, and 89.3% reported no discomfort with peer-led instruction. The peer-led EMT training program significantly improved trauma care performance among PHPs, addressing barriers such as insufficient trauma training resources and geographic constraints. However, skill decay in critical areas highlights the need for regular refresher training. Further research is needed to evaluate the effect of the program on real-world patient outcomes and optimize long-term retention of trauma care skills.