ABSTRACT Title of Dissertation: THE EFFECT OF TWO DEATH EDUCATION PROGRAMS ON EMERGENCY MEDICAL TECHNICIANS

Title of Dissertation: THE EFFECT OF TWO DEATH EDUCATION PROGRAMS ON EMERGENCY MEDICAL TECHNICIANS Tracy Lynne Smith-Cumberland, Doctor of Philosophy, 2004 Dissertation Directed by: Professor Robert Feldman Department of Public and Community Health This study examined the changes in behavioral intent of EMTs in six EMS agencies in Wisconsin after exposure to 1 of 2 death education programs. The effectiveness of the programs was evaluated by a comparison of pretest and posttest scores on behavioral intent of on-scene death-related behaviors using non-equivalent control group design. One intervention group participated in a 2 day workshop using the Emergency Death Education and Crisis Training (EDECT) curriculum. A second intervention group participated in a 2 hour didactic Continuing Medical Education (CME) session on making death notifications. A third group served as a control group and participated in a 2 hour CME session not related to death. Prior to this research, no formal evaluations existed on the impact of these two programs. Ajzen’s (1985) Theory of Planned Behavior was used to predict participant’s deathrelated behavioral intentions, attitudes, subjective norms, and perceived behavioral control towards a behavior. Evaluation included comparisons on multiple measures, which stemmed from the goals of the programs. Study results indicated that the majority of EMTs intend to change their behaviors at the scene of a death after receiving either training program. Changes were greatest for the group exposed to the EDECT curriculum. In addition to testing the hypothesis, several questions explored EMTs’ attitudes toward their role on-scene and their previous death-related training. Analysis of these questions show that most EMTs feel that death notifications and helping bereft families are part of their roles as an EMT. The need for death-related programs to help emergency responders manage bereaved families and the lack of methodologically rigorous evaluation studies of such programs were the principal factors that led to this study. Although there were limitations suggesting caution when interpreting the results, the evaluation showed these programs to be effective in changing the behavioral intent of EMTs. The effectiveness of these programs on EMTs and other emergency providers warrants further study. THE EFFECT OF TWO DEATH EDUCATION PROGRAMS ON EMERGENCY MEDICAL TECHNICIANS by Tracy L. Smith-Cumberland Dissertation submitted to the Faculty of the Graduate School of the University of Maryland College Park in partial fulfillment of the requirements for the degree of Doctor of Philosophy 2004 Advisory Committee Professor Robert Feldman, Chair/Advisor Professor Daniel Leviton Professor Jacqueline Wallen Professor Bruce Walz Assistant Professor Glenn Schiraldi Copyrighted by Tracy L. Smith-Cumberland All rights reserved 2004