Using the complex model to change beliefs regarding proactive coping behaviors in emergency medical service trainees

Exposure to conditions perceived as stressful can be harmful to one's health and is more likely in certain types of careers such as those in emergency medical services (EMS). EMS responders are subject to a higher level of stress referred to as traumatic or critical incident stress due to exposures such as significant injuries to or deaths of a co-responder or child, dismembered bodies, multiple casualty motor vehicle crashes, and violent threats of significant injury or death to oneself or witnessing such threats to others.;In this experimental design study, participants were students in EMT-Basic training courses, who were randomly assigned to an experimental or control group. The experimental group received the experiential, skill-based module, while the control group received the standard EMT-Basic training curriculum module.;Outcome expectation, expectancy value, self-efficacy, and attribution beliefs were measured by pretest and posttest, using the Proactive Behaviors in EMS Appraisal, an instrument designed specifically for the study by the principal investigator. A retrospective pretest, posttest was additionally administered to the experimental group to confirm the validity of the results, ruling out any potential for a response shift bias as a result of exposure to unfamiliar concepts.;Multiple regression analyses were conducted to determine the significant predictors for change in participant beliefs. Participants in the experimental group were shown to have significantly higher levels of outcome expectation, expectancy value, and self-efficacy beliefs regarding the use of positive self-talk and cognitive restructuring behaviors, while there were no significant differences between groups for attribution beliefs.;Minimal time has been devoted during initial EMS training to the development and application of coping behaviors that might be helpful in the management of EMS stress. The purpose of this study was to test an experiential, skill-based module based on the COMPLEX model, designed to promote outcome expectation, expectancy value, self-efficacy, and attribution beliefs regarding proactive coping behaviors associated with breathing, positive self-talk, and cognitive restructuring.;In this one-time intervention, the COMPLEX model appears to have been effective in changing participant beliefs regarding the use of selected coping behaviors in the management of situations perceived to be stressful.