"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Margaret Mead

Leadership and Communication for EMTs in India: Bringing Calm to the Chaos



Emergency medical technicians (EMTs) in low and middle income countries with nascent emergency medical services and prehospital care systems face unique challenges. India’s dense population draws large crowds to field calls, and the general public’s lack of familiarity with EMTs and their work leads to chaotic scenes interfering with patient care. Skills in crowd control and clear communication with the patient, family, and bystanders are imperative. Further, EMT care in India is often directed by physicians at centralized call centers, yet the quality of EMT physician communication varies dramatically due to a lack of a standardized consultation and handoff process compromising patient care and safety.



  • Sept – Oct 2016: Needs assessment of Indian EMTs’ leadership and communication skills in Hyderabad and Ahmedabad, India.
  • Oct 2016: Literature review on EMT communication and leadership skills across various countries.
  • Nov- Jan 2016: Development of a targeted two-day leadership and communication course for EMTs in India.
  • Jan 2017: Course piloted with 60 EMTs and 15 EMT instructors originating from 12 Indian states who then provided feedback on the course structure and content.
  • Apr 2017: EMT Leadership and Communication course launching through a training of trainers format, followed by dissemination nation-wide to 20,000 GVK EMRI EMTs covering a catchment area of over 750 million people.



Pre- and post- course surveys combining novel self assessment questions, an adaptation of the NHS 2012 Leadership Framework Self Assessment, and a validated communication tool utilized in a series of studies by Włoszczak et al.



  • Animated Instructional Videos –change in voiceover track allows translation into any language
  • Instructor Manual
  • EMT Workbook
  • EMT Manual

Leadership and Communication for EMTs in India: Bringing Calm to the Chaos

Author Information

Sybil Zachariah Corresponding Author

Emergency Medicine, Stanford University School of Medicine

Benjamin Lindquist

Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, Select Country

G.V. Ramana Rao

Emergency Medicine Learning Centre (EMLC) & Research, GVK Emergency Management and Research Institute

PDF Share
Converted 476e12404a2911e7998c512375b1c85a l c cugh poster 2017 final