Building School Nurses' Capacity to Lead Medical Emergency Response Teams: Evaluating Knowledge and Practice Changes

Schools increasingly face complex medical emergencies, underscoring the need for coordinated, school-based response systems. School nurses are well positioned to lead Medical Emergency Response Teams (MERTs), yet implementation of coordinated medical emergency response in schools can be constrained by contextual and organizational challenges. We examined the effectiveness of a train-the-trainer program designed to build school nurses' capacity to lead and implement MERTs. Using a mixed-methods design, participants (n = 335) completed a retrospective pre/post-survey immediately after training to assess knowledge across core MERT concepts and a 6-month follow-up survey to examine application in practice. Significant increases in self-reported knowledge were observed across all domains (P < 0.05) and were maintained at 6 months post-training. Follow-up findings indicated active implementation, including MERT formation, staff training, and use of response plans during medical emergencies. Findings demonstrate that professional development can produce sustained improvements in school nurse leadership and medical emergency preparedness.