BACKGROUND: Most current triage tools have been tested among hospital nurses groups but
there are not similar studies in university setting. In this study we analyzed if a course on a new fourlevel
triage model, triage emergency method (TEM), could improve the quality of rating in a group of
nursing students.
METHODS: This observational study was conducted with paper scenarios at the University of
Parma, Italy. Fifty students were assigned a triage level to 105 paper scenarios before and after a
course on triage and TEM. We used weighted kappa statistics to measure the inter-rater reliability of
TEM and assessed its validity by comparing the students' predictions with the triage code rating of a
reference standard (a panel of fi ve experts in the new triage method).
RESULTS: Inter-rater reliability was K=0.42 (95%CI: 0.37–0.46) before the course on TEM, and
K=0.61 (95%CI: 0.56–0.67) after. The accuracy of students' triage rating for the reference standard
triage code was good: 81% (95%CI: 71–90). After the TEM course, the proportion of cases assigned
to each acuity triage level was similar for the student group and the panel of experts.
CONCLUSION: Among the group of nursing students, a brief course on triage and on a new inhospital
triage method seems to improve the quality of rating codes. The new triage method shows
good inter-rater reliability for rating triage acuity and good accuracy in predicting the triage code
rating of the reference standard
