This 3-stage intervention study enrolled all adult patients referred to a universitybased emergency department (ED) during randomly assigned 1-week preeducation or posteducation periods. Triage decisions recorded by ED paramedics (n=8) both before and after an educational training session were compared to decisions made by emergency physicians (EPs). Triage decisions of paramedics and EPs in the preeducation phase showed poor consistency (κ =0.317, κ=0.388). Triage decisions in the posteducation phase increased slightly but were still found to be low. On the other hand, consistency between the triage assessments recorded by paramedics and EPs of the general appearance of patients increased from low in the preeducation phase to moderate in the posteducation phase (κ =0.327, κ=0.500, respectively). The training session was associated with a slight increase in the consistency of triage decisions recorded by paramedics and EPs.