Badiali, S., Giugni, A., and Marcis, L. (2017). Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents? (Abstract only.) Disaster Medicine and Public Health Preparedness. 11(3):305-309.
The authors evaluated whether "last-minute" START training of nonmedical ambulance personnel in Italy during a disaster or MCI (using data from a train system victim database as proxy) would result in more effective triage of patients. There was significant improvement in accuracy, and less over- and under-triage for evaluations performed by the group that received just-in-time training on the START protocol. (Note that validation was against the tool itself, making it unclear whether it improved victim triage.)