'Barefoot doctors' in rural Georgia: The effect of peer selection on the performance of trained volunteers

Does volunteer selection by peers have a measurable effect on volunteer performance? This paper examines this question in the context of a field experiment which used community organizations as a means to select people to serve as Emergency Medical Coordinators (EMCs). Field sites were 36 rural Georgia communities with populations ranging from 150 to 1850. EMCs were trained in a 40 hour program as first responders to emergency incidents and as organizers of an emergency response system within their communities. Their performance in each of these roles was assessed by composite measures (a first aid performance index and an activity index) developed as part of the study. Each sponsor organization conducted the selection of EMCs for their respective communities. The process was monitored and assessed as either comprehensive, including the evaluation and elimination of candidates, or as unstructured where interested individuals self-volunteered. Performance scores were regressed on the selection process variable as well as a set of structural, predisposing and enabling variables. Peer selection was a statistically significant predictor of EMC performance as a first responder but not as a response system organizer. Implications of this result as well as the influence of other independent variables are discussed.