Effective training is critical to survival after major trauma . We tested the effectiveness of a simplified bundle of hemorrhagic shock care ("EMS-TruShoC") delivered via a novel educational methodology ("H.E.E.T.") intended to pragmatically improve prehospital trauma morbidity and mortality. We assessed outcomes in three highly relevant areas: (i) clinical at the patient-level; (ii) implementation, and (iii) educational. The overall design was a Type 2 hybrid implementation-effectiveness study (equal focus on clinical and implementation outcomes). We conducted a quasi-experimental trial to introduce a novel intervention (EMS-TruShoC) which was implemented via a novel educational methodology (H.E.E.T.). We enrolled 198 EMS providers and 770 critical patients. Patients in shock (due to penetrating injuries) who received the TruShoC intervention (delivered by BLS providers) had clinically improved (but statistically non-significant) clinical outcomes compared to control-site patients. We implemented the H.E.E.T. training program with high implementation fidelity (76% mean effectiveness, per RE-AIM). Knowledge and skills acquisition and retention (up to 12-months post-intervention) of TruShoC was superior in our intervention effort.