Officer training has become central to the continuing controversy over Minneapolis Police Department practices. The city administration, cops and many others say new and improved training are key to shifting the culture that has contributed to civilian injuries and deaths at the hands of police.

And yet now the public is learning that some of the same old and arguably discriminatory training is still being done — despite being challenged by experts.

In the federal trial underway in St. Paul for three former Minneapolis officers charged in connection with George Floyd's killing, the defense says that the officers were following department protocol on how to handle someone suffering from "excited delirium" — a disputed diagnosis for a severe form of agitation in which people exhibit aggressive behavior and exceptional strength.

Excited delirium has become an increasingly controversial diagnosis in recent years, with some medical and human rights officials and social justice advocates questioning its use and treatment.

The American Medical Association has publicly opposed it, calling the diagnosis a "manifestation of systemic racism" and saying it has been used as an excuse to explain excessive use of force by police and the use of unneeded sedatives.

A recent Star Tribune news story quoted MPD spokesman Garrett Parten as saying that the department's training "no longer uses the term excited delirium." Parten, who referenced the AMA's guidance, went on to say that, "The most recent fall 2021 training delivered to all department members by the physician did not include the term excited delirium." A spokesman for Mayor Jacob Frey also told the newspaper that the MPD had ended the training.

That was false. Thanks to a public records request, Star Tribune reporter Andy Mannix was able to view video of 2021 training in which the term was still being used.

In the video, Dr. Paul Nystrom, an emergency physician at Hennepin Healthcare and a sworn police officer, says the terminology has become "triggering" for the public. Using a PowerPoint slide with the words "excited delirium" crossed out, he suggested that police call it by another name, such as "severe agitation with delirium."

In addition, during the trial in St. Paul, a former training commander testified that MPD training instructed officers to ignore a city Civil Rights Department study that documented cases of police inappropriately asking paramedics to sedate uncooperative people during emergency calls — often claiming that they were in a state of excited delirium.

After Mannix uncovered the training video, Frey's office released a statement saying he would be reviewing with external medical experts what appeared to be a failure to follow a directive. In the meantime, the mayor directed the MPD to terminate its contract with Nystrom.

Then late Monday, Hennepin Healthcare released a statement taking the blame for the training. "We are extremely sorry for the further harm this has caused to our community," the statement said. "Systemic racism is deeply embedded in law enforcement and health care systems, including ours. We failed to address it here when we had the opportunity and, in doing so, have caused further pain and mistrust."

MPD and city leaders are responsible for police training, and they should have monitored the program closely enough to know Hennepin Healthcare was failing to meet their standards.

Once again, the MPD and city leaders have given citizens reason to question how effective they can be in working with community partners to implement the changes they have championed.