Herman L L, Willoughby P J, Koenigsberg M D, Ward S, McDonald C C
Department of Emergency Medicine, University of Illinois at Chicago, USA.
Prehosp Disaster Med. 1996 Oct-Dec;11(4):292-5. doi: 10.1017/s1049023x00043156.
To determine characteristics of continuing education programs for paramedics in large metropolitan areas, and to make recommendations for changes in the Chicago Emergency Medical Services (EMS) system.
A survey of 95 metropolitan areas from each state in the United States.
EMS medical directors, coordinators, and administrators.
The survey population included 56 respondents. Within this group, 23% were from areas of 1 million people or more, 61% in areas with populations of 100,000 to 1 million and 16% from areas populated by < 100,000 people. Several system types were represented in the survey. In the systems surveyed, 98% mandate didactic continuing education requirements. Clinical continuing education was required by 34% of the systems. Ten systems (18%) awarded continuing education hours for documented in-field experience. This method did not have a specific structure by the majority of users. Both written and skills testing were used by most EMS systems to evaluate paramedic competency. No statistically significant differences (p > 0.05) could be found among population subgroups or EMS system types when evaluating the use of these various methods.
EMS systems primarily use didactic sessions to meet their continuing education requirements. Nearly half of the systems requiring clinical continuing education use in-field credit to fulfill these requirements. In-field credit systems are poorly developed to date. This mechanism may be an effective alternative to usual clinical experiences for paramedics and deserves further investigation.
确定大城市地区护理人员继续教育项目的特点，并为芝加哥紧急医疗服务（EMS）系统的变革提出建议。
对美国每个州的95个大城市地区进行调查。
EMS医疗主任、协调员和管理人员。
调查对象包括56名受访者。在这个群体中，23%来自人口100万及以上的地区，61%来自人口10万至100万的地区，16%来自人口不足10万的地区。调查涵盖了几种系统类型。在所调查的系统中，98%规定了理论继续教育要求。34%的系统要求进行临床继续教育。10个系统（18%）为有记录的现场经验授予继续教育学分。大多数用户对这种方法没有特定的结构。大多数EMS系统使用书面测试和技能测试来评估护理人员的能力。在评估这些不同方法的使用时，在人口亚组或EMS系统类型之间未发现统计学上的显著差异（p>0.05）。
EMS系统主要通过理论课程来满足其继续教育要求。近一半要求临床继续教育的系统利用现场学分来满足这些要求。迄今为止，现场学分系统发展不完善。这种机制可能是护理人员常规临床经验的有效替代方案，值得进一步研究。
