Center for Prehospital Care, University of California: Los Angeles, Los Angeles, California.
National Registry of Emergency Medical Technicians, Columbus, Ohio.
Prehosp Emerg Care. 2024;28(2):326-332. doi: 10.1080/10903127.2023.2245476. Epub 2023 Aug 25.
Initial paramedic education must have sufficient rigor and appropriate resources to prepare graduates to provide lifesaving prehospital care. Despite required national paramedic accreditation, there is substantial variability in paramedic pass rates that may be related to program infrastructure and clinical support. Our objective was to evaluate US paramedic program resources and identify common deficiencies that may affect program completion.
We conducted a cross-sectional mixed methods analysis of the 2018 Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual report, focusing on program Resource Assessment Matrices (RAM). The RAM is a 360-degree evaluation completed by program personnel, advisory committee members, and currently enrolled students to identify program resource deficiencies affecting educational delivery. The analysis included all paramedic programs that reported graduating students in 2018. Resource deficiencies were categorized into ten categories: faculty, medical director, support personnel, curriculum, financial resources, facilities, clinical resources, field resources, learning resources, and physician interaction. Descriptive statistics of resource deficiency categories were conducted, followed by a thematic analysis of deficiencies to identify commonalities. Themes were generated from evaluating individual deficiencies, paired with program-reported analysis and action plans for each entry.
Data from 626 programs were included (response rate = 100%), with 143 programs reporting at least one resource deficiency (23%). A total of 406 deficiencies were identified in the ten categories. The largest categories ( = 406) were medical director (14%), facilities (13%), financial resources (13%), support personnel (11%), and physician interaction (11%). The thematic analysis demonstrated that a lack of medical director engagement in educational activities, inadequate facility resources, and a lack of available financial resources affected the educational environment. Additionally, programs reported poor data collection due to program director turnover.
Resource deficiencies were frequent for programs graduating paramedic students in 2018. Common themes identified were a need for medical director engagement, facility problems, and financial resources. Considering the pivotal role of EMS physicians in prehospital care, a consistent theme throughout the analysis involved challenges with medical director and physician interactions. Future work is needed to determine best practices for paramedic programs to ensure adequate resource availability for initial paramedic education.
初始的急救医疗技术员教育必须具有足够的严谨性和适当的资源，以培养毕业生提供救生的院前护理能力。尽管有国家要求的急救医疗技术员认证，但急救医疗技术员的通过率存在很大差异，这可能与项目基础设施和临床支持有关。我们的目的是评估美国的急救医疗技术员项目资源，并确定可能影响项目完成的常见缺陷。
我们对 2018 年紧急医疗服务专业委员会认证教育项目年度报告进行了一项横断面混合方法分析，重点是项目资源评估矩阵（RAM）。RAM 是由项目人员、顾问委员会成员和当前注册学生完成的 360 度评估，用于确定影响教育交付的项目资源缺陷。分析包括在 2018 年报告毕业学生的所有急救医疗技术员项目。资源缺陷分为十个类别：教师、医疗主任、支持人员、课程、财务资源、设施、临床资源、现场资源、学习资源和医生互动。对资源缺陷类别的描述性统计数据进行了分析，然后对缺陷进行了主题分析，以确定共性。从评估个别缺陷开始生成主题，并与每个条目的项目报告分析和行动计划配对。
纳入了 626 个项目的数据（响应率=100%），其中 143 个项目报告了至少一个资源缺陷（23%）。在十个类别中发现了 406 个缺陷。最大的类别（ =406）是医疗主任（14%）、设施（13%）、财务资源（13%）、支持人员（11%）和医生互动（11%）。主题分析表明，医疗主任参与教育活动不足、设施资源不足以及缺乏可用的财务资源影响了教育环境。此外，项目报告由于项目主任更替导致数据收集不佳。
2018 年毕业的急救医疗技术员项目中资源缺陷频繁。确定的共同主题是需要医疗主任的参与、设施问题和财务资源。考虑到紧急医疗服务医师在院前护理中的关键作用，整个分析过程中的一个一致主题是医疗主任和医生互动的挑战。需要进一步的工作来确定急救医疗技术员项目的最佳实践，以确保初始急救医疗技术员教育有足够的资源。
