education study

[timdog88]

has there ever been a study that correlated patient outcome with the education level of paramedics? I have tried searching for one, but so far no luck. If there has not been one done, then doing one and showing better outcomes with higher paramedic education could be a great first step in raising the bar for minimun education standards.

[Timmy]

I haven't come across a study like this but I'm sure someone has conducted similar research. At a guess I'm sure there is strong evidence pointing towards better outcomes as one would hope with greater education follows a greater scope of practice.

[VentMedic]

has there ever been a study that correlated patient outcome with the education level of paramedics? I have tried searching for one, but so far no luck. If there has not been one done, then doing one and showing better outcomes with higher paramedic education could be a great first step in raising the bar for minimun education standards.

That is because higher education at a degree level is not a requirement for Paramedics in 49 of the 50 states. The stats may not give a true reflection for level of care if only one or two Paramedics in each agency have a degree in EMS or some health science.

Some states only require a minimun of 500 hours of training. Some of the states have limited protocols either at the state level or the reluctance of Medical Directors to allow more responsibilty may also be a reflection of inadequate education standards. California can be used as an example for that.

You might try researching the Oregon website since they do require a degree for their Paramedics. Also some agencies such as Seattle's Medic One that have a more extensive education program could be of some assistance for your research.

Canada and other countries are also a good source for research since they have required much higher education levels for their Paramedics. This also makes their Paramedic better candidates for their Critical, Flight and Specialty transport programs which also has more extensive training then the 3 hour backroom CCT program at many ambulance services or an 80 hour overview of CCT that is so popular in the U.S. and often taken as the end all to Critical Care education for some.

Other healthcare professions have kept stats on higher education and do use them as bargaining factors when petitioning for more reimbursement and privileges.

However, if you are against higher EMS education, you might email the author of this:

2,000 Hours to train a Paramedic?

http://www.fd-doc.com/2000Hours.htm

http://www.fd-doc.com/

Edited April 20, 2009 by VentMedic

[timdog88]

I thought that there were 2 states that required a degree to be a paramedic, one of them was midwestern, if I remember correctly. I would think that one or 2 states full of paramedics, as well as countries such as canada and austrailia, would provide enough cases to compare against non-degreed paramedics, and comparing apples to apples, e.g., same city size, same number of trauma centers, same types of patients, figure out if more education equals better outcomes. It seems to me that it would, but some hard evidence sure would go a long way to convincing state agencies to mandate higher education, and if no study like this has been done, how would someone go about getting the ball rolling?

[VentMedic]

It seems to me that it would, but some hard evidence sure would go a long way to convincing state agencies to mandate higher education, and if no study like this has been done, how would someone go about getting the ball rolling?

Again, have you contacted Oregon or any of the countries that have higher education levels to see where they have gotten their data before you say there are no studies? Just because you can not find it on a GOOGLE search doesn't mean it doesn't exist. Lobbyists usually have their ducks in a row when they petition a state for increased standards.

The reasons for not increasing education standards usually have little to do with patient care.

Edited April 20, 2009 by VentMedic

[WolfmanHarris]

I highly doubt there's any research on this. As Vent mentioned a degree is not required for the vast majority of Paramedics in the United States making comparisons of this sort unlikely. I'm also not aware of any research being done to justify or examine education standards here in Canada as their upward creep was somewhat gradual and based more on practical changes in EMS rather than science. Jurisdictions have set their education for various reasons and I don't see science being top of the list (otherwise OPALS would have killed ALS in Ontario.) nor do I see countries comparing themselves in this field where we're already lagging in research.

I think outcomes is probably a poor place to start with such spotty coverage by degreed medics and the unique nature of each patient. A better starting point might be accuracy of field diagnosis, or accuracy of STEMI recognition. These are more specific, easy to identify goals that can form a starting point. This research could be done starting with a single region and then be repeated later by other regions until hopefully someone takes it and runs and we get some better national research.

And Vent thanks for posting that link. It's incredibly frustrating but understandable if you filter it through the author's perspective. He views EMS from the end point of transport to hospital and looks for whether increased education is necessary for this limited role. Whereas I don't see the increase in education standards as just changing how we operate in this framework (which realistically it won't) but being the impetus to a whole new model for practice. Anyways, I skimmed over some of that article as my frustration increased. Time to go back and finish.

- Matt

[Canadian Caesar]

However, if you are against higher EMS education, you might email the author of this:

2,000 Hours to train a Paramedic?

http://www.fd-doc.com/2000Hours.htm

http://www.fd-doc.com/

So this retard that wrote that article think the only thing that has changed in 23 YEARS of EMS is the time it takes to train?

Surely the expanded scope of practice and the fact that there is actually some Pharmacology involved have nothing to do with it?

He a physician for cryin' out loud.

I can diagnose a heart attack too! It's what Dustdevil is going to have when he reads that retarded article!

P.S. Does being a Firefighter/Medic/Physician make the author a FireGorrila?

Edited April 20, 2009 by Julian Power

[VentMedic]

So this retard that wrote that article think the only thing that has changed in 23 YEARS of EMS is the time it takes to train?

Surely the expanded scope of practice and the fact that there is actually some Pharmacology involved have nothing to do with it?

He a physician for cryin' out loud.

I can diagnose a heart attack too! It's what Dustdevil is going to have when he reads that retarded article!

P.S. Does being a Firefighter/Medic/Physician make the author a FireGorrila?

He was a physician who lives in Florida and is now a consultant. I also believe his experience comes from being an EMT(P) more than being a medical director. So, for some being an EMT-P is so easy....

Sometimes those in the profession are our own worst enemies.

Minimum hours for the Florida Paramedic is 700 and has its own state exam which many other professionals can challenge. But, Florida did enforce the rule for no sleep overs on ALS engines for clinicals. I do consider that a major step forward.

Actually, some of us enjoyed a more expanded scope of practice, especially in Florida, in the earlier years than we do now. I'm not just talking about all the "skills" we used to do either. There was a time when physicians were enthusiatic to support EMS. But, somewhere down the road we changed their minds. Failure to monitor the profession amongst ourselves and lax oversight have eroded the "skills" we do have and are putting them into question.

Would Medic One in Seattle be able to be innovative in their skills/protocols and research if they had to rely only on 600 hours of training? Others such as Ada County (croaker260) have managed to maintain advanced skills/protocols because they have demonstrated a need and have put forth the effort.

Dust has probably seen this article many times since it is still mentioned occasionally 10 years later by certain unions and EMT(P)s who feel education is an invasion of their rights.

This, of course, pertains to the U.S.

Edited April 20, 2009 by VentMedic

[fiznat]

has there ever been a study that correlated patient outcome with the education level of paramedics? I have tried searching for one, but so far no luck. If there has not been one done, then doing one and showing better outcomes with higher paramedic education could be a great first step in raising the bar for minimun education standards.

I imagine the results would be confounded by the fact that paramedics - regardless of "education level" - largely follow a standard set of protocols. The output of work from a paramedic still depends much more on what the protocol says than any independent (educated or not) decision made by that provider.

There is an assumption here that longer training times correlate with more advanced protocols, but I'm not sure even that is true. I imagine establishing that relationship would be the first step in this kind of research.

[VentMedic]

I imagine the results would be confounded by the fact that paramedics - regardless of "education level" - largely follow a standard set of protocols. The output of work from a paramedic still depends much more on what the protocol says than any independent (educated or not) decision made by that provider.

There is an assumption here that longer training times correlate with more advanced protocols, but I'm not sure even that is true. I imagine establishing that relationship would be the first step in this kind of research.

If you look at CCTs, Flight and Specialty transport teams in Canada and other countries where education is higher, you will find they are Paramedic/Paramedic teams. Here in the U.S., the team often includes an RN or will be RN/RN or RN/RRT especially if there are "expanded" protocols. The RN is also usually the higher ranking team member if the partner is a Paramedic and that is often due to the vast differences in education as well as the ability to do advanced protocols especially where medications are concerned.

The U.S. Paramedic has not really given education a chance to see what the possibilites could be. Other healthcare professions have and are making great strides in advancing their scope as well as the level and quality of patient care.

Edited April 20, 2009 by VentMedic