Strategies of high-performing paramedic educational programs.

OBJECTIVE: To identify the specific educational strategies used by paramedic educational programs that have attained consistently high success rates on the National Registry of Emergency Medical Technicians (NREMT) examination.

METHODS: NREMT data from 2003-2007 were analyzed to identify consistently high-performing paramedic educational programs. Representatives from 12 programs that have maintained a 75% first-attempt pass rate for at least four of five years and had more than 20 graduates per year were invited to participate in a focus group. Using the nominal group technique (NGT), participants were asked to answer the following question: "What are specific strategies that lead to a successful paramedic educational program?"

RESULTS: All 12 emergency medical services (EMS) educational programs meeting the eligibility requirements participated. After completing the seven-step NGT process, 12 strategies were identified as leading to a successful paramedic educational program: 1) achieve and maintain national accreditation; 2) maintain high-level entry requirements and prerequisites; 3) provide students with a clear idea of expectations for student success; 4) establish a philosophy and foster a culture that values continuous review and improvement; 5) create your own examinations, lesson plans, presentations, and course materials using multiple current references; 6) emphasize emergency medical technician (EMT)-Basic concepts throughout the class; 7) use frequent case-based classroom scenarios; 8) expose students to as many prehospital advanced life support (ALS) patient contacts as possible, preferably where they are in charge; 9) create and administer valid examinations that have been through a review process (such as qualitative analysis); 10) provide students with frequent detailed feedback regarding their performance (such as formal examination reviews); 11) incorporate critical thinking and problem solving into all testing; and 12) deploy predictive testing with analysis prior to certification.

CONCLUSION: Twelve specific strategies were identified by representatives from high-performing paramedic education programs. Further study should be conducted to determine whether implementation of these recommendations would improve program pass rates on the NREMT credentialing examination and improve entry-level paramedic field performance.