Medical Student Perceptions of Emergency Medical Technician Training During the First Year of Medical School

Figures & data

Table 1 Emergency Medical Technician (EMT) Course Content, Dates and Description

EMT Course Content Area	Required State Hours	Year Students Matriculated into Medical School
		^†2012	^†2013	2014	2015	2016	2017
Preparatory Module	32	35	37	33	33	33	33
Airway Module	20	20	32	22	21	21	21
Patient Assessment Module	20	20	32	20	21	21	21
Medical Module	48	48	59	58	55	55	55
Trauma Module	40	41	43	43	40	40	40
Pediatrics Module	12	17	12	16	12	12	12
Operations Module	12	20	19	18	22	18	18
Skill Prep/Review	16	17	16	18	18	21	21
Total Course Hours	200	218	250	228	222	221	221
Ambulance Field Hours	24	24	24	24	24	24	24
Required Patient Encounters	5	5	10	10	10	10	10
Examinations	N/A	9	6	4	4	4	4
Biomedical Sciences Integration	N/A	No	Yes	Yes	No	No	No
Dates of Course	N/A	August 1-September 9	August 1-November 1	July 31-October 24	July 29-September 18	July 27-September 9	July 19-September 1
Total number of weeks	N/A	5.5	13	11.5	7.5	6.5	6.5

Notes: Biomedical Sciences Integration = Integration of Emergency Medicine Technician (EMT) course with biomedical science content (i.e. gross anatomy).^† Represents data previously published and reprinted with permission from: copyright © The National Association of EMS Physicians, http://www.naemsp.org/Pages/default.aspx, reprinted by permission of Taylor & Francis Ltd, http://www.tandfonline.com on behalf of the National Association of EMS Physicians.⁵

Abbreviation: N/A, not applicable.

Table 2 Student Perceptions of the Statements Related to Emergency Medical Technician (EMT) Course

Statement		Year Students Matriculated into Medical School
		2012	2013	2014	2015	2016	2017
A) Academic Workload/Demands on Student Time	Mean (SEM)	4.31 (0.08)	3.60 (0.08)*^, ***	3.89 (0.05)^†††	4.08 (0.05)^###	4.28 (0.07)	4.46 (0.06)
	N (%)	52 (100%)	45 (83%)	79 (96%)	86 (83%)	65 (63%)	82 (78%)
B) Incorporation of Clinically Relevant Material	Mean (SEM)	4.47 (0.09)	3.95 (0.09)**^, ***	4.35 (0.06)	4.42 (0.05)	4.31 (0.07)*	4.57 (0.06)
	N (%)	52 (100%)	44 (81%)	78 (95%)	86 (83%)	65 (63%)	82 (78%)
C) Fairness of Summative Assessments in Course	Mean (SEM)	4.42 (0.08)	3.89 (0.08)*^, ***	4.04 (0.05)^††,†††	4.17 (0.05)	4.33 (0.07)	4.37 (0.05)
	N (%)	52 (100%)	45 (83%)	79 (96%)	86 (83%)	64 (62%)	81 (77%)
D) Helpfulness in Preparing You for USMLE^® exams	Mean (SEM)	3.55 (0.07) ***	2.58 (0.08)^††,†††	3.14 (0.04)	3.03 (0.04)	2.94 (0.07)	3.71 (0.06)^###
	N (%)	46 (88%)	40 (74%)	72 (88%)	73 (71%)	47 (46%)	62 (59%)
E) Appropriateness of Teaching Methods	Mean (SEM)	4.23 (0.08)	3.41 (0.07)***	4.06 (0.05)^††,†††	4.33 (0.05)	4.11 (0.06)^##	4.41 (0.05)
	N (%)	52 (100%)	46 (85%)	79 (96%)	86 (83%)	64 (62%)	82 (78%)
F) General Module Organization	Mean (SEM)	4.23 (0.08)	3.13 (0.07) ***	3.66 (0.04)^†††	4.14 (0.05)^#	4.03 (0.06)^###	4.38 (0.05)
	N (%)	52 (100%)	45 (83%)	79 (96%)	86 (83%)	65 (63%)	82 (78%)
G) Overall Module Quality	Mean (SEM)	4.37 (0.08)	3.57 (0.07)***	3.97 (0.05)^†††	4.13 (0.05)	4.11 (0.06)	4.46 (0.06)^###
	N (%)	52 (100%)	46 (85%)	78 (95%)	86 (83%)	65 (63%)	82 (78%)

Notes: Results are reported as the mean of the Likert scale responses (Mean) and standard error of the mean (SEM). Likert Scale descriptors with associated point values: Very Dissatisfied = 1, Dissatisfied = 2, Neutral – Neither Satisfied or Dissatisfied = 3, Satisfied = 4, Very Satisfied = 5. N= number of students responding to statement. % = percent of students responding to statement. A) ***p<0.001 2013 vs 2012, 2015, 2016, and 2017. *p<0.05 2013 vs 2014. ^†††p<0.001 2014 vs 2012, 2016 and 2017. ^###p<0.001 2015 vs 2017. B) ***p<0.001 2013 vs 2012, 2015, and 2017. **p<0.01 2013 vs 2014 and 2016. *p<0.05 2016 vs 2017. C) *p<0.05 2013 vs 2015. ***p<0.001 2013 vs 2012, 2016, and 2017. ^††p<0.01 2014 vs 2016. ^†††p<0.001 2014 vs 2017. D) ***p<0.001 2012 vs 2013, 2014, 2015, and 2016. ^†††p<0.001 2013 vs 2014, 2015, and 2017. ^††p<0.01 2013 vs 2016. ^###p<0.001 2017 vs 2014, 2015 and 2016. E) ***p<0.001 2013 vs all other years. ^††p<0.01 2014 vs 2015. ^†††p<0.001 2014 vs 2017. ^##p<0.01 2016 vs 2017. F) ***p<0.001 2013 vs all other years. ^†††p<0.001 2014 vs all other years. ^#p<0.05 2015 vs 2017. ^###p<0.001 2016 vs 2017. G) ***p<0.001 2013 vs all other years. ^†††p<0.001 2014 vs 2012 and 2017. ^###p<0.001 2017 vs 2015 and 2016.

Table 3 Student Perceptions of Experiences and Clinical Skill Development Provided by the Emergency Medical Technician (EMT) Program

Statement		Year of EMT Course
		2012	2013	2014	2015	2016	2017
A) The EMT curriculum provided me with the opportunities I expected	Mean (SEM)	4.25 (0.08)	3.80 (0.08)**^, ***	4.21 (0.05)	4.16 (0.05)	4.02 (0.06)^††	4.35 (0.05)
	N (%)	52 (100%)	46 (85%)	78 (95%)	85 (83%)	64 (62%)	81 (77%)
B) Participating as an EMT made me more confident in my clinical skills	Mean (SEM)	4.35(0.08)***	3.98 (0.08)*^, **	4.30 (0.05)^†††	3.96 (0.05)^##	3.80 (0.07)^###	4.24 (0.05)
	N (%)	52 (100%)	46 (85%)	79 (96%)	85 (83%)	65 (63%)	82 (78%)
C) The EMT curriculum allowed me the opportunity to gain better understanding of our patient population	Mean (SEM)	4.69 (0.10)	4.60 (0.11)	4.62 (0.06)	4.56 (0.05)	4.40 (0.07)	4.57 (0.06)
	N (%)	51 (98%)	45 (83%)	78 (95%)	86 (83%)	65 (63%)	82 (78%)
D) The EMT curriculum gave me a better understanding of the different levels of medical care and how they work together for the care of patients	Mean (SEM)	4.67 (0.10)	4.24 (0.09)*^, **	4.62 (0.06)	4.42 (0.05)	4.38 (0.07)	4.57 (0.06)
	N (%)	51 (98%)	46 (85%)	79 (96%)	86 (83%)	64 (62%)	82 (78%)
E) The EMT curriculum allowed me the opportunity to practice patient based care while interacting with other members of the health care team	Mean (SEM)	4.58 (0.09)**^, ***	3.98 (0.08)^†, ††, †††	4.42 (0.06)^##	4.26 (0.05)	4.12 (0.06)	4.32 (0.05)
	N (%)	52 (100%)	46 (85%)	78 (95%)	86 (83%)	65 (63%)	82 (78%)
F) The EMT curriculum has been a clinically relevant portion of my medical education	Mean (SEM)	4.46 (0.09)*^, ***	3.98 (0.08)^†, †††	4.38 (0.06)^###	4.19 (0.05)	3.97 (0.06)^##	4.27 (0.05)
	N (%)	52 (100%)	46 (85%)	79 (96%)	85 (83%)	64 (62%)	82 (78%)
G) The EMT curriculum had a positive influence on my medical education	Mean (SEM)	4.46 (0.09)*^, **	4.07 (0.09)^††	4.23 (0.05)	4.17 (0.05)	4.12 (0.06)^†	4.39 (0.05)
	N (%)	52 (100%)	46 (85%)	79 (96%)	86 (83%)	65 (63%)	82 (78%)

Notes: Results are reported as the mean of the Likert scale responses (Mean) and standard error of the mean (SEM). Likert Scale descriptors with associated point values: Strongly Disagree = 1, Disagree = 2, Neutral – Neither Agree nor Disagree = 3, Agree = 4, Strongly Agree = 5. N= number of students responding to statement. % = percent of students responding to statement. A) ***p<0.001 2013 vs 2012, 2014 and 2017. **p<0.01 2013 vs 2015. ^††p<0.01 2016 vs 2017. B) ***p<0.001 2012 vs 2015 and 2016. **p<0.01 2013 vs 2012 and 2014. *p<0.05 2013 vs 2017. ^†††p<0.001 2014 vs 2015 and 2016. ^##p<0.01 2015 vs 2017. ^###p<0.001 2016 vs 2017. C) No difference among groups. D) **p<0.01 2013 vs 2012 and 2014. *p<0.05 2013 vs 2017. E) ***p<0.001 2012 vs 2013 and 2016. **p<0.01 2012 vs 2015. ^†††p<0.001 2013 vs 2014. ^†p<0.05 2013 vs 2015. ^††p<0.01 2013 vs 2017. ^##p<0.01 2014 vs 2016. F) ***p<0.001 2012 vs 2013 and 2016. *p<0.05 2012 vs 2015. ^†††p<0.001 2013 vs 2014. ^†p<0.05 2013 vs 2017. ^###p<0.001 2014 vs 2016. ^##p<0.01 2016 vs 2017. G) *p<0.05 2012 vs 2015. **p<0.01 2012 vs 2013 and 2016. ^††p<0.01 2013 vs 2017. ^†p<0.05 2016 vs 2017.

Figure 1 Student perceptions from 6 classes (2012–2017) for the 6 statements (1a-1g) related to the Emergency Medical Technician course. On the X-axis, bar graph shades depict each class and responses based on Likert Scale descriptors as follows: Very Dissatisfied = 1, Dissatisfied = 2, Neutral – Neither Satisfied or Dissatisfied = 3, Satisfied = 4, Very Satisfied = 5. (A) Statement: Academic workload/demands on student time. (B) Statement: Incorporation of clinically relevant material. (C) Statement: Fairness of summative assessments in course. (D) Statement: Helpfulness in Preparing You for USMLE^® exams. (E) Statement: Appropriateness of teaching methods. (F) Statement: General module organization. (G) Statement: Overall module quality.

Figure 2 Student perceptions from 6 classes (2012–2017) for the 6 statements (2a-2g) related to experiences and clinical skill development provided by the Emergency Medical Technician program. On the X-axis, bar graph shades depict each class and responses based on Likert Scale descriptors as follows: Strongly Disagree = 1, Disagree = 2, Neutral – Neither Agree nor Disagree = 3, Agree = 4, Strongly Agree = 5. (A) Statement: The EMT curriculum provided me with the opportunities I expected. (B) Statement: Participating as an EMT made me more confident in my clinical skills. (C) Statement: The EMT curriculum allowed me the opportunity to gain better understanding of our patient population. (D) Statement: The EMT curriculum gave me a better understanding of the different levels of medical care and how they work together for the care of patients. (E) Statement: The EMT curriculum allowed me the opportunity to practice patient-based care while interacting with other members of the health care team. (F) Statement: The EMT curriculum has been a clinically relevant portion of my medical education. (G) Statement: The EMT curriculum had a positive influence on my medical education.

Blackwell TH, Halsey RM, Reinovsky JH. Emergency medical technician training for medical students: a two-year experience. Prehosp Emergency Care. 2016;20(4):518–523. doi:10.3109/10903127.2015.1115930

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