What are the educational and curriculum needs for emergency medical technicians in Taiwan? A scoping review

The Effects of Interactive eBooks on Dyspnea Assessment and Management among Emergency Medical Technicians: A Repeated-Measures Analysis

Dyspnea is a common emergency requiring urgent care, and a variety of factors may mislead emergency medical technicians (EMTs). Typically, EMT education uses traditional lectures with paper books. The effect of interactive eBooks on EMT learning has not been explored. This study aims to develop an interactive eBook in dyspnea assessment and management and to evaluate its learning effect. A quasi-experimental design with three repeated measures was used. A total of 117 EMTs were recruited and assigned to the experimental group (eBook, n = 56) and the comparison group (paper book, n = 61). Questionnaires were administered to both groups at three time points. The results show that both materials can improve cognition and that the interactive eBook has better effects than the paper book. The interactive eBook motivated EMT to learn more than the paper book, but motivation did not last for five weeks. The long-term effect of the interactive eBook on confidence compared to the paper book is significant. The eBook can include real cases, concept maps, videos, quizzes, and instant feedback to meet learner needs. Health educators could integrate technology and cognitive strategies into EMTs’ training curricula to improve their ability to provide better emergency medical services.

Experiential Learning for Psychomotor Skills Development of Emergency Medical Services (EMS) Students: An Action Research

Background

Experiential learning is useful for fostering the development of a wide range of clinical and practical skills. This study aimed to determine the usefulness of experiential learning for psychomotor skills development of emergency medical services (EMS) students.

Methods

An action research approach was used because it is useful for linking theory with action and practice. The Field Internship Student Data Acquisition Project (FISDAP) tool was used to assess and monitor students’ performance and competencies achievement in psychomotor skills. The study was conducted at Prince Sultan College for Emergency Medical Services (PSCEMS), King Saud University (KSU). Skills performance of 71 EMS students were analysed in the experiential learning implemented throughout the curriculum over 3 years.

Results

The finding indicates that the students’ skills performance falls below the minimum requirement during the clinical practicum and significantly improves during the time of internship period. The overall success rate ranges between 26.58% and 35.74% across all the psychomotor skills, whereas during the internship year student’s success rate ranges between 85.49% and 99.4% across all the psychomotor skills.

Conclusion

The findings of this study are promising and show that experiential learning is a useful and effective way to develop psychomotor skills and competencies in EMS students. Educators and policymakers can use the findings for strategizing policies for curriculum planning and development.

Evaluation of Emergency First Response's Competency in Undergraduate College Students: Enhancing Sustainable Medical Education in the Community for Work Occupational Safety

Worldwide, people’s quality of health has been decreasing due to bad eating habits that have generated an increase in diseases such as diabetes, hypertension, overweight, as well as an increase in hours of the daily workday and stress. This situation can generate sudden illness and work accidents where the need to have knowledge in emergency first response (EFR) is necessary for all. Unfortunately, workshops and courses to certify EFR individuals are usually taught only to healthcare professionals. Therefore, to address this need a EFR project has been developed at the Tecnológico de Monterrey (TEC) which consists of a multidisciplinary challenge to train, certify, and evaluate students’ competency as “emergency first responders” in medical emergencies and healthcare awareness. This EFR project has been performed for one week, every year since 2015, and constitutes a joint venture among academic departments, faculty, and industrial/government institutions, which work together in multidisciplinary projects, providing a source of innovative proposals. The EFR project at TEC has provided instruction and certification for 966 students between 2015 to 2019 and this study has analyzed results considering a sample size of 197 participants. The combination of exam evaluation, medical emergency skills verification, and project proposal results indicate that most students reach skill levels between 2 and 3 in EFR competency after successfully completing the program, regardless of their year of study or the undergraduate program they are enrolled on. This evaluation emphasizes the compromise of the institution and its students in preparation for new living under sanitary conditions for pandemic conditions such as COVID-19.

Scoping reviews in medical education: A scoping review

OBJECTIVES

Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities.

METHOD

The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA-ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review.

RESULTS

One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA-ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal.

CONCLUSIONS

Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised.

Cognitive skills of emergency medical services crew members: a literature review

Background

Situation awareness and decision making, listed in non-technical skills taxonomies, are critical for effective and safe performance in high-risk professions. These cognitive skills and their behavioral markers have been studied less in emergency medical services (EMS) crew members. This paper aims to review the existing literature and identify important aspects and behavioral markers of situation awareness and decision making in EMS crew members – those who work in the role of prehospital emergency care providers – and to synthesize findings as a basis for developing a rating and training tool.

Method

The search for relevant articles was conducted using electronic databases, reference lists of relevant reviews and included articles and personal collection of articles. The selection process based on the PRISMA statement yielded a total of 30 articles that met the eligibility criteria. Their findings were qualitatively synthesized using the structured approach, informed by the already known structure: situation awareness and its elements (gathering information, interpreting information, anticipating future states), decision making and its elements (generating and considering options, selecting and implementing an option, reviewing outcome/decision). Moreover, the element of maintaining standards also emerged as highly relevant for cognitive skills.

Results

This review found an increased research interest in the non-technical cognitive skills of EMS crew members. The majority of included articles’ research designs were qualitative, then mixed, Delphi, and quantitative. It revealed several specifics of cognitive skills, such as EMS crew members need to holistically assess a wide range of cues and information, to make various health- and safety-related decisions and take EMS standards into account. However, there was only a limited number of observable markers of cognitive skills, such as acts and verbalizations, that could be considered as examples of good behavior. In addition, findings indicate a lack of articles focused on mass-casualty incidents and the interconnection of cognitive skills with other non-technical and medical skills.

Conclusion

Further research is needed to get a more comprehensive view of behavioral markers of cognitive skills and to develop a rating and training tool to improve EMS crew members’ cognitive performance.

Development of new core competencies for Taiwanese Emergency Medical Technicians

OBJECTIVES

Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan.

METHODS

A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents' perspectives of the Taiwanese EMT training and education system.

RESULTS

The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation.

CONCLUSION

The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and legislation, these findings will inform future curricula design in Taiwan.