Ingrid Ann Brooks

A review of key national reports to describe the development of paramedic education in England (1966–2014)

Introduction In the year 1966, important advances in mobile coronary care and trauma care in the UK and USA influenced globally the development of modern prehospital emergency services and paramedic education. In that year, to meet the evolving role of prehospital care in the UK, the ‘Millar Report’ specified a new syllabus for ambulance personnel in England. As the 50th anniversary of this report approaches, this paper reviews key national UK reports to describe the development of paramedic education in England over this period. Methods A hand search of documents available and a Google search identified documents in the public domain. MEDLINE and CINAHL Plus were searched for peer-reviewed publications. Thematic analysis was used to identify descriptive themes. Results Of the 83 reports and 431 articles screened, 33 documents met our inclusion criteria. We identified four historical periods in English paramedic education: development of paramedic education (1966–1996); paramedic role changes influencing education (1997–2004); paramedic education level changes and the emergency care practitioner (2005–2008); and paramedic education for the future (2010–2014). Our discussion of four descriptive themes: government authority and policy, influence of health professions, quality assurance and development of the paramedic profession includes comparisons with paramedic education in the USA and Australia. Conclusions Political reform agendas and initiatives and advances in clinical medicine largely shaped paramedic roles and education in England. The degree to which the paramedic profession initiated education development is difficult to determine from the literature. Overall, a nationally coherent standard for paramedic education in England needed five decades to develop and mature.

An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014)

INTRODUCTION The Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US. METHOD As US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach. RESULTS Seventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession. CONCLUSION Documents produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.