Authors: Daniel Armstrong, DPT; Jackson D. Déziel, PhD, MPA, NRP; Sarah Glass; Angela Finney; Glen Keating; Lisa Glegg; Christopher Metsgar, MBA, MS, NRP

Introduction:  According to the National Emergency Medical Services Standard curriculum the length for an initial paramedic course is estimated to take approximately 1,000-1,200 hours. The hours spent in a paramedic program span didactic, lab, clinical, and field settings. The hours spent in each of these components also varies among programs. Accreditation guidelines do not offer specific information in which setting the students should concentrate their time. Despite widespread agreement on the importance of non-didactic experiences, the number of hours for each phase remains unclear and inconsistent across programs. This study was designed to explore which non-didactic setting is the most valuable for paramedic students.


Methods: A retrospective analysis of Fisdap educational data was conducted. A total of 3,268 paramedic student records from October 2012 to January 2019 were examined. This study used student performance on the summative Fisdap Paramedic Readiness Exam version 3 (PRE3) as the measure of student success. Student data was analyzed with linear regression and elasticity models to determine if the number of hours students spent in the laboratory, clinical, and field settings were related to performance on the PRE3 summative exam.


Results: Students who took the PRE3 summative exam increased their scores when they had more field (ß=0.011, p<0.000) and lab hours (ß=0.001, p=0.040), while increased clinical times appeared to have a negative impact on PRE3 scores (ß=-0.004, p=0.025). The elasticity function isolated field and laboratory hours as the most important contributor to paramedic student success. For each 10% increase in field hours, student scores on the summative exam increased by 0.33% (ß=0.033, p<0.000). Additionally, a 10% increase in lab hours yielded a PRE3 score increase of 0.08% (ß=0.008, p<0.000). Clinical hours remained negative correlated to student success (ß=-0.011, p=0.081).


Conclusion: The number of hours spent in lab and the field experiences had a statistically significant positive impact on student success on a summative paramedic exam. This study highlights that assessment and skills practice in the lab and internship may be the most beneficial for initial paramedic students.