Understanding the Emergency Medical Technician Training Pipeline

High-quality emergency medical service (EMS) training with minimal attrition and high licensure exam passage rates is crucial for a robust prehospital emergency care system. This study examines the EMS training pipeline, focusing on hidden steps and trainee characteristics that facilitate successful progression. Current research emphasizes course completion and licensure exam passage, but often overlooks the ultimate goal of trainees working or volunteering as EMS professionals, particularly in rural areas. Data was collected via a survey distributed to 386 participants of three hybrid EMT courses in 2022-2023, with a 25.1% response rate. The survey gathered demographic data, licensure status, willingness to pay for training, and confidence in performing EMT duties. Demographic information included age, sex, race, education, and ZIP code, which was cross-referenced to determine rural residency. Participants were asked about their current stage in the EMT licensure process and their maximum willingness to pay for the course. Confidence was measured using a 5-point Likert scale. Analysis involved three logistic regression models to identify factors influencing taking the NREMT exam, passing the exam, and working or volunteering as an EMT. Key findings indicate that confidence and willingness to pay impact taking and passing the NREMT exam. Age and rural residency influence working or volunteering as an EMT. The study highlights the importance of recruiting younger trainees and providing financial support to eliminate training barriers. Trainee confidence is crucial for NREMT exam success, suggesting the need for targeted assessments and support. The findings underscore the need for further research into the entire EMT training pathway, rather than focusing on individual steps. Trainee confidence, age, and willingness to pay are significant factors in EMT licensure success. The study's findings inform program design and highlight the need for recruitment from younger populations to grow the EMS workforce, particularly in rural areas.