From Training to Reality: System-Level Barriers and Behavioral Gaps in Prehospital Cardiopulmonary Resuscitation Among Emergency Medical Technicians in Taiwan

Findings suggest that real-world CPR performance is more influenced by systemic and contextual obstacles than by individual competencies. Enhancing psychological realism, team-based simulations, and debriefing practices may improve learning transfer from training to field performance. The integration of simulation, field video, and EMT reflections underscores that training-performance gaps must be addressed through system-level reforms rather than isolated technical retraining.