Comprehensive Description of the Advanced Emergency Medical Technician Certification Level

Background: The nationally-certified advanced emergency medical technician (AEMT) level was created as an intermediate level of care integrating both basic life support and limited advanced life support. Despite adoption of the AEMT certification level nationally, the characteristics of AEMTs have not previously been described. Our objectives were to describe the demographics of nationally-certified AEMTs in the U.S., and to describe the demographic and program characteristics of the AEMT candidates who took the cognitive examination in 2017. Methods: This was a cross-sectional analysis of all currently nationally-certified AEMTs as of July 1st, 2018 and AEMT candidates who took the National AEMT cognitive examination in 2017 and answered a post-test questionnaire. Descriptive statistics were calculated from the 2 data sources for comparison, along with program-level characteristics. Results: Of all nationally-certified AEMTs (n = 14,973), the workforce was primarily male (71.9%), non-Hispanic white (83.0%), with a median (IQR) age of 30 (25-39), from the Southern National Association of State EMS Officials (NASEMSO) region (48.0%). The demographics of the nationally-certified AEMT workforce were similar to those of 2017 AEMT candidates (n = 5,318). Of candidates who completed the post-test questionnaire (n = 5,068, response rate = 95%), the first-attempt pass rate was 54.7%. Almost a third (31.2%) of AEMT candidates had worked for 1-5 years as an EMT before AEMT training. Common program characteristics included requirements for prior EMT certification (86.8%), provision of a textbook (87.3%) and syllabus (85.0%), and completion of a portfolio (86.0%) and course-ending examination (87.9%). Conclusion: AEMTs fill an important gap in prehospital care between the EMT and paramedic levels in the United States. Many AEMT programs required a current EMT certification and completion of a portfolio and course-ending examination. Implementation of the AEMT certification level could be strengthened through further research into high-quality educational practices for AEMT training programs.