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Understanding Program Attrition: The Influence of Entry Requirements and Student Resources.

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|December 1, 2025
PubMed
Summary

Paramedic program attrition is high, with open enrollment linked to increased dropout rates. Implementing stricter entry requirements like interviews and exams, alongside support like daycare, may improve paramedic retention.

Keywords:
accreditationattritioncertificationemergency medical servicesparamedic education

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Area of Science:

  • Medical Education
  • Emergency Medical Services
  • Workforce Development

Background:

  • Paramedic educational program attrition impacts the emergency medical services (EMS) workforce.
  • Existing retention strategies like entry requirements and resources have unclear effectiveness.
  • High attrition rates lead to a loss of trained clinicians.

Purpose of the Study:

  • To evaluate paramedic program entry requirements and resources.
  • To assess the association between these factors and high educational program attrition.
  • To identify factors influencing paramedic retention.

Main Methods:

  • Cross-sectional survey of 629 paramedic programs using 2023 CoAEMSP annual reports.
  • Analysis included programs with >4 students and at least one graduating cohort in 2021.
  • Descriptive statistics (median, IQR) and proportional differences (PDs) were used to compare attrition groups.

Main Results:

  • The median paramedic program attrition rate was 20%, with 23.5% of programs reporting high attrition.
  • Programs with high attrition were more likely to have open enrollment policies.
  • Low-attrition programs more frequently required preadmission interviews, medical knowledge exams, medical prescreens, and offered daycare.

Conclusions:

  • Significant variability exists in paramedic program entry requirements and student resources.
  • Paramedic programs should consider a combination of entry standards and support systems to enhance student retention.
  • Strategies to improve paramedic retention require a holistic approach addressing both admissions and student support.