Prevalence and Impact of Simulation Substitution on Paramedic Educational Program Success: A National Examination

Area of Science:

• Emergency Medical Services Education
• Medical Simulation
• Healthcare Professional Training

Background:

• Paramedic programs require rigorous training for life-saving skills.
• Limited clinical opportunities sometimes necessitate simulation substitution.
• The impact of simulation on paramedic program success needs evaluation.

Purpose of the Study:

• To determine the prevalence of simulation substitution in paramedic education.
• To assess the association between simulation use and program success on certification exams.

Main Methods:

• Cross-sectional evaluation of 640 paramedic programs graduating in 2019.
• Data sourced from the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual report.
• Simulation substitution assessed across 11 clinical skills; success defined as ≥75% first-attempt pass rate on certification exams.

Main Results:

• 59% of programs utilized simulation substitution for clinical skills.
• Success rates on first-attempt certification exams decreased as simulation substitution increased beyond five skills.
• Programs substituting 6-7 skills had an odds ratio of 0.51 (0.32-0.82); those substituting ≥8 skills had an odds ratio of 0.53 (0.32-0.87).

Conclusions:

• Simulation substitution for clinical skills is prevalent in paramedic education.
• Increased reliance on simulation for more than five skills correlates with lower first-attempt certification exam success.
• Frequent simulation use may negatively impact paramedic program outcomes and graduate readiness.