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Online Engagement of Paramedics as Learners

I have begun my applied research project for Master of Arts in Learning and Technology at Royal Roads University. Here is a brief overview of the project scope.

It is a common practice for paramedics to complete Continuing Medical Education (CME) and/or Continuing Professional Development (CPD) courses each year as part of a requirement to maintain medical certification or professional licenses (British Columbia Emergency Medical Assistants Licensing Board, n.d.) or as a requirement of employment (Provincial Health Services Authority, 2020). Continuing Medical Education (CME) courses and Continuing Professional Development (CPD) courses differ in their definition and outcomes, and the terms are sometimes inappropriately aligned with each other (Institute of Medicine, 2010).  For clarity and simplicity of language, this research project will include both modalities within the global category of Continuing Education.

Continuing Education (CE) is shown to be a critical required element in enhancing the quality of health care delivery (Shortt et al., 2010). The Institute of Medicine (2010) outlines that ongoing professional training is required for the “development of high quality professionals and is necessary for complex technical professions.” The Ambulance Paramedics of British Columbia (n.d.) state that “continuing education ensures that paramedic practice aligns with current research and promotes professional integrity and development” (para. 1). It is essential to recognize that many paramedics complete continuing education courses for intrinsic factors or career advancement opportunities as well (Aragon & Johnson, 2008).  

Prior to the recent shifts in education delivery as a result of the global COVID-19 pandemic, online delivery was growing in popularity for paramedic CE by education leaders and educators. Seen as a solution to geographic limitations and costly onsite delivery, online CE has additional benefits including flexible scheduling, the convenience to learn at one’s own pace, and the ability to allow for learner self-assessment (Jerin & Rea, 2005). Additionally, online CE is generally viewed as remaining accessible long after course completion in comparison to face-to-face delivery (Shortt et al., 2010).

Many paramedics, similar to other adult learners, have reported that current online CE lacks engagement, or is generally uninteresting which precludes successful completion (Hillier, 2015). Further, it is reported that online CE is perceived as requiring occasionally complex computer literacy of the learner, is not maintained and therefore not current when viewed asynchronously, is generalized, lacks diversity in offerings, is not appropriate for the content with untrained educators recording sessions and posting rather than using effective e-Learning methods, and lacks personal or community support.

As a developer of training materials and an educator for paramedic learners, I have witnessed the improvement that well-crafted, best practice-based course materials and resources make in learner engagement and their resulting success. Active engagement with course materials and resources, in addition to engagement with educators and the learner community, is an essential component of success for learners (Dixson, 2015; Pascarella and Terenzini, 2005).

As learner engagement leads to success, this study intends to research and outline the key elements required in the design of online continuing education courses to ensure the engagement of the working paramedic as a learner. 

Research Questions

Primary Research Question

What elements are required in the design of online continuing education courses to ensure the engagement of the working paramedic as a learner?

Sub-question 1

What role does a community of inquiry have in the creation of engaging education materials?How can a Community of Inquiry contribute to the successful design of an online continuing education course?

Sub-question 2

How does self-determination factor into student success?Does engagement improve retention? 

Sub-question 3

How can a course be developed to include critical elements of self-determination identified in the research, such as competence, connection or relatedness, and autonomy (Ryan & Deci, 2000)? 

Definitions of Key Terms

Advanced Care Paramedic (ACP): Ambulance Paramedics of British Columbia (n.d.) defines Advanced Care Paramedics as providers of advanced life support care. In addition to the educational requirements achieved at the Primary Care Paramedic level of practice, ACP practitioners have completed a diploma or degree program in Advanced Care Paramedicine at an accredited post-secondary institution. “ACP’s [sic] are educated and equipped to handle sophisticated and advanced medical treatment to potentially life-threatening emergencies and maintain a targeted response to only the highest acuity calls. ACP’s [sic] provide clinical leadership on complex calls and maintain a progressive scope of practice to manage critically injured patients and reduce morbidity”(Ambulance Paramedics of British Columbia, n.d.-a, para.1).

Continuing Medical Education (CME):  The Accreditation Council for Continuing Medical Education (2019) defines continuing medical education as consisting of “educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that provide services for patients, the public, or the profession. The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public” (para. 1).

Continuing Professional Development (CPD):Continuing professional development (CPD) involves maintaining and enhancing the knowledge, skills and experience related to your professional activities following completion of your formal training. Just as importantly, it involves the development of those personal qualities that are required for carrying out professional and technical duties during a professional’s life. Both technical and non-technical skills need to be developed” (Kloosterman, 2014, para. 1).

Critical Care Paramedic (CCP): The CCP is the highest paramedic level of pre-hospital and inter-hospital care in Canada. “These paramedics operate with the goal of instituting and maintaining tertiary-level emergency and [intensive care unit level] care for the patients with the greatest need while facilitating their transport by air, land, and sea to the appropriate medical facility”(Ambulance Paramedics of British Columbia, n.d.-b, para. 1).

Emergency Medical Responder (EMR):This basic level provides responders with essential treatment skills and a solid basis for more advanced training. This license level includes basic patient assessment skills, CPR-C level, the mechanics and practice of lifting patients, the use of ambulance equipment, including the use of automatic external defibrillators, and utilization of basic symptom relief procedures” (Ambulance Paramedics of British Columbia, n.d.-c, para.1).

National Occupational Competency Profile (NOCP): This document was developed by the Paramedic Association of Canada and contains a set of four integrated competency profiles that define the competencies of paramedics and emergency medical responders within Canada. A competency profile is included for each of the following practitioner levels: Emergency Medical Responder (EMR), Primary Care Paramedic (PCP), Advanced Care Paramedic (ACP), and Critical Care Paramedic (CCP) (Paramedic Association of Canada, 2015b).

Paramedic Association of Canada (PAC)The Paramedic Association of Canada “is comprised of over 20,000 paramedics from coast to coast to coast. The Association is a national organization of prehospital practitioners that exists to promote quality and professional patient care through working relationships among organizations with similar interests. Protection of the Public [sic] and development of the profession in the public interest is the foundation” (Paramedic Association of Canada, 2015a).

Primary Care Paramedic (PCP): The Ambulance Paramedics of British Columbia define the Primary Care Paramedic as possessing a strong foundation in emergency prehospital care.  The PCP is “trained to work in unpredictable and dynamic environments while ensuring safe, proficient and efficient patient care and transportation. PCP practitioners are often first on scene to an emergency and are highly skilled in call management including patient assessment and treatment, triage, inter-agency response, scene management and safe transport. . . . Primary Care Paramedics are educated and equipped to handle a multitude of events ranging from routine elderly and community support . . . to medical and traumatic emergencies requiring technical skills and pharmacological intervention” (n.d.-e, para. 1).

Dissemination Opportunities

I have had the opportunity to discuss and present topics related to paramedic continuing education at numerous conferences and faculty development sessions. These venues and occasions will continue to serve as dissemination avenues for this research project. Additionally, the final manuscript will be submitted to medical education or online education journals for publication consideration, along with grey literature sources such as the Paramedicine trade magazine. Further awareness to the results of this research project will be shared through social media channels, including my personal and academic blog, Twitter, LinkedIn and ResearchGate. 

Theoretical Framework

The foundation of our applied research projects is an education theoretical framework. This framework is compared to the blueprint for a house by Grant & Osanloo (2014) and “the foundation from which all knowledge is constructed (metaphorically and literally) for a research study.”

For my research project, I will be exploring in detail the question: “what elements are required in the design of online continuing education courses to ensure the engagement of the working paramedic as a learner?” As part of the investigation and preparation to date, I have researched and reviewed several theoretical frameworks. Three frameworks continue to guide my professional practice as an education leader: constructivism, engagement theory, and self-determination. In my opinion, all are required for the successful design of education courses and will be explored through a literature review and as potential secondary questions. However, engagement theory appears to be most appropriate for the primary foundational framework of my research project.

Engagement theory outlines the learners’ participation and interaction with the learning material, activities, and community (Meece et al., 1988) as these “engagement techniques may be one key to making online learning productive for the institution but, more importantly, ensuring that students are successful“ (Meyer, 2014). A significant amount of research on the correlation between engagement and student success exists (Bryson & Hand, 2007), which is why I have chosen it as my foundational framework. By researching methods that may be utilized to engage the working paramedic as a learner, I intend to develop a resource for educators that would allow for improved student retention and success.

Thank you for taking some time out of your day. What are your thoughts on this research project? What has been your experience with continuing professional development? Please comment below.

Enjoy the rest of your day!

Image by energepic.com from Pexels used under open license.


Accreditation Council for Continuing Medical Education. (2019). CME Content: Definition and Examples. https://www.accme.org/accreditation-rules/policies/cme-content-definition-and-examples

Ambulance Paramedics of British Columbia. (n.d.-a). Advanced Care Paramedic. Retrieved November 26, 2020, from http://www.apbc.ca/about-us/levels-of-service/advanced-care-paramedic-acp/

Ambulance Paramedics of British Columbia. (n.d.-b). Critical Care Paramedic. Retrieved November 26, 2020, from http://www.apbc.ca/about-us/levels-of-service/critical-care-paramedic-ccp/

Ambulance Paramedics of British Columbia. (n.d.-c). Emergency Medical Responder. Retrieved November 26, 2020, from http://www.apbc.ca/about-us/levels-of-service/emergency-medical-responder-emr/

Ambulance Paramedics of British Columbia. (n.d.-d). Levels Of Service. Retrieved November 20, 2020, from http://www.apbc.ca/about-us/levels-of-service/

Ambulance Paramedics of British Columbia. (n.d.-e). Primary Care Paramedic. Retrieved November 26, 2020, from http://www.apbc.ca/about-us/levels-of-service/primary-care-paramedic-pcp/

Aragon, S. R., & Johnson, E. S. (2008). Factors Influencing Completion and Noncompletion of Community College Online Courses. American Journal of Distance Education22(3), 146–158. https://doi.org/10.1080/08923640802239962

British Columbia Emergency Medical Assistants Licensing Board. (n.d.). Continuing Competence, Continuing Education. Retrieved November 25, 2020, from https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/partners/colleges-boards-and-commissions/emergency-medical-assistants-licensing-board/continuing-competence

Bryson, C., & Hand, L. (2007). The Role of Engagement in Inspiring Teaching and Learning. Innovations in Education and Teaching International44(4), 349–362. https://doi.org/10.1080/14703290701602748

Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your “House.” Administrative Issues Journal: Connecting Education, Practice, and Research4(2), 12–26. https://doi.org/10.5929/2014.4.2.9

Hillier, T. (2015). Exploring Paramedic Perceptions of Quality in Online Continuing Medical Education. Royal Roads University.Institute of Medicine. (2010). Redesigning Continuing Education in the Health Professions. National Academies Press. https://doi.org/10.17226/12704

Jerin, J. M., & Rea, T. D. (2005). Web-Based Training for EMT Continuing Education. Prehospital Emergency Care9(3), 333–337. https://doi.org/10.1080/10903120590962274

Kloosterman, V. (2014). What is Continuing Professional Development? Continuing Professional Development. https://continuingprofessionaldevelopment.org/what-is-continuing-professional-development/

Meece, J. L., Blumenfeld, P. C., & Hoyle, R. H. (1988). Students’ Goal Orientations and Cognitive Engagement in Classroom Activities. Journal of Educational Psychology80(4), 514–523. https://doi.org/10.1111/j.1468-5957.1993.tb00290.x

Meyer, K. A. (2014). Student Engagement in Online Learning: What Works and Why. In Student Engagement Online: What Works and Why (pp. 1–14). John Wiley & Sons, Inc. https://doi.org/10.1002/aehe.20018

Paramedic Association of Canada. (2015a). About. https://www.paramedic.ca/site/home?page=homeParamedic Association of Canada. (2015b). National Occupational Competency Profile. https://www.paramedic.ca/site/nocp?nav=02

Provincial Health Services Authority. (2020). New Hire Orientation Curriculum for BCEHS Employees. https://learninghub.phsa.ca/Courses/8275/phsa-new-hire-orientation-curriculum-for-bcehs-cupe-employees

Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist55(1), 68–78. https://doi.org/10.1037110003-066X.55.1.68

Shortt, S. E. D., Guillemette, J.-M., Duncan, A. M., & Kirby, F. (2010). Defining Quality Criteria for Online Continuing Medical Education Modules Using Modified Nominal Group Technique. Journal of Continuing Education in the Health Professions30(4), 246–250. https://doi.org/10.1002/chp


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