Research - Publications
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Studnek JR, Fernandez AR, Margolis GS, O’Connor RE (2009). Physician Oversight in EMS: Where Are We? Prehospital Emergency Care, 13:1, 53-58.
This project quantified the amount of contact nationally registered EMS professionals have with their medical director. Participants indicated how often they interacted with their
medical director in three specific situations (participation in continuing education, met personally to discuss an EMS issue, and saw medical director at the scene of an EMS call).
Overall, 62.5% individuals reported having contact with the medical director in one of the above situations within the last 6 months. MD contact significantly increased with
certification level (EMT-Basic 47.6%, EMT-Intermediate 62.3%, and Paramedic 78.5%) and varied by service type (hospital based 78.8%, county/municipal 70.8%, private 67.6%, military
62.4%, government 61.1%, fire based 57.0%, and volunteer 50.8%). EMS professionals working in urban areas were more likely to report recent MD contact than those in rural areas
(64.9% vs. 59.2%).
Studnek JR and Fernandez AR (2008). Characteristics of Emergency Medical Technicians Involved in Ambulance Crashes. Prehospital and Disaster Medicine, 23(5): 432-37.
This study utilizes a national sample of Emergency Medical Services (EMS) professionals to explore the demographic and work related characteristics associated with involvement in
ambulance crashes. 8.6% of the EMS professionals surveyed being involved in an ambulance crash within the past 12 months. When controlling for call volume and time in an ambulance,
the odds of involvement in an ambulance crash within the past year were significantly higher for younger EMS professionals and those reporting sleep problems.
Studnek JR and Fernandez AR (2008). Organizational Description and Emergency Preparedness of Nationally Registered First Responders. Prehospital and Disaster Medicine, 23(3): 250-255.
This project resulted from the analysis of Nationally Registered First Responders (NRFR) re-registering in 2006. The majority (75%) of NRFR performed work in rural areas and work for fire departments (61%). More than a quarter of NRFRs received no training in the management and treatment of patients involved in biological, chemical, nuclear, explosive emergencies, or structural collapse within the past 24 months.
Margolis GS, Studnek JR, Fernandez AR, Mistovich J (2008). Strategies of High-Performing EMT-Basic Educational Programs. Prehospital Emergency Care 2008, 12:206-211.
A nominal group technique was used to identify the specific strategies used by high-performing EMT-Basic programs to maintain high first time pass rates. From these, the following
seven recommendations to improve pass rates on the NREMT certification exam were derived: 1) secure strong institution support, 2) hire well qualified EMT lead instructors, 3) strive
for instructional consistency 4) recruit students who are positively motivated to succeed, 5) admit students who have demonstrated that they have the academic skills necessary to
complete the course, 6) develop student test taking skills, and 7) establish a course passing standards that exceed minimum competency.
Fernandez AR, Studnek JR, Margolis GS (2008). Estimating the Probability of Passing the National Paramedic Certification Examination. Academic Emergency Medicine 2008, 15:258-264.
The objective of this study was to utilize student and program characteristics to build a multivariable logistic regression model to determine the probability of success on the cognitive
portion of the national paramedic certification exam. Two programmatic characteristics (national accreditation and instructor qualification), six student characteristics (high school class
rank, years of education, required for employment, age, race, and gender), and one graduate characteristic (estimated time since course completion) had a significant effect on the
probability of passing the national paramedic certification examination. A change in either of these variables can increase or decrease a student’s probability of passing the exam.
Russ-Eft DF, Dickison PD, Levine R (2008). Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project. Human Resource Development Quarterly,
vol. 19, No. 4.
This study examined the factors that related to objective and subjective career success. Education, experience, and hours worked predicted objective career success, while satisfactions with others and supervisor predicted subjective career success. Minority status was not related to either objective or subjective career success. Gender was unrelated to subjective career success, but negatively influenced objective success.
Studnek JR, Ferketich A, Crawford JM (2007). On the Job Illness and Injury Resulting in Lost Work Time Among a National Cohort of Emergency Medical Services Professionals.
American Journal of Industrial Medicine 2007, 50(12):921-931.
This study estimated the prevalence and incidence of job-related illness or injury resulting in lost work time of Emergency Medical Services (EMS). The prevalence of job-related
illness or injury with time away from work was estimated at 9.4%, with a one-year incidence estimated at 8.1 per 100 EMS providers. It appears that increasing call volume, an urban
work environment and a history of back problems were associated with increased reporting of job-related illness or injury.
Studnek JR, Ferketich A (2007). Organizational Policy and Other Factors Associated with Emergency Medical Technician Seat Belt Use. Journal of Safety Research, 2007;38(1):1-8.
As part of biennial re-registration paperwork, nationally registered EMTs were asked to describe their seat belt use while in the front seats of an ambulance. A logistic regression
model was fit to estimate the association between seat belt use, organizational seat belt policy, type of EMS organization worked for, EMT certification level, and the size of
community where EMS work is performed. Of the 41,823 EMTs that re-registered in 2003, surveys were received from 29,575 (70.7%). Participants reporting no organizational seat belt
policy had lower odds of seat belt usage when compared to individuals that do have a seat belt policy. Paramedics and those working in rural areas also had lower odds of seat belt
use. Several factors were found to be associated with seat belt usage among EMTs however, it appears that only one, organizational policy, is a modifiable characteristic.
Studnek JR, Crawford JM (2007). Factors Associated With Back Problems Among Emergency Medical Technicians. American Journal of Industrial Medicine, 2007;50(6):464-469.
This project evaluated the association between back problems and individual and work-related characteristics. EMTs dissatisfied with their current assignment were 9 times more
likely to report back problems that those who are satisfied. EMTs reporting good or fair fitness were more than 3 times more likely to experience back problems than those with
excellent fitness. Results from this analysis suggest that there are two modifiable factors associated with self-reported back problems among EMTs, satisfaction with current
assignment and self-reported physical fitness.
Dickison PD, Hostler D, Platt TE, Wang H (2006). Program Accreditation Effect on Paramedic Credentialing Examination Success Rate. Prehospital Emergency Care, Apr-Jun 2006; vol. 10, no. 2.
This study described the relationship between completion of an accredited paramedic educational program and achieving a passing score on the National Registry Paramedic Certification
Examination. Students who attended an accredited program were more likely to pass the examination. Attendance at an accredited training program was independently associated with
passing the examination even after accounting for confounding demographic factors.
Russ-Eft DF, Dickison PD, Levine R (2005). Instructor Quality Affecting Emergency Medical Technician (EMT) Preparedness: A LEADS Project. International Journal of Training and
Development, 9:4.
Secondary analysis of the LEADS database, examined the effects of instructor quality on the level of preparedness of EMS personnel. Results showed significant differences in the
student ratings of ten dimensions of EMS instructor preparedness (trauma patient assessment, medical patient assessment, cardiac arrest management, airway management, spinal
immobilization, fracture management, hemorrhage control, childbirth, pediatric patient management, patient transport) for both EMT Basics and EMT Paramedics.
Pirrallo RG, Levine R, Dickison PD (2005). Behavioral Health Risk Factors of U.S. Emergency Medical Technicians: The LEADS Project. Prehospital and Disaster Medicine,
Jul-Aug 2005; vol. 20, no. 4.
This study describes the behavioral health risk factors for EMTs and paramedics in the United States using a health survey. The responses were compared to surveys from the Center
for Disease Control and Prevention and from The National Highway Traffic and Safety Administration. EMT-Basics were shown to drive slower than paramedics. When discussing EMS
professionals, males drove faster, drank more and wore their seatbelts less often than females. However, females smoked more and engaged in vigorous exercise less than males.
Overall, EMS professionals were shown to wear their seatbelts less, drive faster and were less likely to engage in moderate physical exercise compared to other adults in the United
States
Brown WE, Margolis GS, Levine R (2005). Peer Evaluation of the Professional Behaviors of EMTs. Prehospital and Disaster Medicine, Mar-Apr 2005; vol. 20, no. 2.
This study used a peer evaluation methodology to assess the affective competencies of practicing EMS providers. EMT-Basics and paramedics rated their partners with respect to 11
categories of professional behavior. Overall national registered paramedics rated their partners significantly lower than did nationally registered EMT-Basics. Experienced EMT-Basics
rated their partners significantly lower than did newer EMT-Basics. Those EMS professionals who indicated high satisfaction with their current EMS assignment rated their partners
more highly on professional behaviors than did those who were not as satisfied. Overall, the peer evaluation of professional behaviors was “good”.
Brown WE, Dawson DE, Levine R (2003). Compensation, Benefits, and Satisfaction: The Longitudinal Emergency Medical Technician Demographic Study (LEADS) Project.
Prehospital Emergency Care 2003, 7:357.
This study describes the compensation, benefit package and level of satisfaction with the benefits of nationally registered emergency medical technicians using the Longitudinal
Emergency Medical Technician Demographic Study. 86% of compensated EMT-Basics and 85% of compensated paramedics were employed primarily as patient care providers. Mean earnings for
EMT-Basics was $18,324 and for paramedics was $34,654. At least 26% of compensated EMT-Basics and 9% of paramedics had no health insurance. The majority of nationally registered
EMS professionals reported that their retirement plans were not adequate to meet their financial needs. EMS professionals are not satisfied with the appreciation and recognition they
receive from their employers. One third are not satisfied with the benefits they receive and nearly all believe that EMS professionals should be paid more for the job they do.
Dawson DE, Brown WE, Harwell TS (2003). Assessment of Nationally Registered Emergency Medical Technicians Certification Training in the United States: The LEADS Project.
Prehospital Emergency Care, 7:114-119.
This study describes the adequacy and characteristics of emergency medical services education as assessed by surveying a stratified random sample of nationally registered EMT-Basics
and paramedics. EMT-Basics and paramedics were satisfied and felt well prepared by their certification courses. Opportunities to improve certification training exist, particularly
related to childbirth and pediatric patient management.
Brown WE, Dickison PD, Misselbeck WJ, Levine R (2002). Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS): An Interim Report. Prehospital Emergency
Care, 6:433-439.
This was an interim report of The Longitudinal Emergency Medical Technician Attributes and Demographics Study. This report describes many characteristics of nationally registered
EMT-Basics and Paramedics including the educational level, gender, racial and ethnic makeup, marital status, and level of practice. Median income and median years worked in the
profession were also among the many characteristics described in this report.