Effective EMT Education: Brick or Click

Introduction: The advent of online education has opened the door to novel training options. However, it is unclear if online programs can match the success of their traditional counterparts. Though many online/hybrid emergency medical technician (EMT) and paramedic courses exist nationwide, little empirical data exists to support program effectiveness.

Objective: Evaluate whether online/hybrid EMT education is as effective as traditional in-class EMT education.

Methods: A 12-month retrospective review of both online/hybrid and traditional EMT education began in August 2017. Both classes totaled 182 hours of training, including 24 hours of ambulance ride-along and the same textbook, based on the U.S. Department of Transportation EMT curriculum, grading policy, exams, and policy manual. All the traditional students’ hours were in person, while hybrid students completed didactic education (54 hours) in an online synchronous format with 52 hours of in-person skills labs. Both courses were evaluated for completion and NREMT certification exam passage rates. Course completion was defined as students who completed all course requirements among those who took the first exam. Pearson’s chi-square tests of proportions were performed to quantify differences in outcomes between the two independent samples of EMT course types.

Results: In total 1,062 students enrolled in the EMT courses (521 hybrid, 541 traditional), and 991 students took the first course exam (473 hybrid, 518 traditional). Among those who took the first exam, no significant difference was found in course completion rates (71.9% hybrid, 76.8% traditional, p=0.077). No significant differences were found in first-attempt NREMT passage rates (98.2% hybrid, 98.8% traditional, p=0.54) or within 3 attempts (98.5% hybrid, 98.8% traditional, p=0.75). Student demographics were unavailable so data could not be adjusted for student-level characteristics.

Conclusions: Similar outcomes in completion and NREMT passage rates suggest the hybrid course prepares students for the NREMT exam as well as the traditional course. Further research is necessary to understand which student-level factors are associated with attrition, retention, and success in hybrid online EMT education.