Sowing the Seeds

     Although EMS recruitment and retention issues have been frequently discussed, little scientific research has been conducted to determine why people are entering and leaving the EMS field. To date no research has been done to analyze the demographics of people enrolling in EMT classes and determine what their attitudes and expectations are for employment.

     Our group of authors from the Loyola University Medical Center EMS office in Chicago wanted to investigate the demographics, perceptions and expectations of those who enroll in EMT classes, regardless of their completion, anticipated employment or long-term success. Therefore, we undertook the SEEDS Project—the Study of Employment Expectations and Demographics of EMT Students. The objectives we outlined are shown in Table 1.

     By better understanding these EMT students, we hope EMS managers will be better equipped to address recruitment and retention problems.

METHODS
     A survey instrument consisting of 15 questions was distributed to instructors of EMT classes throughout the Chicagoland area. Survey responses were collected from March–September 2006. Prior to distribution of the study, paramedics and EMTs employed by the Loyola EMS office evaluated survey questions for format and content and concluded that all selections were exhaustive and exclusive. Approval with waiver of consent from the Loyola University Medical Center's Institutional Review Board was obtained. Consent was also obtained from the lead instructor at each surveyed location. A cover letter was included with the survey explaining the goals of the project, informing the students that participation was voluntary, and assuring that responses would remain anonymous. The survey was administered to students within the first two weeks of classes beginning.

RESULTS AND DISCUSSION
     A total of 203 of a possible 232 surveys (82%) were returned from seven different locations. The demographics of EMT students are shown in Table 2.

     Students taking EMT classes were mainly young adults, 80% of them being 30 and younger. Almost 70% had at least some college education, and over one third had prior healthcare experience (mostly as Certified Nursing Assistants). A prior study showed that EMTs in 2003 were most likely to have high school educations (45.7%), but large numbers held associate's (25.1%) or bachelor's degrees (22.2%), and very few (0.35%) had less than a high school education.³ This is important for EMS educators to know. The range of students' educational backgrounds can be quite broad, and may affect how they are taught and tested. We were surprised with the numbers of college-educated students. Only 74 of the 203 respondents (36%) reported family histories of EMS employment; 75 (37%) had prior healthcare experience; and 16 (8%) had military experience. This leads us to wonder what factors are attracting students to our classes.

EMPLOYMENT CHARACTERISTICS
     Most students (95%) planned to utilize their EMT licenses upon completion of the class (see Table 3). A surprising finding was the number of students who had plans to complete further education. Forty-four (22%) planned to get EMT-Intermediate licenses, 127 (63%) paramedic licenses, 37 (18%) wanted to become Registered Nurses, 11 (5%) wanted to go to medical school, and 13 (6%) planned to obtain dispatcher certifications. The most interesting of these findings lies with the EMT-I and paramedic licenses. Intermediate EMT licenses are not recognized in northern Illinois and northwestern Indiana, the location of all the classes surveyed. Therefore, these 44 students either plan to relocate after completing their classes or have a gross misunderstanding of the levels of prehospital care workers in their areas. Because of this, we strongly advocate that educators take time early in an EMT class to explain the EMS profession, possible opportunities for advancement, and the scope of practice for each level of EMS.