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Purpose: This study aims to assess the reliability and validity of a Korean version of the satisfactionwith simulation experience (SSE) scale for low-, medium-, and high-fidelity simulations amongparamedic students. Methods: Exploratory factor analysis with varimax rotation was used to determine construct validity. Cronbach's alpha was calculated to assess internal consistency reliability. Results: Cronbach's alpha for the overall scale was .841. Exploratory factor analysis yielded athree-factor structure composed of clinical learning, clinical reasoning and debriefing and reflection. Each of the subscales had high internal consistency, with Cronbach's alphas of .852, .790 and .913,respectively. With respect to year, freshmen scored the highest on the SSE scale. With respect to typeof simulation, the medium-fidelity group reported the highest satisfaction. Generally, the studentswere satisfied with debriefing and reflection. Conclusion: The Korean version of the SSE scale was shown to be a reliable and valid instrument forassessing satisfaction with simulation learning in paramedic students.

Purpose: A descriptive study design was used to investigate infection management awareness andinfection management performance for clothing management in 119 emergency medical technicians (EMTs). Method: 188 paramedics and basic EMTs completed questionnaires between March 1 and April 30, 2013in Jeollabuk-do. Results: Participants' average score for infection control awareness was 2.69 and that for performancewas 1.58, with the differences being statistically significant (t = 931.455, p = .003). Participants' generalcharacteristics resulted in differences in infection management performance. Women (1.63) have scoredhigher than men (1.28), and the difference was statistically significant (t = 11.174, p = .001). Participants who had clinical experience (1.63) had higher scores than participants who did haveclinical experience before (1.53) and, again, the difference was significant (t = 7.167, p = .009). Conclusion: Education program for infection management is need to be developed for more effectiveinfection management.

Purpose: The purpose of this study was to establish novice user guidelines for efficient externallaryngeal manipulation for intubation in difficult airway management. Methods: This study included 59 pre-qualified junior and senior emergency medical service students. The participants were instructed at random to intubate a manikin equipped with a cervical collar, thussimulating a difficult airway, using three types of external laryngeal manipulation: bimanuallaryngoscopy, backward-rightward pressure, and cricoid pressure. The resultant intubation time andglottic view grade scores were estimated. Results: Intubation time was longest using the bimanual manipulation method, followed by cricoid pressureand backward-rightward pressure. A low Cormack-Lehane glottic view score was obtained regardless of theassisted compression method used. Conclusion: Backward-rightward pressure may be the most efficient method of external laryngealmanipulation on the basis of the intubation time and improvement in glottic view.

Purpose: This study aimed to investigate the level of knowledge and education regarding basic lifesupport (BLS) among scuba divers. Methods: Data collected from 125 scuba divers in Jeju-do were subjected to frequency, t-test, ANOVA,and Chi-square analyses using the SPSS 18.0 program. Results: 42.1% of the subjects was trained BLS for more than an hour less than 4 hours, and 52.6% ofthe subjects was trained BLS for less than 3 months in scuba diving institutions. Statisticallysignificant difference was observed in the competence for performing cardiopulmonary resuscitationduring BLS education according to gender and age further regarding the necessity of BLS education,significant difference was observed with respect to age, job, academic background, monthly income, andparticipation period of scuba divers. The divers wished to learn cardiopulmonary resuscitation (72.8%),medical first aid (8.0%), and measures to be taken in cases of trauma (8.0%). The knowledge score forBLS among scuba divers was significantly different depending on the gender, age, marital status andfrequency of participation. Conclusion: It is necessary to develop and implement a safety education program for scuba divers.

Purpose: This study aimed to examine the degree of paramedics' professional self- concept,empowerment, and burnout and to verify the effects of empowerment and burnout on their professionalself-concept. Method: The study subjects were 116 in-hospital paramedics who completed a structured questionnaire. Data were collected between June 18 and 25, 2013. Results: The results were as follows. First, the paramedics' mean score for professional self-conceptwas 2.93 (range: 1-4), and the mean scores for empowerment and burnout were 2.87 (range: 1-4) and2.48 (range: 1-5). Second, in terms of the general characteristics of the paramedics, professionalself-concept showed significant differences based on sex, religion, work experience, and medicalinstitution classification. Third, professional self-concept had a positive correlation with empowerment,and professional self-concept and empowerment had negative correlations with burnout. Fourth, themain variables affecting paramedics' professional self-concept were gender and total years of work experience. Conclusion: It is necessary to develop program to reduce paramedics' burnout and qualitatively improveparamedic services.

Purpose: This study aims to provide suggestions for improving the liberal arts curriculum for the 3-year emergency medical technology course by conducting a comparative research on the liberal artscurricula across 10 colleges. Methods: Various aspects of liberal arts subjects, such as basic directions set out by the curriculum,credit scores, and distribution, were studied. Results: Of the 10 colleges, 9 did not stated purpose of liberal arts education. All 10 offered coursesincluding foreign language, computer, and self-management, however each subjects did not havereflections of course visions. Findings revealed the credit score ratio of liberal arts subjects to berelatively lower than the major subjects. Students had limited opportunity to choose liberal artssubjects, with only a small proportion of the course available for elective subjects. Most liberal artssubjects were completed in the first year. Subjects' experience was not expanded and deepenedgradually. Subject choices often overlapped, with limited variety of available subjects. Conclusion: For competent emergency medical technicians, the 3-year emergency medical technologycourse should improve the quality of its liberal arts offerings. The study of liberal arts provides theopportunity to develop broad perspectives and mature attitudes.

Purpose: This descriptive study examined awareness of and ethical attitudes associated with Do NotResuscitate (DNR) orders in 119 emergency medical technicians (EMTs). Method: In total, 255 paramedics and basic EMTs completed questionnaires between March and May,2013. Data were analyzed using the SPSS WIN 18.0 program. Results: A chi-square analysis revealed significantly different responses given by paramedics and basicEMTs: Paramedics gave “the reason in which DNR is not necessary”, as being “due to unclear DNRdecision time” whereas basic EMTs answered that this was “due to a legal problem” ( χ2 = 12.680, p <.05). Paramedics disagreed with the statement, “It is natural for medical teams to have less interest inpatients with DNT orders”, whereas basic EMTs agreed with the statement ( χ2 = 6.666, p < .05). Conclusion: A unified manual on attitude toward DNR orders, taking account of social and culturefactors, needs to be developed. This research provides a base line for future research.

Purpose: This study attempts to provide information for developing a preceptorship education programby analyzing the recognition and acceptance of the introduction of paramedic preceptorship in theclinical practice of paramedic students in Korea. Methods: Data were collected from 120 paramedics from December 26, 2013, to February 20, 2014. Aquestionnaire consisting 33 questions was administered, and the collected data were analyzed usingSPSS version 21.0. Results: The overall responses were positive, and the subjects were very interested in the introductionof paramedic preceptorship in paramedic education and clinical practice settings. The mean score forpreceptorship acceptance was 3.97 on a 5-point Likert scale. In terms of recognition, 59.0% of the 78subjects were able to explain preceptorship. In terms of acceptance, 85.8% of the subjects agreed withpreceptorship and 81.7% considered an effective training method. Conclusion: Most of the subjects agreed that preceptorship is very important for the education of paramedicstudents. The preceptorship education program development will be the basis of clinical practice.

Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinicalcharacteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergencymedical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours afterreturn of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Datawere analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystandersin 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventriculartachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR durationwas 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standardprehospital care for these patients and educational programs regarding CPR for lay rescues should bedeveloped.

Purpose: The emergency medical service (EMS) system in Japan is similar to that in Korea. This studyreviewed the development of paramedics who are major personnel in the respective EMS system of theircountry. Methods: We searched law for paramedics and publications in J-stage, MEDLINE and the webpage ofJapan's Fire and Disaster Management Agency. Results: Paramedic training had started in Japan in 1991, and most paramedics were employed in firedepartments. In Japan, ambulances belonging to fire department are staffed by a three-person unit,including at least one paramedic. Medical control advisory boards were established in all Japaneseprefectures in 2003 with the purpose of upgrading the activities of ambulance personnel, includingparamedics. The scope of paramedics' work has been widened owing to the continued efforts of medicalcontrol advisory boards. This allows them to perform invasive procedures including tracheal intubation,intravenous line placement, and epinephrine administration under medical control of a physician. Conclusion: As paramedics' responsibilities expand, further development of the paramedic role and aneffective medical control advisory board system are imperative both Korea and Japan.