Earticle

Purpose: To adjust item numbers in a national test, this study used item response theory to examine changes in average scores, reliability, difficulty, and discrimination according to the adjustment of item numbers. Methods: We analyzed the dichotomous coding of correct and incorrect answers of 473 examinees in a mock test conducted in 2023. Additionally, as an explanatory pilot study, we used an online questionnaire to survey experts on their perceptions of the appropriate item numbers for each test subject from January 18, 2024, to February 15, 2024. Results: Regarding the item numbers on the national exam, experts preferred to reduce the number of management of emergency patients (33.14±6.09, p<.05) and advanced emergency medical care: subtopics (104.49±11.55, p<.05), and the total number of questions (217.82±20.95, p<.05). In a simulation set in which items with low item fit were removed after fitting a two-parameter item response theory model, reliability was maintained at .910 until the 5th test consisting of 185 questions with little loss of difficulty, discrimination, and average score, and there was no correlation between item numbers and average score. Conclusion: Experts responded that reducing the number of items on the national exam was appropriate. As a result of the item reduction simulation, there was no significant loss in the average score, difficulty, discrimination, or reliability. More reliable results could be obtained if the results were based on a validity analysis and analyzed using actual national exams.

Purpose: This study aims to examine how college students perceive the usage environment of electric kickboards, recognize safety issues, and seek ways to improve them. Methods: A descriptive survey was conducted on 180 college students from November 1 to November 8, 2023, to analyze the environment and risks associated with using electric kickboards. Results: College students perceived electric kickboards as extremely dangerous. However, they did not receive safety education and 76.4% of the subjects did not wear safety helmets when driving electric kickboards. Women suggested lowering the speed of electric kickboards, including in certain sections, and emphasized that the more accidents they experienced, the more necessary it was to improve regulations. Conclusion: This study comprehensively illustrates the perception of risk and speed improvement among electric kickboard users, and emphasizes the need to prepare detailed guidelines for implementing and operating safety education.

Purpose: This study aimed to assess the appointment status of medical directors and the state of direct medical oversight in private ambulance services, including an analysis of the characteristics of the direct medical oversight requested by private ambulance services. Methods: This study investigated the appointment status of medical directors and direct medical oversight in private ambulance services based on official information disclosed by the National Emergency Medical Center and 17 local governments, along with 8,119 ‘Dispatch and Treatment Records’ collected by a university hospital from 2020 to 2022. Results: Among 129 private ambulance services, 96.12% (124 agencies) had only one medical director, and 43.8% of the medical directors were Emergency Physicians. Over the past three years, the national average direct medical oversight request rate for private ambulance services was 34.68%. In 11.14% of the cases, records stated that EMS providers communicated with the medical director but did not receive direct medical oversight. Conversely, in 36.98% of cases, records incorrectly indicated that EMS providers did not communicate with the medical director but were noted as having received direct medical oversight (p<.05). Most private ambulance services request the direct medical oversight of a single director. Conclusion: This study highlights issues, such as the suitability of the medical director's specialty and inaccuracies in private EMS providers' methods for documenting Dispatch and Treatment Records.

Purpose: This retrospective study analyzed the effects of advanced life support on the recovery of spontaneous circulation (SC) in patients with out-of-hospital cardiac arrest. Methods: The subjects of this study were out-of-hospital cardiac arrest patients transferred to the hospital by 119 paramedics in Gyeongsangbuk-do from January 1, 2021, to December 31, 2022, amounting to a total of 2,524 patients. Results: The younger the age, the higher the probability of recovery of spontaneous circulation, and it was higher when cardiac arrest occurred in a public place or was witnessed. If the patient's initial electrocardiogram rhythm is defibrillable, the probability of recovery from spontaneous circulation is high. The recovery of the spontaneous circulation rate decreased with time between the time of report and the time of contact with the patient. Recovery of the spontaneous circulation rate was high when mechanical chest compression devices and advanced airways were not used. Additionally, this study had positive effects on defibrillation, peripheral intravenous catheter insertion, and epinephrine infusion. Conclusion: Paramedics should actively perform peripheral intravenous catheter insertion and epinephrine infusion, and it should be possible to clearly determine whether defibrillation should be applied through electrocardiographic education.

Purpose: This study investigated career identity, decision-making, and preparation behaviors among emergency medical service (EMS) students after clinical practice, aiming to enhance their career guidance by identifying influential factors. Methods: This study targeted 178 students enrolled in the Department of Paramedicine in K-do, G-do, and D metropolitan cities. Data were collected between March 14th and April 30, 2024. The collected data were analyzed using SPSS 25.0, employing techniques such as frequency, correlation, and multiple regression analyses. Results: The findings indicated that components of career identity, encompassing affective and cognitive aspects, exerted significant effects on career decision levels (career assurance and career indecision) (p<.01, p<.001), whereas behavioral factors influenced aspects of career preparation, such as tool preparation, information collection, and practical effort(p<.001). Moreover, career decision levels (career assurance and career indecision) were found to affect information collection, a subcomponent of career preparation(p<.05, p<.01). Conclusion: Considering these factors and actively empathizing with and counseling students would lead to effective career guidance in the field of Emergency Medical Services.

Purpose: This study aimed to derive detailed insights into emergency medical technicians’ (EMTs) perceptions regarding continuing education. Methods: We conducted a descriptive survey. The interview participants were 20 EMTs, divided into four groups: six Fire Department EMTs, five Hospital EMTs, five Clinical EMTs (excluding the ER and Fire Department), and four Non-Clinical EMTs. Data were collected through focus group interviews (FGIs) and semistructured questionnaires. The interview periods were March 25, 2022, and March 27, 2022. Results: Continuing education was primarily field-oriented, leading to lower satisfaction among non-field EMTs. To enhance satisfaction, training should be tailored to the specific roles and experiences of the EMTs. Additionally, quality management of lectures, instructor selection, and video quality require reconsideration. Key factors that enhance satisfaction include a wider variety of courses, up-to-date information, and relevant course content, regardless of job role or experience. Conclusion: Incorporating feedback into EMTs' perceptions of continuing education can lead to the development of more effective curricula and improved quality management. This approach is expected to enhance both educational satisfaction and job performance.

Purpose: This study aimed to compare the effectiveness of one-hand compression method (one-hand) and two-thumb compression methods (two-thumb) using a 3-year-old pediatric mannequin. Methods: Participants in the experiment were randomly assigned to 21 people with one hand and 21 people with two thumbs, who had completed a basic life support training course. The mannequin used a few junior QCPR manikis (Laerdal, Norway), based on an age of 3. The study followed the guidelines for two-rescuer pediatric CPR, performing chest compressions and ventilations in a 15:2 ratio for 5 cycles, 10 minutes. The chest compression number, depth, speed rate, and recoil rate were measured after 1, 3, and 5 cycles, respectively. Data were analyzed using SPSS 23.0. Results: Comparing the efficiency of chest compressions performed during 1, 3, and 5 cycles, the depth of chest compressions was 40.84±3.10 mm for the two thumbs and 51.48±4.79 mm for the one-hand, which was significantly different (p<.001). According to pediatric CPR guidelines, the frequency corresponding to the compression depth range of 40.00-50.00 mm was statistically higher at 57.1% (12 people) of two thumb than at 23.8% (5 people) of one hand (p<.001). Conclusion: While the current guidelines recommend one- or two-thumb encircling hand compressions for larger children, the use of one- or two-handed wrapped thumb compressions should be considered for smaller children, depending on the rescuer's judgment, when distinguishing between a child and an infant is difficult.

Purpose: This study attempted to identify correlation between communication skills, self-control, and adaptation to college life and identify how communication skills, self-control, and adaptation to college life influence factors influence clinical practice stress among health-related college students. Methods: Data for this study were collected through an online questionnaire for nine days from April 15, 2024, to April 23, 2024, targeting health-related college students nationwide who experienced clinical practice. Results: Clinical practice stress showed a significant negative correlation with communication skills(r=-.387, p<.001), self-regulation(r=-.355, p<.001), and adaptation to college life(r=-.433, p<.001). The factor that most influenced clinical practice stress was adaptation to college life, with an explanatory power of 20%. Conclusion: It is necessary to reduce stress in clinical practice by improving communication skills, self-control, and adaptation to college life through practical measures such as academic support services, psychological counseling, and major-related programs.

Purpose: This study aimed to examine paramedic students’ attitudes towards death with dignity and identify the factors that influence their attitudes toward death with dignity. Methods: The study was conducted with 288 paramedic students in Districts C and D from April 13 to May 4, 2024. The questionnaire was self-reported and collected by sending a URL to those who agreed to participate. Results: The mean scores for the variables were 3.03 for perception of death, 2.92 for awareness of biomedical ethics, and 3.16 for attitude toward death with dignity. Positive correlations were observed between the perception of death and awareness of biomedical ethics(r=.172, p=.004). Negative correlations were observed between the perception of death and attitudes toward death and dignity(r=-.289, p<.001). The factor that most influenced the attitude toward death with dignity was the perception of death(β=-.219, p<.001). Conclusion: Biomedical ethics education suitable for the job is needed to promote a positive attitude toward death with dignity by promoting a positive perception of death and improving awareness of biomedical ethics.

Purpose: This study aimed to explore the use of web-based virtual simulations to improve the learning flow, problem-solving ability, and academic self-efficacy of paramedicine students. Methods: This study used a pre–post comparison design with 40 pamedicine students at one university. the participants were third grade students and participated in web based virtual simulation(vSimⓇ). The difference between the pre-post was analyzed using a Paired Sample t-test with SPSS 26.0. Results: After web based virtual simulation using vSimⓇ program than before, significantly higher learning flow(t=12.74, p<.001), problem-solving process(t=5.78, p<.001), academic self-efficacy(t=2.77, p<.001), Paramedic-Care Skills Confidence(t=6.30, p<.001). Conclusion: The results indicated the positive effects of web-based virtual simulation(vSimⓇ) learning method and suggests implications for learners and instructors.

Purpose: This study aimed to investigate awareness of disaster safety related to the local safety level index (LSLI) and public safety consciousness index (PSCI) among college students in Jeju. Methods: This was a descriptive cross-sectional study. The data were analyzed using the t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis using SPSS 26.0. Results: Awareness of disaster safety related to the local safety level index (LSLI) and PSCI was high. PSCI was significantly positive correlated with LSLI(r=.402, p<.01) and accounted for 17.5% of LSLI. Conclusion: The influencing factor for LSCI among PSCs was living safety, suggesting that safety education should focus on life safety.

Purpose: Ensuring prompt and consistent 119 emergency services for all citizens is crucial and requires every region to adhere to prescribed deployment standards Methods: This study assessed the compliance with 119 emergency resource deployment standards in 229 districts (si-gun-gu) by analyzing data from 18 fire headquarters as of December 31, 2022. Results: At the Sigun-gu level, 16 areas (7%) did not meet the fire station standards. Among the 229 si-gun-gu, 25 (10.9%) failed operational ambulance standards, and 114 (49.8%) did not meet the 119 first responder standards. Areas lacking fire station standards had lower financial self-sufficiency and higher elderly and single-person elderly household proportions (p<.05). Areas not meeting ambulance standards had lower proportions of these populations, but higher financial self-sufficiency. In addition, areas that did not meet the 119 first-responder standards had greater financial autonomy (p<.05). Areas meeting only basic fire station standards had higher proportions of elderly and single-person households and lower financial self-sufficiency. Areas meeting only ambulance standards had lower financial autonomy, whereas those meeting only emergency medical technician standards had lower financial self-sufficiency and a higher elderly proportions (p<.05). Conclusion: Si-gun-gu, with a large elderly population and poor finances, often fails to meet fire station standards and meets only the basic criteria. Continuous monitoring and targeted management are crucial for reducing disparities in 119 resource allocation and improving the overall deployment.