Earticle

Purpose: This study aimed to synthesize empirical findings on factors affecting the turnover intention of EMT-Paramedics in Korea through a meta-analysis and to identify variables with significant effect sizes. Methods: This descriptive meta-analysis included seven Korean studies published up to May 2025 that reported correlation coefficients between turnover intention and related variables among paramedics. A systematic literature search was performed following PRISMA guidelines. Effect sizes were calculated using Comprehensive Meta-Analysis 3.0, and heterogeneity and publication bias were assessed. Results: The personal characteristics of paramedics that showed the largest effects on turnover intention included lack of job autonomy (ES = -1.510), interpersonal conflict (ES = -1.510), self-efficacy (ES = -1.160), and organizational commitment (ES = -0.874). Job stress, compensation, and working conditions had moderate effects, while sleep-related variables had small effects. Overall heterogeneity was high (Q = 432.175, I2 = 93.753). Conclusion: Turnover intention is influenced by multidimensional factors across psychological, organizational, and health domains. Priority should be given to organizational interventions that enhance autonomy, reduce interpersonal conflict, and support psychological well-being. Longitudinal studies are recommended to explore causal pathways.

Purpose: This study aimed to evaluate the academic achievement of paramedic students based on admission motivation and admission type using Item Response Theory (IRT). Methods: A total of 68 third-year paramedic students participated in a mock national licensing examination. A two-parameter logistic IRT model was used to assess item discrimination and difficulty. A kernel density map was used to visualize the distribution of ability levels across different subgroups. Results: Item characteristics often did not align with students’ ability levels, suggesting room for improvement. Students admitted based on personal recommendations or aptitude demonstrated higher academic achievement, whereas transfer students had lower scores on advanced subjects. Conclusion: IRT-based analysis provided detailed insights into academic performance according to students’ background factors. The findings support the use of IRT to enhance educational assessments, inform curriculum development, and tailor individualized learning strategies.

Purpose: This study aimed to evaluate the appropriateness of the American Heart Association guidelines for determining tidal volume (TV) based on the actual pulmonary capacity of Korean adults. It also assessed the awareness and application of predicted body weight (PBW) in ventilation training. Methods: A mixed methods design was used. Spirometry-based TV measurements were collected from 44 Korean adults (29 males and 15 females) with prior ventilation education. A structured survey of 104 participants was conducted to assess their understanding of PBW. PBW was calculated using the National Institutes of Health and Acute Respiratory Distress Syndrome Network (ARDSNet) formulas, and measured TV values were compared with PBW-based reference values. Results: Most respondents (>90%) lacked awareness of PBW and tended to estimate the appropriate TV based on actual body weight rather than height-based PBW. Based on spirometry measurements, the average TV for Korean males was 6.66 mL/kg and that for females was 7.52 mL/kg, both within the ARDSNet guideline range of 6-8 mL/kg. However, females with smaller-than-average body size (<162 cm) tended to have relatively lower TV values, suggesting that applying a fixed ventilation volume of 500-600 mL may lead to overventilation in this group. Conclusion: Although the ARDSNet guideline is generally applicable, fixed-volume ventilation may risk overventilation in shorter Korean adults, particularly women. Integrating PBW-based education into cardiopulmonary resuscitation and ventilation training is essential to promote individualized, safe, and effective respiratory care.

Purpose: This study aimed to examine changes in the clinical duties and working conditions of emergency medical technician-paramedics (EMT-Ps) in training hospitals following a 2024 resident and intern strike. The goal was to provide empirical evidence to redefine the roles of EMT-Ps and the need for institutional reform in the emergency medical system. Methods: A cross-sectional online survey was conducted among 161 EMT-Ps working at the emergency centers of designated training hospitals. Changes in duties and procedures performed before and after the strike were analyzed using descriptive statistics and chi-square tests. Results: The frequency of key procedures, including arterial blood sampling, gastric lavage, digital rectal examination, Foley catheterization, and wound suturing, increased significantly. Several new procedures, such as wound closure and drug administration during cardiac arrest, were performed by EMT-Ps after the strike, which had not been performed previously. This indicates that EMT-Ps played a compensatory clinical role during physician shortages (p < .05). Conclusion: The findings suggest that in crisis situations, EMT-Ps can expand their roles beyond prehospital care to include hospital-based clinical responsibilities. These results underscore the urgent need to revise legal definitions, institutional policies, and training curricula to support the expanded scope of EMT-P practices in hospitals. Establishing clear legal protections and standardized guidelines is essential to ensure patient safety and workforce sustainability in emergency medical services.

Purpose: This study aimed to explore the relationship between the Myers-Briggs Type Indicator (MBTI) personality types and clinical practice stress, coping strategies, and resilience among paramedic students who had undergone clinical training. Through this investigation, the study seeks to enhance understanding of the stress experienced by students and to propose more effective educational support strategies for future applications. Methods: Data were collected from paramedic students who had participated in clinical practice at a university in Metropolitan City A between March 20 and April 20, 2025, using a self-administered questionnaire and the MBTI personality type inventory. Results: Resilience was positively correlated with problem-focused coping (r = .514, p < .001) and seeking social support (r = .195, p = .013), and negatively correlated with clinical practice stress (r= -.304, p < .001). The factors influencing resilience were clinical practice stress (β = -.307, p < .001), problem-focused coping (β = .500, p < .001), and the E-I (Extraversion-Introversion) preference indicator of the MBTI personality type (β = -.215, p = .001), with an explanatory power of 38.1%. Conclusion: Factors influencing resilience were identified as clinical practice stress, problem-focused coping, and the E-I (extraversion-introversion) preference indicator of the MBTI personality type. However, as this study was conducted among emergency medical services students in a specific region, the generalizability of the results is limited. Follow-up research is required to develop and apply stress reduction programs to enhance resilience and alleviate clinical practice stress among emergency medical science students with clinical experience, as well as conducting multicenter studies to broaden the regional scope.

Purpose: This comparative experimental study aimed to analyze the impact of clinical practice experience on paramedic students’ knowledge of bag-valve mask (BVM) devices and their ventilation performance. Methods: A total of 52 third- and fourth-year students enrolled in the emergency medical service department of a university in Chungcheongnam-do participated in the study. Theoretical knowledge was evaluated using a structured pretest. Operational competence was assessed with an advanced airway simulator (BT-CSIE, Korea) to measure average tidal volume, inspiratory time, and interbreath interval. Results: Students who completed the clinical practice course demonstrated significantly better inspiratory time (p = .005) and interbreath interval (p < .001) during endotracheal tube ventilation. Furthermore, those with actual experience ventilating real patients achieved more accurate tidal volume delivery when using a face mask (p = .002). However, the correlation between BVM knowledge and procedural skills was not statistically significant. Conclusion: Clinical training and direct patient exposure appear to enhance BVM proficiency among paramedic students. These findings suggest that integrated education—including not only repeated procedural training but also real-world performance opportunities in clinical settings—is effective.

연구 목적: 본 연구는 병원 전 응급상황에서 다양한 시술 자세에 따른 기관내삽관 수행 특성을 분석하 여, 응급구조학 교육현장에서 보다 실전적인 시뮬레이션 기반 교육전략 수립에 기초자료를 제공하고자 수행되었다. 연구 방법: 이 연구는 J대학교 응급구조학 전공 학생 30명을 대상으로 시뮬레이션 기반 반복측정 실험으로 설계되었다. 참여자들은 침대 위, 무릎 꿇기, 엎드리기, 옆자세 등 총 4가지 시술자세를 동일한 순서로 수행하였 고, 각 자세에 대해 삽관 소요시간, 깊이, 수행 난이도, 몰입도, 신체적 불편감, 유연성 인식, 선호도 및 교육적 인식을 자가 평가하였다. 정량 데이터는 반복측정 분산분석(Repeated measures ANOVA), 주관 평가는 Friedman 검정, 상관분석은 Pearson/Spearman을 활용하여 분석하였다. 연구 결과: 기관내삽관 깊이는 시술자세에 따라 유의한 차이를 보였으며, 침대 위 자세가 가장 깊은 삽관 경향을 보였다. 수행 난이도와 신체적 불편감은 무릎 꿇기와 옆자세에서 가장 높았다. 참여자의 선호도는 테이 블 사용 자세가 가장 높았고, 불가 시 무릎 꿇기 자세가 대안으로 선호되었다. 결 론: 현실적인 현장 대응력을 강화하기 위해 바닥 시술 자세를 포함한 반복 시뮬레이션 훈련을 제안한다.

Purpose: This study aimed to analyze the performance and perception of endotracheal intubation across various procedural positions in prehospital emergency situations and to provide basic data for developing more practical simulation-based educational strategies in emergency medical science. Methods: This simulation-based repeated-measures experiment included 30 emergency medical science students at J University. Participants performed intubation in four procedural positions in the same order: bed, kneeling, prone, and lateral. They self-assessed intubation time, depth, difficulty, immersion, physical discomfort, perceived flexibility, preference, and educational awareness for each position. Quantitative data were analyzed using repeated-measures analysis of variance, the Friedman test for subjective evaluation, and Pearson or Spearman correlation analysis. Results: The endotracheal intubation depth differed significantly by procedural position, with the bed position tending to produce the deepest intubation. Difficulty and physical discomfort were highest in the kneeling and lateral positions. Participants preferred the bed position most, and when this was not possible, the kneeling position was preferred. Conclusion: Repetitive simulation training that includes floor-level procedural positions is necessary to enhance realistic field-response capabilities.

Purpose: The employment landscape of emergency medical team (EMT)-paramedics plays a pivotal role in maintaining the quality and stability of emergency medical services. However, empirical studies based on real-world employment data are limited. This study investigated hiring trends, job conditions, and qualification requirements by analyzing EMT-paramedic job postings. Methods: Job postings for EMT-paramedics were collected daily from September 20 to December 19, 2024, via two major online recruitment platforms: Saramin and Employment24. A total of 531 postings were analyzed after applying inclusion and exclusion criteria. Variables such as employer type, employment type, salary range, required education, experience, and working conditions were extracted. Descriptive statistics were calculated, and chi-square tests were performed. Results: Most postings were from secondary medical institutions (39.5%) and private ambulance services (28.6%). Most employers hired for a single position (64.2%), and the most common work regions were Gyeonggi-do (23.4%) and Seoul (14.5%). Salaries were not specified in 83.4% of postings, with only 9.2% indicating salaries between 25 and 30 million Korean won. Permanent employment was the most frequent type (63.3%), whereas 20.1% of the postings were either contract-based or mixed employment types. A three-month probation period was most common (37.5%), although nearly half did not specify any probation term. Regarding qualifications, 84.9% of the postings were open to applicants without prior experience, and 66.3% required only a high school diploma. Chi-square tests revealed no statistically significant association between salary level and required experience (p = .922) or between salary level and educational requirements (p = .620). However, salary level was significant association with employment type (p < .001), indicating that higher salaries tended to be linked to more stable employment terms. Conclusion: This study provides empirical insights into EMT-paramedic employment trends, emphasizing a strong demand for entry-level workers, the dominance of permanent roles, and a lack of salary transparency. These findings underscore the need for standardized job posting practices, employment stabilization measures, and policy efforts to ensure consistent hiring standards. Further research should include long-term data and qualitative approaches to better understand EMT-paramedic employment dynamics and guide workforce planning.