Furthermore, this training methodology had not been in place for the initial training of EMTs surveyed and, taking cognisance of the survey results, it would appear that EMTs might use e-learning followed by practical reinforcement, but would appear less eager to use e-learning alone as a means to maintain competence. Our survey included 22 potential CPC activities (see Table 4) and asked which activities did EMTs believe were

relevant/irrelevant. The find more results showed that practical, hands-on activities were preferred over theoretical/non-practice type activities. Also, there were less negative responses regarding activities related to practical skills than to theoretical Inhibitors,research,lifescience,medical skills. This further substantiates the case for practical, hands-on activities,

whether as a standalone activity or coupled with the e-learning approach. The EMTs surveyed in this study seemed to share the view of Ruiz et al in that perhaps they did not value e-learning as a replacement for traditional instructor-led Inhibitors,research,lifescience,medical training but rather as a complement to it, forming part of a blended-learning strategy [31]. EMTs function in environments that require lateral thinking [34]. Arguably, variation in learning methodologies could be encouraged so to Inhibitors,research,lifescience,medical facilitate the variations in personal learning styles while also taking cognisance of nuances in practice. Previous studies with Irish advanced paramedics and paramedics Inhibitors,research,lifescience,medical reinforce the concept of practical-type learning as a preferred methodology and as an effective way of maintaining skills [7,35] and that skills practice is an integral part of maintaining competence [36]. Indeed, our results, in part, reinforce the focus of older/traditional basic training curricula for ambulance staff in the United Kingdom and Ireland, which for the most part, was skills-based [37]. Inhibitors,research,lifescience,medical This is quite different to results seen for other professions who tend to prefer attending conferences, lectures and reading of

relevant journals [9,12], even though there Urease is little evidence to suggest that attending conferences had any direct impact on improving professional practice [38]. CPC annual hours Internationally, there are similarities in the way in which CPC hours are recorded, most being based on an hours-related credit system, in which one hour of educational activity equates to one credit and the number of credit/hours required vary from between 50–100 per year [30]. Irish doctors now, under the Medical Practitioners Act [27] must meet professional competence requirements [39] and this currently is 50 hours per year. In that context, the respondents in this survey believe that it would not be unreasonable to expect EMTs to complete 20–40 hours annually. Limitations The study had a number of strengths and weaknesses.