History of the Community Paramedic Training Program

Premergency's Community Paramedic Training Program was first offered in 2015 as part of a study commissioned by the Canadian Safety and Security Program, Defence Research and Development Canada. The study can be reviewed in its entirety here. The program was designed in cooperation with the initial participating paramedic services (County of Renfrew Paramedic Services and Hastings Quinte Paramedic Services) and stakeholders, and continues to be revised and updated according to the needs of the existing and new participating paramedic services.

The original program was 200 hours long, including clinical placements within the participating paramedic services. The current Community Paramedic Training Program is an updated version of the 100-hour didactic portion, using current adult educational principles.

Paramedic services that have participated to date are:

• Renfrew County Paramedic Services
• Hastings Quinte Paramedic Services
• City of Greater Sudbury Paramedic Services
• Parry Sound District EMS
• District of Nippissing Paramedic Services
• Grey County Paramedic Services
• County of Dufferin Paramedic Services
• Middlesex-London Paramedic Service
• Island EMS (PEI)
• Northumberland Paramedic Service
• Oneida Nation Paramedic Services
• Region of Durham Paramedic Services
• Haldimand County Paramedic Services
• Region of Niagara EMS
• Cochrane District Paramedic Services
• Region of Halton Paramedic Services
• Bruce County Paramedic Services
• Lennox and Addington Paramedic Service
• York Region Paramedic Services
• Algoma District Paramedic Services
• Peel Regional Paramedic Services
• Ottawa Paramedic Service
• Leeds Grenville Paramedic Service
• Manitoulin-Sudbury District Paramedic Service
• Guelph Wellington Paramedic Service
• Norfolk County Paramedic Service
• Perth County Paramedic Service
• Lambton County EMS
• Naotkamegwanning EMS
• Peterborough County - City Paramedics
• Kenora District - Northwest EMS
• Essex-Windsor EMS
• Yukon Emergency Medical Services

Comments from our Participants

The comments below are excerpts from participants' reflection-on-learning final assignments and are unsolicited (used with permission).

"The format of this course was very suited to adult learning. Breaking down modules in the beginning, with a lot of information and identifying our own strengths and areas for improvement, was a helpful self-reflection. Reading the posts of others in the program and being able to apply insight from their experience was an amazing tool and interesting way of learning. I have definitely grown in my profession from this course. It has resulted in a significant increase in my knowledge base, skills and aptitude as a CP medic. I would recommend this course for all new CP medics".

"The more effort I put into my work, the more I learned…. I enjoyed doing research, having discussions with my group, and joining in debate over certain topics…. I discussed with my peers and engaged in professional dialogue."

"This program was a great opportunity for professional development as it required a multidisciplinary approach to find a solution to a problem or to determine an appropriate care plan for individual patients. I believe that this experience has better prepared me to face the challenges of working as a community paramedic."

"Feedback from others has challenged my research. It’s inspired me to search deeper into areas I’ve been admittedly unfamiliar with and grow… As a result, I’ve become more informed and insightful."-

"I was surprised to see the depth to which Community Paramedics practice, how well the self-directed learning worked for all of us, how well the online forums aided in the continuation of the learning process, and how well the PBL and self-directed learning worked for me."

"I feel as though my research and analysis of the various topics covered in this course has made me much better at deciding the pertinent and crucial information needed to explain my thought process. I felt inspired at times, and also felt discouraged at times. However, this conflict I feel has pushed me into a new horizon of research and development within myself."-

"My evaluation of my new knowledge, skills, and attitudes is 'good'. With anything, to be 'very good', you need to practice. I am very excited to practice these new skills and develop my knowledge and attitude to support the new role that I have the privilege to play.

"For myself, I learned so much, from how we have to respond and think differently than we have been previously taught and believe me after having one way of thinking and treating acute problems for over 30 years it took me a while to change my thought process"

"Participating in discussions gave me insight into my areas of weakness or lack of knowledge. … I was able to gain validation on my thoughts, & concepts through others, & all this prompting me to further research on areas I was not so knowledgeable about. … I learned from other’s points of view, shared knowledge, & lived experience.”

“I didn't realize how much depth of learning could take place until I read my peers' posts. They inspired me to push myself to excel. I was skeptical of the discussion forum learning, mostly due to my lack of experience, but it has caused me to reflect and think more in-depth about the care plans of patients and feel I have learned so much from my peers' forum posts.”

"I have learned a lot through what my peers’ posted in the discussion forums. …  They were able to think differently than myself and brought up multiple different topics or expanded on knowledge that I did not feel was that important. … The forums showed me areas where I needed to expand my knowledge/focus.”

"Having never completed an online course before this was a new challenge for me. Problem Based Learning created many challenges but with some perseverance I overcame these challenges. …  I adapted well and wrote some very informative posts …  I demonstrated excellence in my preparation by researching the topics thoroughly. …  I can now say [with this new knowledge] I am confident that I can write a care plan to address a patient’s medical needs, make their daily living a little bit easier, and improve their quality of life and overall wellbeing. Thanks again for a great program”

"I learned a great deal from the posts of others.  Sometimes it was new information that I had not seen before.  Other times it was a different presentation of information that I had seen before that really helped solidify the information in my head. …  The varied perspectives and research focus of other classmates made this course even more educational. … It has taught me that my colleagues are excellent resources that I should utilize more often.”

"At first, I was not sure what to expect. Once I started the online program, I was impressed with all the work that was done to put the course together. I enjoyed the actual patient case studies and the problem-based training approach. … Overall, I have learned quite a bit about geriatric medicine. ... I have now learned a great deal on prevention, education resources that are available, chronic disease management, mental health, pharmacology, and palliative care. … I have learned how to perform a more detailed assessment and provide treatment for patients at home to prevent frequent hospital visits".

"I found the learning enjoyable in that I am trying to change my mindset from critical practice to a community-based model. ... This program has given me insight into some of the typical patient’s that we may encounter. I feel that I have been given the skill to accurately assesses my patient and determine their needs. ... I feel the knowledge base I have gained has enhanced my mindset to migrate to a Community Paramedic practice with a positive conviction".

"Reviewing the materials and constructing posts of quality is a great way to learn. Adding in questions to other post and managing responses made you look deeper into things and explore more thoroughly. . . .  I did a significant amount of self-directed learning and self-reflection and I feel I have gained a significant increase in knowledge, skills and attitudes when it comes to Community Paramedicine".

"Our group had many participants with different levels and years of experience. This really helped establish different types of learning opportunities by the way each individual approached the subject and posted their views from their extensive research. In my preceptorship, … I was able to see how all the education and objectives were well thought out, making it all much clearer”.

"I found the learning model more enjoyable than I ever remember, from high school or when I was in college. I think this time, I was reviewing material that I was interested in, finding resources that I found valuable, making it much easier to stay engaged. I chose to investigate as opposed to being told what to investigate. I think that also helped with my ability to retain what I was reading. Over the course of the program I found I was having more success finding what information was pertinent to me and finding and filtering through research material more efficiently".

"I am glad that in this course, there has been a focus on some various diseases and probably the one's that we will see the most in the community. It has helped shift the basic understanding I've had of them from an emergency perspective to more of the ongoing need to understand daily issues of people living with these conditions”.

"Discussion-based learning has helped me to develop a better understanding of Community Paramedicine as a whole and what I feel my role specifically will be when I begin working in this capacity. … I feel that I have gained a great deal of valuable knowledge from this course and will continue learning well beyond the end date thanks to the methods I’ve learned”.

"I believe this course has provided me with the tools to become an efficient, knowledgeable, and compassionate Community Paramedic. The new skills and information I gained (different assessment and how to apply them, community resources, differential diagnostic tools, pathophysiology, pharmacology, communication, and interview techniques) will be used on a daily basis".

"I think what I will take away most from this program is just how different the Community Paramedic role is from my current role as a Paramedic on the trucks. The case studies played a big role in this. I look back at the challenge I had when I first got to read the case studies, “what can I get done in 20 minutes” to get this patient assessed, treated and mobile to the hospital! As I progressed, I found myself referring to these fictional people first as patients, then as clients, then by name. This change in my thought process has been and will be invaluable moving forward. Out on the road, we often forget that our patients are first and foremost people".

"I can see myself in the field, thinking back to conversations and situations from this course, and use certain things on my own, not necessarily always knowledge, but ways of approaching or thinking”. -

"When I reflect back to the course and this type of learning I realized that PBL is a style that I enjoy.  When I am studying or doing a course, I would usually take notes, complete the course and move on having retained some of what I learned.  I found I retained more information because not only did I have to read and learn the material, but I was responsible to extrapolate information from my notes to create posts.  This extra step really helped me retain more information and catered well to my learning styles".

"The opportunity to learn from the forums, and my own research, has improved my patient assessment skills and resulted in an enhanced patient assessment. This has allowed for a more in-depth portrait of a patient’s situation and their referral, or treatment needs. ... I have appreciated the opportunity to learn from others and share my own experiences".

"This course taught me the limitations of my perspective, and allowed me to view the material from five other vantage points”

"Something that this program is helping me discover is that all of us in this group are undergoing a paradigm shift. A paradigm shift is a fundamental change in our approach or underlying assumptions. We are realising that as a group, the way we have been approaching seniors has to change completely".

"Overall I have found this course to be informative and thought provoking. It has been interesting to read the responses of my colleagues and come to understand their view points. It has given me insight into my own perspectives and short comings and has provided the tools to overcome those gaps".

"This program has resulted in increased confidence and knowledge, enhanced assessments, and improved me as paramedic. It has given me the tools necessary to provide consistent and excellent patient care as I enter into community practice". 

"I have learned that self guided reading and research is different than the learning that I am used to as a paramedic. Normally, we are given goals, and then given exactly what we need to learn. After researching and doing problem based learning over the past couple of months, I am starting to like this method. It allows me to learn at a pace I can absorb and allows me to take different paths to find the answer. The challenge in this type of learning is you have to be self motivated. You get back what you put into it". 

"This method of self-directed learning has resulted in a substantial increase in new knowledge, skills and attitude toward Community Paramedicine, and the teaching methodology as a whole. The self-directed learning from self-reflection on online discussions and self-guided reading and research, has been invaluable. Going into this course, I thought I had a pretty good grasp on what a Community Paramedic was and what they do. Now, reflecting at the end, I realise I had a lot to learn".

"Through the research required for the course discussion forums, I gained an entirely new view on community paramedicine and a better understanding of the potential of paramedics in a Community Paramedic role. On top of the new found passion for this type of paramedicine, I have become more comfortable in this role after learning new approaches to patient care that I would have never had gained without the self-directed research". 

"Focusing on the three individuals [case studies] for this course and applying the work to their separate conditions reminds me of the reason I’m in this profession: to help people".

"There is no doubt this course has made me a better rounded Paramedic with just the increase in knowledge base alone. But I have also learned new investigative skills and assessments that will allow me to provide better care for our patients. Collectively, this has increased my interest in furthering my education, and to consider the possibilities of our newly expanded Community Paramedic Program, and what other opportunities it could lead to." 

"After being out of school for many years, adapting to the abundance of reading material and required research proved to be an extreme challenge. The need to re-evaluate my learning methods and techniques, as well as adjust my thought process, became very evident. Fortunately, after I totally engaged and applied myself, I found the learning experience to be very enjoyable. I was able to explore new and uncharted medical territory, giving my practice a new lease on life". 

"This course was particularly effective at challenging my attitude towards what I consider “Paramedicine” to be and enabled me to consider the vast potential that we as Paramedics have to contribute to our communities in such a variety of ways.  It is no simple task to reconfigure one’s mindset, but as I progressed through the course I was able to expand mine from a focused, time-limited emergency response to a broader holistic approach that encompasses health/social/emotional/psychological aspects of the geriatric population as well as community involvement, allied agency resources and family influences and support systems". 

"This model of learning was a new way to learn. Instead of exams and knowledge checkpoints, it was more focused at our own pace of learning. We took interest in things that we didn’t know before and used the presentations and learning material as a basis to formulate plans and answers. The discussions gave us things to think about which we didn’t really think of before. This course taught me a lot about myself…  to adjust my own ways of thinking and assessing".

"I believe having discussions around the case studies and various topics has great learning value for us to learn from each other, and it certainly helped me consolidate much of the knowledge. … The course made me reflect on my past experiences and perceptions and think about ways I can use my newly solidified knowledge and skills to provide better patient-centered care in the future". 

"This course was a real eye-opening experience for me – there has been little over the past decade that has demanded me to think as critically as I have here. …  I spent a lot of time navigating the grey areas in my knowledge. …  There is without a doubt a freshly established base of knowledge I will be walking away with and the best part for me was the new tools, abilities,  and WHERE to look for information when I need it most.  This was a fantastic course and a very accurate wakeup call as to what I should be expecting as my journey into the life of a CP begins.” 

"This course was nothing of what I expected and everything I needed. … The personal experiences and stories shared by each individual in this course has opened my eyes and mind to the many diverse ways we can support our patients within the community".

"I have learned a great deal from my colleague's discussion posts, and reading their perspectives has definitely led me to think more critically about my practice, and to implement changes to continually better it. … The didactic portion and posts directing us to do our own research have also benefitted me, and have definitely led me to understand my client's and patient's pathologies more deeply than before. … I absolutely feel now as though I am a different, more well-rounded, and all together better medic than I was when I first started this course".

"The course really put caring for complex medical patients into perspective, demonstrating how medications, mental health, environment, and disease processes are all connected. ...The education provided in the course reignited my passion for medical learning… and challenged me to develop skills in reading comprehension, and data collection and analysis". 

"There was a lot of information to process.  It forced me to research and the research taught me what I needed to learn. This style of learning is more work intensive but produces superior retention results compared to just memorizing a bunch of facts. … The introduction of the case study characters Mabel, Dawn and Howard (fictional characters based on real CP clients) was a brilliant way to stress what to expect, how to prepare, how to proceed, problems you may encounter, who to collaborate with, and how care plans are ever evolving because health changes".

"I feel that this community paramedicine course allowed me to become a better critical thinker, and ultimately a better practitioner and patient advocate. This course fostered unbiased responses and a broad-minded outlook … I feel that I will continue to use my learned “think outside the box” attitude, patience and empathy to further my knowledge and to improve quality of life for my patients. … This course allowed me to set aside my 'reactive' approach that we often use in regular paramedicine and alter it to a 'preventative' approach as used in community paramedicine".

"I found myself enjoying the discussions and was intrigued by the thoughts and ideas of others. I found myself wanting to add to the discussion. I feel that the three patients [in our case studies] started off on paper, however, as we progressed, they were coming to life.  Every module built some more relevance and understanding of them".

"I believe that I learned quite a bit and expanded my personal knowledge of paramedicine as whole. During this program, I used quite a bit of this on road during my actual shifts. My level of awareness of patient presentation and the level of questioning I have has shifted for the better".

"Reading through some of the dialogue gave me insight into how other people approach the job. ... I learn best by practical experiences and I found this one of the best takeaways from doing this course without having the actual practical experience. I’ve got a word document full of tips now for first visits, tough conversations, and practical tools to use from everyone that I wouldn’t have taken away otherwise if I had just gone through this course on my own. I was able to use this on my shadow shifts a number of times".

"For me, the Community Care Practitioner Course was stressful, time consuming, frustrating, enlightening, and educational but most importantly worth every blood, sweat and tear I put into it".

"I have learned a lot more [using problem based learning] than I would have learning in the traditional way. I have learned a better way to learn".

"I learned more with active participation, different perspectives from others and feedback, than I would in a traditional classroom setting. I retained more information and it opened my eyes to different perspectives by others that I would normally would never have thought about. [This style of] learning expands our skillset and develops critical thinking skills. … It changes our perspective, seeing more sides of the same situation and understanding more deeply."

"This style of learning is innovative for me, and I have to say it did promote a lot of self-learning. I came into this new role with my previous experience working as a frontline paramedic and I learned very quickly that the perspective of a community paramedic is very different. As I went through the case-studies of Mable Howard and Dawn, I can see myself slowly grow as a community paramedic. The readings and research plus the actual home visits and cases I have manage up to this date working as a community paramedic ... has changed the way I look at patients. … I now understand that being a community paramedic is not just a role, but a mindset and this course has made me realize that. I can see my growth as a paramedic in the journey of completing this course". 

"My learning during this course has greatly affected my clinical practice as a CP and I believe that it will allow me to provide better care for my patients".

"I have been great at memorizing things in the past. I think thats the reason why I have always been successful when applying myself in traditional courses. This course challenged me to approach the material in a new way and for that reason I think I will  retain the information I learned better in the future".

"This program helped me to build on what I did know, helped me learn things I had no idea of, and improve my ability to research areas in my future career".

"By the end of the first module, I was hooked. ... I started this course feeling like a rookie and left feeling like a ten-year veteran. I then took that knowledge and shared it with my co-workers, creating a confident work environment. ... I was feeling confident in my role to educate my co-workers and guide them with my newfound knowledge. ... This course has given me the knowledge to lead my team."

"When reflecting on where I started from at the beginning of module 1 to where I am now, while composing this assignment, I can not believe how far I have come.  I have done my undergraduate degree, obtained two diplomas and performed several online continuing education courses, but this was the first time I have completed a course that uses the Problem Based Learning (PBL) format.  I was a bit skeptical at the beginning due to its different approach to Adult Education.  I questioned how much this style of learning would increase my knowledge and now, I cannot think of a way to learn that is better than this format.  By allowing me to choose discussion points that I was not familiar with it really allowed me to bring my knowledge to a different level.  This combined with reading other individual discussions that typically were on other discussion points allowed to elevate my knowledge even further.  This was topped off by the facilitator of the course pushing discussions even further.  By making remarks and asking questions of certain posts I made allowed me to continue to dig deeper for knowledge and once again to expand my toolbox even more."

"This course has made me evaluate myself on a professional and personal level.“

"I truly believe that this course has inspired me to learn more, improve my communication and to really consider the bigger picture. Thank-you for creating a course that is not just theory based but progressive case study based. It has opened my eyes to the road that we will take with our patients. I have learned a great deal about myself and the preconceived notions I had about my ability to help others. The roadblocks will be endless but the tools I learned will help me navigate them.”

"I found the first couple of weeks very difficult. After I completed the first couple of modules, I noticed a change and began looking forward to the next subject and began finding myself taking longer to do my write-up (not in a bad way) as I would “go down the rabbit hole” and continue reading through more and more peer-reviewed papers and websites. My love for learning returned, and I wanted to engage more and look for answers into why and how community paramedic programs are helpful in the aging population and people who can be suffering from multiple disease conditions and co-morbidities. 
"

"Having the opportunity to build on my medical knowledge and integrate new assessments and treatment options has been an exciting journey. Through the self-guided readings, didactic presentations, and my research, the procedures and treatments that were introduced in this course will be put into practice while not only working as a community paramedic but also while working on the 911 side of paramedicine. Wanting to not only learn the techniques but also understand their importance on both the patient and scientific levels has made me a better paramedic and reignited a passion for learning."

"Through interacting and exchanging ideas in our discussion boards, I have recognized the importance of information sharing and gaining new perspectives. It challenged my outlook on certain topics and also provided me with an opportunity to share perspectives on others' thoughts. This was pivotal in building my confidence and made me feel connected to a team of individuals with a similar desire to serve others."

"The learning I acquired during the modules helped solidify knowledge gaps and gain strength in that knowledge with the discussions with my peers. I have also developed a different attitude in my approach to patient care with Community Paramedicine. I’m leaving this course feeling prepared to provide care to patients in the community using my knowledge and skill set that I have obtained in this course." 

"I admit that I was pleasantly surprised once I started to create these patient profiles and can honestly say that I don’t think that there would be any better way to deliver this course.  We got to develop these patients visits and profiles from the ground up and were able to see them through to completion much the same as we would be on the road.  I found the discussion posts quite interesting.  I was able to gather more of an appreciation not only for how other services run their CP programs, but I was also able to gather a significant amount of insight into the many other ways that my peers may run calls.  We were all able to offer insight into other tests, assessments, treatments, therapeutics that may be offered to our clients and different ways to handle tough situations.  It has really broadened my approach to my calls and my clients."

"I have come to learn much about myself and must admit that I’ve come to respect this type of learning (if not love it).  I can appreciate that delving into a topic, researching, and picking through the material to determine what is pertinent, and formulating my post allows for more in-depth learning and retention.  The best part though is the opportunity to read my peers’ posts and learn from them as well, on the avenues that they chose to explore, or the different view that was taken on the same topics.  The grade that I have assigned myself reflects not only my contributions to the program, but also the growth and knowledge that I have gained through this type of program. … I have grown immensely in my learning ability, not just in the knowledge that I have gained.  This experience has educated me on education, not just Community Paramedic knowledge."

"Admittedly, at first I was not a fan of PBL. 'Teach me what I need to know and I will learn.' PBL forces you to learn by thinking on your own and helps develop the tools needed to make critical decisions. PBL won’t teach and won’t decide for you. … Moving forward, my brain has been rewired … rather than relying on our memory to treat, we will use our mind to problem solve. How we do that isn’t based on what we learned in this Community Paramedic Practitioner course, but on how we learned. Now, how we think as a CP is founded on how we learned."-

"I have developed a deeper understanding of the course content, honed my critical thinking abilities, and cultivated a collaborative approach to community paramedicine."

"The information that I have learned, and the education that I have received, in this course will be instrumental in my success as I venture out into the community. I feel much more confident and equipped to enter the community and help them with their needs and their social determinants of health." 

"When I would first read the assignment [instructions] there was a thought that all of my peers would likely have similar ideas and conclusions. However, when I began to read other’s posts, I became aware of how different our viewpoints can be. This allowed me to become more open-minded and gain a greater appreciation for these differences. There were a lot of things I would never have learned if it wasn’t for other’s insights allowing me to look at things from a different point of view. I was able to identify attitudes and biases that I have and work to address them."