TDNet Discover

The purpose of this quantitative study was to examine whether differences existed in EMS providers’ self-reported confidence in clinical decision-making following simulation-based continuing education (SBCE). Situational awareness theory guided the study, emphasizing the role of perception, comprehension, and projection in complex environments. A causalcomparative, cross-sectional design addressed the research question: What is the difference in EMS providers’ self-reported confidence in clinical decision-making after SBCE? Archival postcourse survey data were analyzed from 1,325 EMS providers across 93 agencies who completed one of seven simulation courses. Confidence was measured with a single five-point Likert-type item, and data analysis included descriptive statistics, assumption testing, one-way ANOVA, Welch’s ANOVA, and effect sizes. Results showed no statistically significant differences in confidence by course topic (ANOVA: F(6,1318) = 1.82, p = .093; Welch: F(6,501.85) = 1.52, p = .168; η² = .008). Confidence was consistently high across all simulations, indicating that the format itself, rather than topic, influenced outcomes. These findings suggest that simulation provides a broadly effective means of reinforcing provider confidence, regardless of content area, and it is recommended that EMS educators focus on scenario quality and debriefing practices when designing SBCE. Future research should use validated multi-item confidence measures, include demographic covariates, and explore longitudinal effects of SBCE.