Raven EMS Education Program Manual
Employer Survey Form

The primary goal of an EMS education program is to prepare the graduate to function as a competent entry-level EMT or Paramedic. As part of the national accreditation process, we need your feedback and candid responses to fully evaluate if we are meeting the needs of our communities of interest.

This survey is designed to help the program faculty determine the strengths and areas for improvement for the program. All data will be kept confidential and will be used for program evaluation purposes only. Thank you in advance for your valuable feedback regarding the educational process.

Please enter demographic data. The information is not shared and is reviewed collectively with all responses.

Your name:

Graduate/Employee name:

Date:

How long has the graduate/employee been licensed (months)?

Cognitive Successful/competent: No prompting Marginal: Inconsistent, not yet competent Unsuccessful: Required excessive or critical prompting
Does the graduate meet the competencies of an entry-level EMT or Paramedic in the COGNITIVE(knowledge) domain?
Which areas are deficient or need improvement?
  • Safety
  • Patient assessment and history
  • Wellness
  • Documentation
  • Pharmacology
  • Medical emergencies
  • Trauma
  • Operations
  • Special considerations (pediatrics, geriatrics, etc.)
  • Introductory (medical legal, pathophysiology, airway, etc.)
  • Other:
    • Psychomotor Successful/competent: No prompting Marginal: Inconsistent, not yet competent Unsuccessful: Required excessive or critical prompting
    Does the graduate meet the competencies of an entry-level EMT or Paramedic in the PSYCHOMOTOR (skills) domain?
    Which areas are deficient or need improvement?
  • Airway management and ventilation
  • Physical examination - Adult
  • Physical examination - Pediatric
  • Medication administration
  • Medical management
  • Trauma management
  • Special patient management
  • Circulation management
  • Other:
    • Affective Successful/competent: No prompting Marginal: Inconsistent, not yet competent Unsuccessful: Required excessive or critical prompting
    Does the graduate meet the competencies of an entry-level EMT or Paramedic in the AFFECTIVE (behavior) domain?
    Which areas are deficient or need improvement?
  • Teamwork and diplomacy
  • Respect
  • Patient advocacy
  • Self-confidence
  • Appearance and hygiene
  • Communications
  • Empathy
  • Integrity
  • Leadership
  • Reflective practice
  • Other:
    • Final Thoughts Yes No
    Are you satisfied with the educational preparation of the graduate/employee?
    Comments
    Please share any additional information you wish the program or the accrediting agency to know:

    Thank you for giving your time and sharing your feedback.

    Change Log (3.85.250.EMSF)

    DateAuthorDescription of ChangeCitations
    2024-05-17Becker, T.Theron Jack BeckerAdded employer survey and graduate survey from.(CoAEMSP, 2024)CoAEMSP. (2024). Resource library. Committee on Accreditation of EMS Programs. https://coaemsp.org/resource-library
    2025-01-06Becker, T.Theron Jack BeckerMoved online from Adobe InDesign document.
    Relevant. Resolute. Ready.
    Raven EMS Education Manual - Table of Contents
    BeckerTeam (main page)