Emergency medical services (EMS) are an emergency response system that provide immediate care to patients in the home, work or other out-of-hospital environments. EMS aim to reduce patient mortality in the prehospital setting and improve patient outcomes.
EMS employ practitioners at several levels. These include the emergency medical responder, the emergency medical technician (EMT), the advanced emergency medical technician and the paramedic (Markenson and Foltin, 1999). First established in the 1960s in the United States, paramedics are trained EMS personnel who provide advanced life support to sick and injured patients (Williams et al, 2021).
Paramedic training includes more than 1000 hours of classroom, clinical and field training (Phelps, 2015). Although training requirements vary from state to state, most educational programmes use the National Emergency Medical Services Education Standards (NEMSES), published by the National Highway Traffic Safety Administration (NHTSA) (2009). These guidelines allow paramedic learning programmes to train candidates to a national standard. The Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions is the only organisation that accredits paramedic training programmes in the United States (Commission on Accreditation of Allied Health Education Programs, 2015).
Although there are more than 300 paramedic training programmes in the United States, a college degree is not required as a standard in the paramedic profession. Only Kansas and Oregon require new paramedics to possess a minimum of an associate degree to obtain state certification, yet no specific degree major is required (Caffrey et al, 2019). While each degree programme contains course materials and objectives specific to a major, students may also acquire indirect benefits, including soft skills.
This study investigated how paramedics view the necessity of obtaining a minimum of an associate degree to pursue the profession and whether the soft skills obtained or enhanced with a college degree would apply to and benefit the paramedic role. Students' soft skills traditionally obtained or enhanced while engaged in degree programmes include communication, applying the writing process and employing analytical skills in various situations. Furthermore, on average, individuals with college degrees earn 18.3% and 67% more when they hold associate and bachelor's degrees, respectively (Chen, 2017).
The college major, however, was not a factor in this study as participants with a degree had various majors associated with this qualification. This study examined the perception of paramedics to determine their beliefs on whether soft skills will improve or are necessary to the paramedic profession.
The hypothesis for this study was: if paramedics have a minimum of an associate degree, then they are more likely to believe that their education has contributed to the development of their soft skills.
While the topic of ongoing debate, the EMS profession in the United States does not presently have a standard college degree (major or degree level). Therefore, this study did not focus on any one degree type or major – only the minimum of an associate degree.
Background
In the United States, there are four recognised levels of college degrees: two are considered undergraduate, and two graduate. The first undergraduate level is the associate degree, which is generally worth 60 credits and is commonly completed at a local community or junior college. The baccalaureate or bachelor's degree is the most common degree and typically requires 120 credits, traditionally taking 4 years to complete. For graduate degrees, the first level is the master's degree, which generally needs between 30 and 60 credits. The final level is the doctorate, which typically requires original research and approximately 60 credits, and can take 4–8 years to complete (Beliles, 2022).
Associate degrees are not awarded in the UK. Instead, the higher national diploma is a foundation degree, combining classroom and workplace study. This academic level of achievement can be applied towards the completion of a bachelor's degree, which, unlike in the United States, generally takes about 3 years (Mont Rose College of Management and Science, 2023). The graduate degrees in the UK (called postgraduate degrees) are similar to those in the United States. However, unlike the undergraduate degree that has required courses that are not specific to the major, the master's level is generally more specific. It can often be completed in a year, while the master's degree in the United States typically takes 2–3 years to complete (IvyWise, 2024).
Hard skills are defined as those commonly appearing on a resume, such as cardiopulmonary resuscitation certification, education and work experience (Robles, 2012). Although hard skills are generally an employer's focus, demonstrating soft skills can set applicants apart (Dixon et al, 2010).
‘Soft skills’ is a term used to describe skills such as communication, critical thinking and writing (Cobanoglu et al, 2006). Employers consider the use of soft skills necessary, yet separate from the technical skills acquired during an initial training programme (James and James, 2004). Robles (2012) found that communication was among the soft skills employers wanted for employees.
Many soft skills are honed while at college. Students attain such skills and attributes through completing required coursework and meeting deadlines. As they are routinely placed in groups to complete projects, they improve their soft skills, including those in communication, analysis and critical thinking. These skills attained from completing a degree contribute to professional attributes including commitment, team-building, communications and interpersonal skills, as they are embedded in such programmes (Appleby, 2017).
Communication, for example, is an essential EMS skill that is practised in every patient interaction. This particular skill is mentioned multiple times in the NEMSES Paramedic Instructional Guidelines (NHTSA, 2009).
In addition, writing skills are frequently used in the EMS profession. Along with a verbal report, paramedics must compose coherent and concise charting of all patient interactions to ensure the proper continuance of care once the patient is transferred to the receiving facility.
Another soft skill commonly addressed in degree programmes is critical thinking. Critical thinking is the practice of making decisions based on the present situation and information available to attain the best outcome (O'Meara et al, 2014). Paramedics use critical thinking in everyday practice when interacting with patients and making rapid and potentially life-saving decisions (Caffrey et al, 2019).
In 2018, the National EMS Management Association, the National Association of EMS Educators, and the International Association of Flight and Critical Care Paramedics published a joint paper stating their position that the paramedic profession should require a minimum of an associate degree (Caffrey et al, 2019). The authors cited the increasing complexity of paramedic practice and the need for additional education requirements as the basis for their position. They also stated that paramedics must increase their writing and oral communication skills to be strong providers and leaders in EMS (Caffrey et al, 2019).
Contrarily, a 2018 joint position statement from the International Association of Fire Chiefs (IAFC) opposed paramedics being required to complete a degree. They stated that there was no evidence that a degree makes a better paramedic. However, this position statement did not define what constitutes a ‘better paramedic’. The IAFC further argued that requiring college degrees for paramedics would raise costs as a result of initial training and a demand for higher salaries upon achieving the qualification. They also believed that raising education requirements would reduce the number of individuals willing to become paramedics, resulting in a paramedic shortage (IAFC, 2018). However, there are no published data to support or refute these claims.
As the UK's paramedic profession began to move toward a BSc requirement, paramedic employers responded with resistance. They complained that higher education standards would remove control from the local level and eventually require higher salaries for graduate paramedics, increasing overall operational costs.
However, instituting BSc degrees for paramedics resulted in only a slight increase in wages. In the UK, paramedics are generally paid a similar wage to nurses (National Careers Service, 2025a; 2025b). This is not the case in the United States, where paramedics make an average of $53 180 (£42 600) a year and nurses earn an average of $86 070 (£68 950) a year (US Bureau of Labor Statistics, 2023a; 2023b).
Paramedic training programmes in the UK must now be at the BSc level. The move to mandate paramedic training at BSc degree level arose from the increasing scope of practice for paramedics and the desire to be classified as a profession (Fellows B, personal communication, 28 May 2020). In addition, paramedics in the UK worked with the government to produce the Paramedic Evidenced Based Education Project (PEEP), which was created to eliminate inconsistencies in paramedic practice (Allied Health Solutions, 2013). As a result, the progression to a BSc allowed paramedic training to be standardised while incorporating evidence-based standards and removing inconsistencies (NHS England, 2025).
The paramedic profession is still defining its role in the healthcare industry as its responsibilities have also increased. Traditionally, paramedic education in the United States included an initial training programme at a hospital or fire department. As the profession has evolved, standards of education and programmes need to be accredited to be eligible for National Registry of Emergency Medical Technicians (NREMT) certification.
Because of these changes, this study investigated the perception of paramedics in the United States of the necessity of obtaining a minimum of an associate degree and the education of that degree in acquiring or enhancing soft skills that would be beneficial to their professional role.
Methodology
This study used a mixed-methods design to assess whether paramedics perceived the need for a minimum of an associate degree and if they believed this degree helped them acquire soft skills.
The first method was comparative, using a quantitative survey to determine the significance of the need for a college degree in paramedicine. The second used phenomenological data from a qualitative survey to gain deeper insights into participants' experiences in paramedicine and how they felt their education, specifically in developing soft skills, influenced their job performance (Creswell, 2015).
Each state office of EMS was contacted and asked to help distribute this study to their paramedics. Some offices provided a direct email list for all current paramedics to the researchers; many distributed the survey on the researchers' behalf; and some chose not to distribute or respond to the request. Additionally, several state and national private paramedic organisations agreed to participate by distributing the surveys to their members. All paramedics who were certified/licensed at the time of the study were eligible to take part.
Paramedic participants completed a survey with 5-point Likert scales that focused on the importance and applicability of college degrees in their profession. In addition, a subgroup of paramedics, comprising both those with and without degrees, completed an open-ended follow-up questionnaire addressing the perceived necessity of skills in the areas of analysis, writing, communication and critical thinking.
The results were analysed and data disaggregated by education level and by region. The purpose of recording the region was to determine patterns of participant responses based on the area where they worked (Table 1). The region grouping was adopted from the National Association of State EMS Officials, and is used by several national EMS agencies, including the NREMT (National Association of State EMS Officials, 2025).
National Association of State EMS Officials regions
| East Region | South Region | Great Lakes Region | Western Plains Region | West Region |
|---|---|---|---|---|
| Connecticut | Alabama | Illinois | Colorado | Alaska |
| Delaware | Arkansas | Indiana | Iowa | Arizona |
| Maine | Florida | Michigan | Kansas | California |
| Maryland | Georgia | Minnesota | Missouri | Hawaii |
| Massachusetts | Kentucky | Ohio | Montana | Idaho |
| New Hampshire | Louisiana | Wisconsin | Nebraska | Nevada |
| New Jersey | Mississippi | New Mexico | Oregon | |
| New York | North Carolina | North Dakota | Washington | |
| Pennsylvania | Oklahoma | South Dakota | ||
| Rhode Island | South Carolina | Utah | ||
| Vermont | Tennessee | Wyoming | ||
| West Virginia | Texas | |||
| Virginia |
Paramedic survey instrument
The researchers created a 39-question survey to assess paramedics' perceptions of college degrees and their necessity in the paramedic profession. This paramedic survey instrument (PSI) was created because no similar survey instrument had been developed.
Paramedicine qualitative survey
The researchers also created an eight-question, open-ended, follow-up survey to investigate paramedic views on the applicability of soft skills acquired from a college degree programme.
The purpose of this paramedicine qualitative survey (PQS) was to allow elaboration beyond the Likert scales in the PSI. Since this survey was qualitative in design, it was not part of the PSI arm but an opportunity for a small number of participants to give more detailed information.
This questionnaire was randomly sent to 10 paramedics in each of the five regions (East, South, Great Lakes, Western Plains and West), which had participated in the quantitative survey and indicated they would be interested in completing the questionnaire. Of the 50 participants invited to participate in the PQS, 12 completed it: five who had a college degree and seven who did not.
The responses were coded to determine any recurring themes. A second coder was used for purposes of inter-rater reliability (IRR), and the correlation coefficient was found to be 86% IRR, which exceeds 75%, and so, is considered moderately strong (Beaudry and Miller, 2016).
Institutional review and consent
The researchers applied for institutional review board approval at Caldwell University in November 2021 and received approval on 15 December 2021. The IRB application included all survey instruments, the study's objectives, the research's significance and how all responses would be submitted anonymously. Additionally, the application included the exact wording for the consent for participation, which appeared at the very beginning of the surveys.
Results
A total of 4542 paramedics responded to the PSI. Of these, 617 were removed as they did not indicate that they were current paramedics in the United States. Therefore, 3925 participants were included in the final analysis.
Data were analysed according to level of education and region of the United States where the paramedics were employed (Table 2). The results encompass all degree majors and are disaggregated by degree-level completion (associates, bachelors, masters, and doctorate).
Demographics
| n | % | |
|---|---|---|
| Years worked as a paramedic | ||
| 0–10 years | 1536 | 39.1 |
| 11–20 years | 1196 | 30.5 |
| >20 years | 1193 | 30.4 |
| Highest level of education | ||
| High school/general educational development | 968 | 24.7 |
| Associate degree (2-year degree) | 1183 | 30.1 |
| Bachelor's degree (4-year degree) | 1185 | 30.2 |
| Master's degree | 495 | 12.6 |
| Doctoral degree | 94 | 2.4 |
| Regions | ||
| East | 832 | 21.1 |
| South | 1611 | 41 |
| Great Lakes | 475 | 12.1 |
| Western | 696 | 17.7 |
| West | 311 | 7.9 |
A two-way ANOVA test was used to determine the effect of the highest level of completed education on soft skill benefits and how beliefs varied by region (Table 3). Table 3 shows the statistically significant relationship between education level and the perception of soft skills benefits. The main effect of the highest level of education was statistically significant (F(4, 3900)=220.966; P<0.001), indicating a difference in the perception of college soft skill benefits in line with level of education.
Tests of between-subjects effects (H1; n=3925)
| Source | Type III SS | df | MS | F | P | Partial η2 |
|---|---|---|---|---|---|---|
| Corrected model | 1271.95 | 24 | 53.00 | 53.330 | <0.001 | 0.247 |
| Intercept | 14275.24 | 1 | 14275.24 | 14364.644 | <0.001 | 0.786 |
| Education | 878.36 | 4 | 219.59 | 220.966 | <0.001 | 0.185 |
| Region | 2.34 | 4 | 0.58 | 0.588 | 0.671 | 0.001 |
| Education/region | 18.35 | 16 | 1.15 | 1.154 | 0.298 | 0.005 |
| Error | 3875.73 | 3900 | 0.99 | |||
| Total | 55459.71 | 3925 | ||||
| Corrected total | 5147.67 | 3924 |
There was no statistical significance (P=0.298) in the variation of the responses between regions. Table 4 demonstrates that as post-secondary education increases, so does the perception of the need for a degree and its impact on attaining soft skills. For example, participants whose highest educational attainment was high school/general educational development had means and standard errors of 2.62 (SE=0.07), 2.68 (SE=0.05), 2.62 (SE=0.10), 2.84 (SE=0.09) and 2.87 (SE=0.11) for the East, South, Great Lakes, Western Plains and West Regions, respectively. This pattern among regions continued as education level increased. The results for variation according to education levels showed statistical significance (P<0.001). As educational level increased, participants believed that post-secondary training may have improved soft skills attainment.
Estimated marginal means (H1)
| (n=3925) | High school/GED | Associate degree | Bachelor's degree | Master's degree | Doctoral degree | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Region | Mean | SE | Mean | SE | Mean | SE | Mean | SE | Mean | SE |
| East | 2.62 | 0.07 | 3.64 | 0.07 | 3.96 | 0.06 | 4.21 | 0.09 | 4.32 | 0.18 |
| South | 2.68 | 0.05 | 3.51 | 0.05 | 3.95 | 0.05 | 4.26 | 0.08 | 4.54 | 0.18 |
| Great Lakes | 2.62 | 0.1 | 3.62 | 0.08 | 4.04 | 0.09 | 4.58 | 0.13 | 4.06 | 0.29 |
| Western Plains | 2.84 | 0.09 | 3.48 | 0.06 | 4.01 | 0.07 | 4.13 | 0.11 | 4.24 | 0.27 |
| West | 2.87 | 0.11 | 3.62 | 0.1 | 4.07 | 0.1 | 4.42 | 0.17 | 4.61 | 0.5 |
| Overall | 2.73 | 0.04 | 3.57 | 0.03 | 4.01 | 0.03 | 4.32 | 0.05 | 4.35 | 0.14 |
GED: general educational development; SE: standard error
Certain statements on the PSI pertained specifically to soft skills and college-degree attainment (Table 5). While most participants responded favourably to the suggestion that a college degree helped them to develop the specified soft skills, there was some variation. Means ranged from 3.30 (cultural competence) to 4.06 (writing) on a 5-point scale. However, the SDs ranged from 1.16 (writing) to 1.42 (cultural competence). These high standard deviations may indicate that, as education level increases, agreement regarding the acquisition of soft skills through post-secondary education may vary.
Soft skill Likert scale responses to paramedicine qualitative survey
| (n=3925) | Mean | SD |
|---|---|---|
| PQ20.1 A college degree has developed (or could develop) my critical thinking skills | 3.50 | (1.39) |
| PQ20.2 A college degree has enhanced (or could enhance) my analyzing skills | 3.53 | (1.37) |
| PQ20.3 A college degree has enhanced (or could enhance) my cultural competence | 3.30 | (1.42) |
| PQ20.4 A college degree has improved (or could improve) my leadership abilities | 3.44 | (1.35) |
| PQ20.5 A college degree has improved (or could improve) my verbal communication skills | 3.72 | (1.29) |
| PQ20.6 A college degree has improved (or could improve) my writing skills. | 4.06 | (1.16) |
SD: standard deviation
The data in these surveys support the study's hypothesis; paramedics with a minimum of an associate degree perceived that their education had contributed to developing the four soft skills of critical thinking, analysing, writing and communication.
Paramedicine qualitative survey
Twelve paramedics completed the PQS; five had a degree, and seven did not.
Paramedics with a degree
Of the five participants with a degree, two agreed that taking it aided in developing critical thinking and indicated that a college degree requires a person to have an open mind to see different views of a situation (Table 5). One stated:
‘Yes. A well-rounded education exposes us to new knowledge and stretches our minds to consider things in new ways.’
The two participants who did not believe college degrees advance critical thinking commented that critical thinking requires an in-depth field training programme, which does not occur in a college classroom. One stated:
‘No, most critical thinking skills are soft skills and require an in-depth field training program.’
The one unsure participant stated:
‘The ability to argue (as in effectively present a case, not verbal aggression), came from my classroom experience. My degree gave me the ability to provide whole patient care and guidance as opposed to using the ER as a “safety net” when my skills are not needed.’
When asked if a degree would advance analysing skills, four of five participants indicated that it would. They commented that graduate paramedics often find more clues and incorporate such information in their patient reports. One participant stated:
‘Lab time and advanced science courses help with this by teaching how a large thing (say, an organ) is made up of smaller items and how the interaction of these items can affect the whole.’
However, one participant disagreed, stating that soft skills such as analysing are adequately taught in technical schools.
All but one paramedic responded favourably to believing that a degree advances writing skills. They stated that writing skills were essential in moving paramedics toward becoming independent clinicians. One stated:
‘Without the feedback from professors and professionals, the chart submitted by a paramedic or EMT frequently looks as if the provider is poorly educated and unskilled.’
The last soft skill addressed was communication, and the responses were mixed. Participants who believed that college degrees advance these skills compared communication to being an athlete. Much like an athlete who is coached and practises, a student in college learns how to communicate and practises this skill throughout this time. One participant stated:
‘Yes. As with reading and writing, practice increases the ability to communicate. College affords this opportunity.’
Another participant disagreed, stating that this could be learned in the field or at trade school.
The majority of the responses from paramedics with a degree perceived that this qualification contributed to the development of soft skills, particularly in the areas of analysis and writing.
These responses were consistent with the data from the PSI that demonstrated that paramedics with at least an associate degree agreed that their qualification contributed to the development of their soft skills.
Paramedics without a degree
Seven paramedics who did not have a college degree completed the PQS (Table 6).
Paramedicine qualitative survey responses
| Paramedics with a college degree | Paramedics without a college degree | |
|---|---|---|
| Critical thinking and college degree | Two participants agreed that a degree requires an open mind and an understanding of different viewpoints of a situation | One participant agreed, as college courses are relevant and improve understanding of content |
| Two participants did not agree as it results from field training | Most participants disagreed, stating that real-life experiences promote critical thinking | |
| One participant was unsure but stated it may help in certain aspects | ||
| Analysing skills and college degree | Most participants agreed as they find clues and information from patient reports | One participant agreed as it was part of a college programme |
| One participant disagreed as this information can be learned from a technical school | Most participants disagreed as experience and field training provided this skill | |
| One participant was unsure and stated it could if completed courses were in the sciences | ||
| Writing skills and college degree | Most participants agreed that it is essential and that, with writing at college, communication improves | Most participants agreed as it occurs throughout college courses |
| One participant disagreed with no explanation | Two participants stated no, as not everyone with degrees was an effective writer | |
| One participant was unsure and stated it was possible, but not guaranteed | ||
| Communication skills and college degree | Most participants said yes as this is learned and practised in college courses through discussions and exchanging ideas | Most responded yes and one stated that a speech course also helps |
| One participant was unsure as it depended on the class format | Two participants stated no but did not provide a rationale | |
| Two participants were unsure and felt it could help depending on the course | ||
| Summary | Responses centred more around college degrees supporting these skills | Varied responses, with many unsure as to whether a degree helped these skills |
When asked if critical thinking is advanced by a college degree, only one paramedic indicated that it could contribute to developing this soft skill. This paramedic was pursuing a bachelor's degree and stated that courses are relevant and improve an understanding of other aspects of healthcare.
Four participants did not support this belief. Of those, one participant stated that college courses focus on ‘facts rather than reason.’
Another stated:
‘No, I believe that experience, whether life or in clinical, allows paramedics to advance critical thinking skills.’
Two participants were unsure.
Only one of the seven participants agreed that a college degree advances analysing skills. This person noted that it is an important part of nursing training. Another was unsure and stated that coursework could advance analytical skills to some extent, especially in science courses. The three participants who disagreed stressed field training and years of experience.
Regarding writing skills, four of the seven participants responded favourably to the idea that college degrees improve one's writing. One stated:
‘Yes I do, as it gives the basics of grammar and how to articulate the facts in patient care.’
Of the two participants who disagreed, one stated:
‘No. I have seen incredibly well written papers by people without college degrees and some of the most horrible papers written by people with advanced degrees.’
Finally, one unsure participant stated that although a college degree can further this skill, this was not guaranteed.
Of the three participants who responded favourably to college degrees advancing communication skills, one provided details:
‘Yes. Many college degree programs require a speech course. This can help a provider with their communication skills.’
The other two participants simply stated ‘absolutely’ and ‘yes’. Two participants stated no and two were unsure. The lack of consistency in agreement from this group was also evidenced in the data from the PSI that demonstrated that paramedics without a college degree did not generally agree that it contributes to developing their soft skills.
Consequently, as completed education levels rose, so did participants' belief that college degrees contributed to soft skills development.
Discussion
Data from the PSI demonstrated a statistically significant relationship between education levels and the belief that completing a college degree advances soft skills development. Data also revealed means above 3.0 in all education groups except in paramedics who reported not having a college degree. In addition, these means rose with each level of completed college education, from 3.48 with an associate degree to 4.61 with a doctoral degree. Therefore, as paramedics' education level increased, so did their belief that their college degree contributed to their soft skills development.
Additionally, regardless of completed education level, participants believed that soft skills were needed, with means above 3.0 (Table 5). For example, analysing and critical thinking skills scored 3.50 and 3.53, respectively, while communication and writing skills scored 3.72 and 4.06, respectively.
Although the data in the PQS were more specifically supportive of analysing and writing skills in the group that possessed a college degree, many responses also identified some level of merit in a college degree for critical thinking and communication skills. These participants mentioned that the ability to break down complex situations into smaller chunks improves analytical skills.
Conversely, paramedics who did not possess a college degree were less likely to respond favourably to the idea that a college degree develops soft skills, specifically critical thinking and analysing (Table 6). However, like the college degree group, this group had more positive than negative responses regarding writing skills. Additionally, approximately half of the participants without a degree found some level of merit in developing communication skills from a college degree, as did those who had a degree. However, those without a degree commented that life experience was the primary developer of critical thinking and that online education can be detrimental to communication skills.
The data for this research question supported the belief that completing a college degree may help paramedics develop soft skills. Although the qualitative responses were from a small subset of participants, most of those with a college degree favoured this belief. In contrast, paramedics who did not have a college degree did not see the benefits of completing one to develop soft skills. PSI data also revealed that, as the level of education rose, so did the belief that completing their college degree contributed to the development of soft skills (Table 4). Additionally, these beliefs did not vary between the five regions, suggesting that location does not affect a paramedic's perceived beliefs around a college degree.
Paramedics who complete a college degree perceived that their higher education contributed to the development of the four specified soft skills.
Limitations
Although this study was the first that specifically examined the necessity and benefits of a college degree for paramedics, the findings were primarily perception-based. Outcomes assessments in standardised testing may provide more definitive data regarding learned and applied knowledge from college degrees.
Additionally, the researchers could not determine clinical outcomes in patients who received treatment from paramedics with college degrees versus those without a college degree. This type of research requires partnerships with paramedics, paramedic employers, hospitals and patients.
The small sample size for the open-ended questionnaire is another limitation. While these responses could not be generalised, they did provide some insight into the data derived from the PSI.
Future research
Future research should focus on specific majors and degree levels that benefit paramedics.
Additionally, this research may be drawn on to help modify specific courses that benefit paramedics and assist in developing a specific degree for paramedics.
Research examining and comparing soft skills development from field experience to college degree completion may provide a clearer picture of how each benefits paramedics.
A study focusing on the clinical impacts of patient care and subsequent outcomes of paramedics with and without a degree could provide insight into other ways in which such education benefits paramedic practice. Similar studies in nursing have demonstrated improved patient outcomes in clinical areas staffed with nurses who hold bachelor's degrees (Aiken et al, 2014).
Finally, future research may look at paramedicine from a global perspective to evaluate the different requirements at an international level. This may provide greater insight into the skills needed by paramedics to best support their patients.
Conclusion
Soft skills are considered separate from the technical or hard skills part of an initial training programme and are highly sought by employers (James and James, 2004)
The data for this research support the belief that many paramedics who complete a college degree perceived that such study may help develop soft skills. These skills include communicating, analysing, writing and critical thinking (Cobanoglu et al, 2006). In contrast, paramedics who do not possess a college degree do not agree with this belief.
This was also seen in the PSI data where, as the completed level of education rose, so did the belief that completing a college degree contributed to soft skills development.