In addition to the practical-type, hands-on activities preferred for CPC maintenance, EMTs also considered the following activities very relevant or relevant in maintaining Continuous Professional Competence: courses accredited by PHECC 96% (307/319); keeping a learning portfolio 90% (288/319); mentoring others 87% (277/317); lecturing/teaching

86% (276/319); being a Tutor 79% (251/316); attending relevant conferences 78% (246/317); appraisal with a senior EMT officer (or above) 78% (248/319); case study review 64% (204/317); being an examiner 69% (222/319); appraisal with a doctor/medical supervisor 65% (207/320); first aid competitions 50% (159/315); project work Inhibitors,research,lifescience,medical 48% (152/318); appraisal of a journal

publication 39% (124/316). Discussion Whilst there is evidence of competence and CPD programmes within ambulance services internationally (e.g., Norway [18], Australia [19], UK [20], Canada [21]), the evidence of any consultation Inhibitors,research,lifescience,medical with practitioners prior to the introduction of such programmes is scarce. EMTs must embrace the multitude of activities that contribute to a professional’s development and the outcome of good CPD should be practitioners with increased Inhibitors,research,lifescience,medical competence and improved patient care [22]. This is the first study of attitudes towards professional competence among EMTs in Ireland and Inhibitors,research,lifescience,medical indicates that there appears to be a genuine enthusiasm for the introduction of CPC and a positive link to professionalism, similar to other healthcare professions [9,11,12,23-26]. This enthusiasm towards CPC is reinforced further as a significant number of EMTs are already maintaining a learning portfolio and participating in CPC activities, as the vast Decitabine molecular weight majority of participants agreed that CPC should be a requirement for PHECC registration and as 95% believed

that registration with PHECC is of personal importance to them. This view of CPD being a requirement Inhibitors,research,lifescience,medical for registration is supported by legislation for some professions [27-29] or shown in previous studies to be shared by practitioners themselves [26,30]. first E-learning E-learning is the use of internet technologies to enhance knowledge and performance [31]. There are many formats in which e-learning is delivered and many terms synonymous with e-learning, such as web-based (WBL) or on-line learning. One of the advantages of e-learning is that it can be synchronous or asynchronous and, therefore, can be flexible and particularly attractive for pre-hospital practitioners. In Ireland, PHECC has progressed the use of on-line examinations and learning modules since its formation. Indeed, Irish EMT examinations are delivered partially via an electronic software programme.