Introduction: Objective: To identify self-perceived knowledge deficits of paramedics, barriers to training and desired methods of self-directed continuing education. Methods: A written 58 question survey was delivered to all 1262 paramedics under the jurisdiction of a single base-hospital in Ontario, Canada. Respondents were asked to select deficit, no deficit or not applicable from a 37-point, anatomic systems-based list. They were then asked to identify from a 15-point list which educational modalities they would choose to address any knowledge deficits. Finally, they were asked which factors they took into consideration when choosing their self-directed continuing education. Results: Seven hundred forty-six of 1262 paramedics (59.11%) completed the surveys. Of these respondents, 82 (10.99%) were advanced care paramedics, while 664 (89.01%) were primary care paramedics. Of the 645 who responded with their primary geographical setting: 136 (21.09%) listed a primary urban practice, 126 (19.53%) listed a primary rural practice and 287 (44.50%) reported a split urban and rural practice. The most common perceived deficits (respondent number, percentage); were electrolyte disturbance (418, 56.03%), neonatal resuscitation (386, 51.74%), pediatric respiratory disorder (381, 51.07%), arrhythmia (377, 50.53%), and pediatric cardiac arrest (317, 42.49%). The top 5 educational opportunities they were most likely to choose included online module (464, 62.20%), in-class lecture (423, 56.70%), web-based review (403, 54.02%), webinar (301, 40.35%) and peer consult (237, 31.77%). The top 3 barriers to choosing continuing education were work scheduling (479, 64.21%), location/ease of attending (382, 51.21%), and cost (305, 40.88%). Conclusion: Paramedics in this base hospital system identified pediatric critical care situations, electrolyte abnormalities and cardiac arrhythmia as self-perceived deficits. The most commonly selected educational opportunities included online learning, in-person training and peer consult. These preferred modalities are consistent with the identified barriers of work scheduling, ease of attending and cost. Targeted educational needs based assessments can help ensure that appropriate topics are delivered in a fashion that help overcome identified barriers to self-directed learning.