The formal training for Emergency Medical Technician (EMT) in Taiwan was legislated by Emergency Medical Care Services Act in 1995. Very little research discusses the competency of EMTs. The purpose of this study was to assess the determinants of competency for the EMT-II in Taiwan.

In June 2005, a cross-sectional survey was targeted on firefighters with EMT-II certificate and having a minimum work experience of three months in central Taiwan. Kirkpatrick's (1994) four-level model guided the development of conceptual framework and questionnaire. Structural Equation Modeling (SEM) was adopted for the analysis.

One thousand and seventy-three EMT-IIs were included in the study. Majority of them were male (99.4%) with an average age of 34.46 years old. Among them, 96.5% were careered EMTs with 130.33 months of field experiences. The competency of EMT-II was measured by 4 indicators of error reduction, quality improvement, achievement orientation, and efficiency improvement. The construct of ‘Capability Enhancement’ dominated EMT-IIs' ‘Competency’, followed by ‘Length of Time for Field experience’, ‘Instructor Expertise’, ‘TA Expertise’, and ‘Willingness to Learn’. Both ‘Age’ and ‘Total Course Time’ had a negative effect on ‘Competency’. ‘Capability Enhancement’ was mainly influenced by ‘Practice Absorption’ and ‘Theory Absorption’, followed by “Willingness to Learn”, ‘Instructor Expertise’, ‘Total Course Time’, ‘TA Expertise’, ‘Self Confidence’ and ‘Practicum Time in Ambulance Station’. However, the construct of ‘Teaching Technique” imposed a negative effect on ‘Capability Enhancement’.

The SEM model explains 75.7% of the variances in competency for EMT-IIs. The ‘Competency’ is dominated by ‘Capability Enhancement’. Improving the quality of course, instead of time, and recruiting younger EMT-IIs may advance the competency. Modification of ‘Teaching Technique’ may enhance the capability of EMT-IIs.