title: A review of key national reports to describe the development of paramedic education in England (1966-2014).
abstract: BACKGROUND
  In the year 1966, important advances in mobile coronary care and trauma care in the UK and USA influenced globally the development of modern prehospital emergency services and paramedic education. In that year, to meet the evolving role of prehospital care in the UK, the 'Millar Report' specified a new syllabus for ambulance personnel in England. As the 50th anniversary of this report approaches, this paper reviews key national UK reports to describe the development of paramedic education in England over this period.
  
  
  METHODS
  A hand search of documents available and a Google search identified documents in the public domain. MEDLINE and CINAHL Plus were searched for peer-reviewed publications. Thematic analysis was used to identify descriptive themes.
  
  
  RESULTS
  Of the 83 reports and 431 articles screened, 33 documents met our inclusion criteria. We identified four historical periods in English paramedic education: development of paramedic education (1966-1996); paramedic role changes influencing education (1997-2004); paramedic education level changes and the emergency care practitioner (2005-2008); and paramedic education for the future (2010-2014). Our discussion of four descriptive themes: government authority and policy, influence of health professions, quality assurance and development of the paramedic profession includes comparisons with paramedic education in the USA and Australia.
  
  
  CONCLUSIONS
  Political reform agendas and initiatives and advances in clinical medicine largely shaped paramedic roles and education in England. The degree to which the paramedic profession initiated education development is difficult to determine from the literature. Overall, a nationally coherent standard for paramedic education in England needed five decades to develop and mature.
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.
authors.forename: Ingrid Ann
authors.identifier: http://orcid.org/0000-0003-3296-7569
authors.initials: IA
authors.lastname: Brooks
authors.affiliation: Warwick Medical School and Heart of England NHS Foundation Trust, Birmingham, West Midlands, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooke
authors.affiliation: Disaster Resilience Initiative, Monash Injury Research Institute, Monash University, Clayton, Victoria, Australia.
authors.forename: Caroline
authors.identifier: http://orcid.org/0000-0002-6967-3444
authors.initials: C
authors.lastname: Spencer
authors.affiliation: Disaster Resilience Initiative, Monash Injury Research Institute, Monash University, Clayton, Victoria, Australia.
authors.forename: Frank
authors.initials: F
authors.lastname: Archer
mesh_terms: D000488:Allied Health Personnel / Q000193:education*; D004739:England; D006302:Health Services Research; D006801:Humans
keywords: education; emergency ambulance systems