As part of the yearly maintenance of certification, each Paramedic must successfully complete an Annual Practice Review at the level for which s/he is certified. The APR day consists of an 8 hour day with the following components:

• A didactic presentation

The skill stations are largely peer review format, with focus on skill completion, recollection and application of CPER Medical Directives and related pathophysiology. The peer review skill station format will encourage both active and passive learning as both a participant and evaluator. Aspects of skill demonstration, Medical Directive association and a review of pathological processes allow the learner to examine a particular condition or skill from a variety of angles.

The scenario component will focus on critical thinking and decision making. Scenarios are designed such that the focus will be on thorough assessment and critical thinking prior to any initiation of treatment.
The format for the APRs are authorized by Medical Council and addresses problem based learning strategies while minimizing negative external motivation thus allowing a real time remediation of any potential patient management concerns.