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200 hours is nowhere sufficient to do what we are expected to do with the little add-on cert here. While I like being more useful to my medic, developing a skill takes more than a 24 hour class and a day at the ED getting 10 sticks.
But the 24 hr class +10 live sticks isn't supposed to develop the skill. Like anything else, that should prepare you to go into the world and develop the skill with at least some foundation. Remember, the EMT-IV cert isn't supposed to be stand alone or based on knowledge. That add on is pretty much just supposed to make EMTs more useful on an ALS ambulance, which I think it does pretty effectively. It's a purely technical skill, and I think the class as it stands now is enough to teach the skill acquisition alone.