Emergency Medical Services (EMS) continuing professional education (CPE) continues to focus on standardized programs and a complex system of education credits for recertification/relicensure rather than whether the CPE produced any changed in patient outcomes. While EMS preservice education has developed significantly since the 1980s with the inclusion of advancements in adult education best practices, EMS CPE has not followed suit. Though various individuals and organizations have called for more localization in CPE efforts, EMS still witnesses a lack of meaningful CPE designed to address specific learning needs unique to the local area or an individual prehospital care provider. This study was designed to understand EMS educators practices of conducting needs assessments to identify and prioritize CPE for prehospital care providers. This quantitative study utilized a 97-item survey instrument to examine four major aspects that impact CPE topic selection (sources of information, factors that influence CPE decision making, strategies to collect data, and strategies to analyze data) with a comprehensive catalog of CPE offered by EMS educators. EMS educators identified as Training Officers with the National Registry of Emergency Medical Technicians (NREMT) served as the population for this study. From the population, 634 responses were deemed usable, resulting in an 18.4% adjusted return rate. Respondents ranged in age from 20 to 68, with a mean of 44.1, were primarily Caucasian (93.8%), male (75.2%), certified/licensed at the paramedic level (75.0%) for between 1 to 37 years (mean = 16.12 years), and Nationally Registered (71.4%). Most had some college, but no degree (31.2%) and did have some formal training in adult education and needs assessment. The responses revealed that recertification/relicensure is the primary driver of EMS CPE. EMS educators have a dependence on mandates and recommendations from others over extent data, which biases CPE decision-making. EMS educators do recognize the limitations that scarce resources play in what ultimately CPE is conducted while restricted EMS educator authority may prevent evidence-based CPE needs from being conducted. Finally, while needs assessments strategies were frequently used, they may not be used to their fullest.