The first article in this three-part series explored the general concepts of the new EMS education standards. Detailed content and conceptual differences were highlighted in the second part of the series. In this final installment, we look at how the standards will be implemented and examine some of the issues associated with a physical and philosophical change in EMS education.
After speaking to educators from all corners of the country, their feelings about the new standards might be summed up as cautious optimism. While educators are concerned about the differences in content and concept--in addition to the additional work involved in implementation--few are actually against the new standards. It appears the open process during implementation, combined with the perceived need for a more efficient and professional approach to EMS education, is behind this positive reception of the standards. After presenting workshops around the country to introduce educators to the new standards, I have gathered their most common concerns and broken them down into the following questions:
How will a course taught in one state be similar to one in another state without more detailed content description like in the old curriculum?
The short answer is, in some ways it will be the same and in other ways it will be different--just like it is now. EMT courses in the United States range from 120 hours to over 250 hours. There are significant differences in both scope and course duration in currently existing classes, which in effect makes the lack of declarative less an issue than would appear on initial impression.
As mentioned in previous articles in this series, it is widely considered to be a maturation process where we are using current science (as opposed to outdated curricula) as the basis for EMS training. This not only moves EMS to a more professional model, but one that is more in line with other allied health professions.
The lack of declarative teaching information in the standards creates a void when compared to what instructors are used to receiving. A lesson in the prior curricula may contain literally pages of objectives--something not present in the standards.
Jane Pollock, EMT-P, an EMS instructor in Greenville, NC, explains a dilemma faced by many educators and institutions: "For now, the various state-approved EMS teaching institutions have to develop objectives for their programs to meet the new EMS standards, even though our state has not yet adopted the new standards."
While the education standards offer instructional guidelines to help clarify the standards' intent, it is clear that they are simply and importantly only guidelines. It is also worth noting that the EMT guidelines as initially released contain some content not included in the EMT scope of practice and are somewhat subjective in their interpretation of the depth of material in the standards. The instructional guidelines were envisioned to help educators transition to the new standards. It is not anticipated that they will be revised or continued to other versions of future educations standards.
How will a national examination apply to providers trained in different areas?
Just as we do it now. The National Registry of EMTs does periodic practice analyses of both BLS and ALS providers. For many years, the NREMT exams have not been solely based on the curriculum, but on the skills and knowledge needed by EMS providers to practice on the street. As EMS has evolved, so has the exam. If there has been a significant change in science or the addition or deletion of a modality from the EMS providers' skill set, this is reflected in the examination--even though it goes against the curricula currently in use. Since the curricula were published throughout the 1990s, there have been significant changes in emergency medicine, including significant changes in American Heart Association guidelines, which have all been reflected in the NREMT exams. More than 40 states currently use the NREMT exam at some certification or licensure level.