This is the second in a series of three articles on the new National EMS Education Standards. This article will look at some of the details and differences in the education standards as compared with curricula developed in the 1990s.
Differences will be found between the education standards and existing curricula on both minor and more significant conceptual levels.
Prior curricula were developed with significant restrictions early in the process. Early curriculum development was based on a predetermined number of hours, which placed limits on the skills and concepts presented. The current education standards were developed based on the EMS Core Content and Scope of Practice documents and recommend content based on determination of the depth and breadth of the material, and do not have a set number of hours. Course length is based on competency, not hours.
This is also the first time all four levels were created at the same time. Previous levels were done at different times (EMT-B 1994, First Responder 1995, Paramedic 1998 and EMT-Intermediate 1999). The development as a continuum rather than separately helped to strategically differentiate the levels while implementing the scope of practice document in an effective and timely manner.
Organization of the standards also varies significantly from the older national standard curricula. Prior curricula were defined into lessons placed specifically into modules. This created an implication that the curriculum was to be followed in the order presented. The educational standards use competencies with content elaboration and clinical behaviors/judgments as the structure of the document. The presentation itself implies less designated structure and allows more freedom in presentation.
EMERGENCY MEDICAL RESPONDER
A name change is the first difference between the new EMR and the old First Responder. The differences are much deeper in content and concept.
The 1995 First Responder was capped at 40 hours in development and was designed for those peripherally involved in EMS. Although most books and courses had significantly enriched content, the curriculum itself was limited to illness and injury where a first responder could physically make a difference. This resulted in a curriculum that taught environmental emergencies and childbirth but did not contain cardiac or respiratory emergencies—very common complaints—because the first responder wasn't taught oxygen therapy and couldn't directly impact the condition.
The Emergency Medical Responder standards use the depth and breadth concepts to guide education appropriate for someone who responds to emergencies regardless of their affiliation. Higher levels are given to critical measures such as scene size-up, airway and primary assessment, while a wider range of medical and traumatic conditions are introduced at a simple breadth and depth.
EMERGENCY MEDICAL TECHNICIAN
The first change (and one that is welcomed by many) to the Emergency Medical Technician level is dropping "Basic." The new level is "Emergency Medical Technician."
On the conceptual basis, this level has undergone a significant philosophical change. The 1994 EMT-B assumed the student did not need to know anything that wouldn't directly impact care. For example, the EMT didn't have to know anything about specific respiratory conditions, because at the EMT-B level, treatment for all respiratory conditions is essentially the same. The term "painful swollen deformed extremity" (instead of fracture or suspected fracture) was a rallying cry for those who believed the curriculum was too simplistic and restrictive.
The EMT-B curriculum resulted in a chasm between the document, practice and education. Many supplemented (or "enriched" as it was known at the time) the curriculum with additional depth and breadth.