Anyone who has been an EMS educator for more than 15 years will recall the transition from EMT to EMT-B. Developed in relative secrecy, the 1994 release of the EMT-B curriculum brought what appeared to be unprecedented changes to the terminology, scope and practice of EMS. There was an initial wave of anger and disbelief--a sense of loss--in a curriculum many believed "dumbed down" EMS education. Subsequently, curricula were released for all remaining levels of EMS training, ending with EMT-Intermediate in 1999.
If the 1990s brought unprecedented change to EMS education, it was only unprecedented until the release of the National EMS Education Standards in 2009. The education standards process, which was open for comment from the EMS community from beginning to end and uses a non-prescriptive approach, could be considered almost the opposite of the 1994 curriculum release. Coming full circle, the new education standards bring us back to many 1985 terms and concepts, including primary and secondary assessments, and drop "Basic" from the EMT certification level.
This series of three articles will introduce educators to the education standards, detail some of the changes in concept and content, and interview educators and administrators about how these changes will be implemented.
The education standards are one step in a long process that began with the 1993 EMS Education and Practice Blueprint to help define EMS providers and practice on a national level. In 1996, the EMS Agenda for the Future was developed, followed in 1998 by the EMS Education Agenda for the Future: A Systems Approach. The education agenda began a long-term vision in which the education standards play a central role. In the document, the following processes were recommended:
- National EMS Core Content: A list of skills and knowledge necessary for the practice of EMS. This was completed in 2005.
- National EMS Scope of Practice: This 2006 document distributes material identified in the core content document among four levels of EMS provider: Emergency Medical Responder, Emergency Medical Technician, Advanced EMT and Paramedic. The scope of practice identifies minimum knowledge and skills for providers at each level.
- National EMS Educations Standards: released in 2009.
- National EMS Certification: future release.
National EMS Education Program Accreditation: future release.
EMS stakeholders who participated in developing the Education Agenda believed that:
- An established national EMS education system would align EMS with other health professions and enhance the professional credibility of EMS practitioners.
- National EMS education standards should replace the National Standard Curricula (NSC) in order to increase instructor flexibility and provide a greater ability to adapt to local needs and resources.
- Education standards would permit introduction of new technologies and evidence-based medicine without requiring a full revision of the entire education program.
- The Education Agenda would assist states in standardizing provider levels across the nation, affording ease of reciprocity and greater opportunities for career growth in EMS.
- EMS scope of practice should be based on evidence, including practice analysis and research, of what does and doesn't work in the field.
- National EMS certification standardizes verification of entry-level competency and supports EMS career mobility.
Figure 1 shows the interrelation of components mapped in the EMS Education Agenda for the Future.
It was also determined that the education standards, when released, should use a non-prescriptive approach. Unlike the voluminous 1994 curriculum, which contained a detailed declarative section for each lesson, the 2009 standards are designed to be a "living, breathing" document designed to weather changes in medicine and technology that quickly outdate prior curricula.
CURRICULA VS. STANDARDS: A SIDE-BY-SIDE COMPARISON