Becoming an Education Architect

Developing a high-caliber training program takes considerable planning. From assessing training needs to developing objectives, lesson plans and course materials, training officers continuously look at the structure of programs and fine-tune the processes. In 2004, Florida college professors Walter Dick, Lou Carey and James Carey developed a model for designing training programs called the Systematic Design of Instruction.1 A schematic adapting the approach is shown in Figure 1. This article discusses sections of the model and provides EMS educators with ideas to assist them in developing training programs for their EMS crews.

Training Needs
     Before creating a new program, the EMS training officer must conduct a needs analysis and assessment, set goals for the training program, and determine for whom and where the training will be conducted.

     Identifying the topics to be taught is referred to as conducting a needs analysis or needs assessment. While often used interchangeably, these two concepts are significantly different. According to training consultant Donald J. Ford, a needs assessment consists of identifying the knowledge, skills and attitudes (KSA) that are needed to perform the job.2 The needs assessment also seeks to identify gaps in those KSA that must be filled so employees are performing at the same or a standardized level. In contrast, a needs analysis determines if training or some other intervention can resolve performance problems or create a change in performance based upon the needs of the EMS system.

Needs Assessment
     In EMS, the required KSA are set by the national standard EMT and paramedic curricula, as well as by state and local laws and rules.

     A needs assessment will determine the KSA for a specific EMS provider. Thus, the training officer must identify the knowledge, skills and attitudes that all employees must have in order to perform at the entry level for that specific employer. When performance gaps are identified, training is often provided to eliminate the deficiencies.

     In conducting a needs assessment, human-resources consultant Robert Rouda and professor Mitch Kusy suggest that the training officer evaluate the current state of KSA within the EMS provider by examining base-level requirements compared with the current performance level.3 They also suggest that the training officer look for problems or performance gaps, such as variations from benchmarks. For example, if the endotracheal intubation rate for the provider is low (

     All essential knowledge, skills and attitudes must be listed and compared to current performance. Skills checklists may be useful in evaluating performance benchmarks of a given organization. Further, a brainstorming session involving management and field personnel can help identify KSA that are critical to the success of the EMS organization.

Needs Analysis
     In contrast to a needs assessment, a training needs analysis looks at four areas of the organization. According to performance consultants James and Dana Robinson, the four areas of need in an organization include:4

• Business needs such as obtaining correct billing information or enhanced customer service
• Performance needs such as reducing reaction or response times
• Training needs that enhance job knowledge and, ultimately, patient care
• Work-environment needs such as equipment that will facilitate or enhance care.
       Human-resources specialist Jeannette Swist offers five reasons for a needs analysis that include determining if training is relevant to the employee's actual job, determining if training will result in improved performance, evaluating the effect of training on patient care, separating training needs from management problems and linking between the EMS provider's goals and visions with job performance.5