Longtime EMS educator Art Hsieh discussed the future of paramedicine at the National Association of EMS Educators (NAEMSE) Symposium August 10 in Washington, DC. His session, titled “Higher Education in EMS: Savior or Senseless,” engaged a room full of educators with one of our industry’s most heated topics. A known advocate for a degree requirement for paramedics, Hsieh challenged, “It’s time for a change.”
Paramedicine has become more complex. Initial education requirements have increased and are still not sufficient to include all the information providers will need in the field. Hsieh also mentioned the ever-increasing dependence on technology in the field and its effect on the knowledge base required of paramedics. He argued that a degree requirement for paramedics would offer additional time to cover this overflow. He also contended that a degree requirement would allow paramedicine and paramedics to grow clinically in the future.
Hsieh proposed that adding English, math and liberal arts to paramedics’ curriculum would promote development of their thinking and benefit their associated evolution from technicians to clinicians. Some of these additional classes, like English, would benefit workplace tasks like charting and information-gathering by developing reading comprehension and writing proficiency; math would help logic and decision making and likely improve calculations. Liberal arts courses would relate to areas like ethics, philosophy and exposure to different ideas. Hsieh acknowledged that the development of thinking requires time to manifest, but it occurs during this exposure to liberal education.
He also charged educators and leaders to train people today for tomorrow’s EMS systems. He estimated it would take approximately a decade to integrate an associate’s degree requirement for all paramedics, with grandfathering for current practitioners. With reimbursement another hot topic, he referenced the possible CMS perception of EMS and paramedics as technicians with a basic responsibility of driving patients to definitive care—not initiators of care provided as part of a continuum. A degree requirement, he said, will contribute to CMS recognition of paramedics as clinicians.
Hsieh referenced the National EMS Management Association’s 2017 Trend Report finding that two-thirds of EMS leaders want college-educated paramedics—but few take the step of requiring a degree during their hiring process. He also mentioned that the fire service prefers candidates with degrees for their management positions, as the achievement demonstrates commitment and drive.
Hsieh advocated for the benefits a degree would afford individual providers. A degree is about longevity—access to the career ladder. Financial decimation after work injury is not unknown in EMS, as there are limited options for paramedics who cannot continue in the field. Combined with experience, particularly in allied fields such as bioresearch or medical sales, a degree can help ease providers into post-EMS careers.
Hsieh didn’t leave EMS educators off the hook. Teaching paramedics and EMTs is a complex task, and many EMS educators hold at least a bachelor’s degree. He charged them to move up to the master’s level to attain par with educators in other health professions, such as nursing.
Hsieh closed by mentioning the necessity of true self-governance. He noted that the National EMS Scope of Practice Model was not decided by paramedics—although many EMS-related groups contributed, it was driven by state EMS directors, whose regulations often cater to the least competent providers. He charged state directors to incorporate degree requirements for paramedics as well.
Hsieh cited other health professions that faced the same growing pains over degree requirements and advised educators and leaders to use those experiences to inform their planning. Higher education will not only influence higher-level clinicians but improve the leadership and business aspects of EMS as well. Higher-education requirements are about the profession of paramedicine, and until EMS providers become licensed and have a degree to practice, Hsieh warned, our progress will be hindered.
Amy Eisenhauer is a presenter at EMS conferences nationwide, raising awareness on topics such as provider suicide, response to hoarding events and career development for EMS professionals. As a certified emergency medical technician, she has served the New Jersey EMS community as a volunteer and career provider since 1995, in addition to roles as an EMS educator and training officer. She hosts an interactive blog at TheEMSsiren.com.