Latest News from CoAEMSP

By Patricia L. Tritt, RN, MA & Debra Cason RN, MS, EMT-P

Have you ever heard the refrain in EMS: "Why won't they treat us as professionals?"

Are you familiar with the defining characteristics of a profession? Some of the characteristics include: skill based on theoretical knowledge; extensive period of education where specialized practical experience is provided; testing of competence; formal qualifications based upon education; regulation (typically) by statute; affairs of its members regulated by professional bodies; training involving obtaining degrees and professional qualifications; regular up-dating of skills through continuing education; and standardization of professional training.

So how do we stack up? There are some hits and some misses. But a recurring theme appears to be education: and of course not just any education but quality education. How do we assess quality in EMS 'training' programs? And by the way, is it 'training' or is it 'education'? There is an old saying, after all, that we train pets but we educate people.

Quality begins by evaluating ourselves against a set of industry established standards. Do we meet the minimum Standards and Guidelines set by our peer group under the auspices of the Commission on Accreditation of Allied Health Education Programs (CAAHEP)? That is really how accreditation works in Paramedic education--and every other health profession field. We evaluate ourselves against the CAAHEP Standards. The most recent Standards and Guidelines were established by the EMS community in 2005. Once we evaluate ourselves against these Standards and Guidelines and document our findings, we invite our peers to come to our program and see for themselves how it is done. They will look for the following: How we deliver our services; how we evaluate the competency of our graduates; how we assure that each graduate is competent--not just in what he/she knows but also how he/she performs and behaves professionally.

A ten year old document titled the EMS Education Agenda for the Future calls for a system of education in EMS that is similar to other health professions. That system has not previously existed in EMS education because our birth, growth and development have taken a different path than most health professions. EMS has definitely grown and matured but our system of education has primarily been dependent on a single component: a national standard curriculum. The authors of the Education Agenda, and the many groups and individuals that provided input into the document, called for a system that included a systematic development of education standards and graduation from an accredited Paramedic program in order to take the national credentialing exam. This system approach is common and expected in other more mature health professions as well as other disciplines. This 2000 document was not the first time that accreditation was called for by the EMS community. The 1996 document EMS Agenda for the Future recommended "accreditation should be sought to demonstrate that educational programs provided meet a predefined national standard of quality."

Since that time, research has been published that validates the role of accreditation in quality. Current research articles published in peer-review academic journals indicate an increased success rate on national certification exams from graduates of nationally accredited Paramedic programs.*

After years of discussion, in June 2008, the NREMT Board of Directors formally discussed the possibility of requiring graduation from a CAAHEP accredited program in order to take the Paramedic NREMT exam. Discussion included concerns about acceptance of the concept by state governments, EMS provider agencies, Paramedic education programs as well as others. More discussion followed about how long the EMS community has discussed the concept, how many other professions require accreditation, that the NREMT is the only entity that could make the change, and that the role of the NREMT is to protect citizens. In June 2008, the NREMT Board decided to table any action and continue these discussions with the EMS community.

In November 2008, the NREMT board voted to require graduation from a CAAHEP accredited program in order to take the NREMT exam beginning 2013. As predicted, many agencies and governments and individuals were distressed about the impact of the plan. And yet, many were also saying that the time had come and why continue to discuss accreditation without any movement in the direction recommended 14 years ago? Many have said this is the path to professionalism and they want to travel there along with their colleagues.

The CoAEMSP has been reaching out to state officials, professional organizations such as the IAFC, NAEMSE, NASEMSO, and individual institutions to provide information on accreditation, the benefits, and the process. These forums for discussion and technical assistance facilitate the preparation of Paramedic programs that are not currently accredited and provide guidance in completing the process. One of the incentives for early submission of a self study provides additional time for a program director to obtain a Bachelors degree if the initial self study is submitted before January 1, 2011. Many new tools, such as sample documents and reports, have been developed to assist programs and are available at coaemsp.org. If you would like more information or if you would like a CoAEMSP member to address your organization, call 817-330-0080.

The accreditation process is one more step toward the acceptance of Paramedics as 'professionals' and accreditation as credible education.

RESOURCES

*"Estimating the Probability of Passing the National Paramedic Certification Examination", Antonio R. Fernandez, BS, NREMT-P; Jonathan Studnek, MS, NREMT-P; Gregg S. Margolis, PhD, NREMT-P (2008).

"Program Accreditation Effect on Paramedic Credentialing Examination Success Rate", Philip Dickison, RN, BBA; David Hostler, PhD; Thomas E. Platt, Med; Henry E. Wang, MD, MPH (2006).

"Strategies of High Performing Paramedic Programs", Gregg Margolis, PhD, NREMT-P; Gabe Romero, MBA, NREMT-P; Antonio R. Fernandez, BS, NREMT-P; Jonathan Studnek, PhD, NREMT-P (2009).

Patricia Tritt, RN, MA is Director of EMS and Trauma at HealthONE EMS in Englewood, CO. She is also a member of the Board of Directors for the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP).

Debra Cason, RN, MS, EMT-P is the Program Director and Associate Professor of Emergency Medicine Education at the University of Texas Southwestern Medical Center, Dallas, Texas. She is also Vice-Chair of the Board of Directors for the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP).