September 9, 2011
CoAEMSP Site Visitor Scoop

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Institute of Medicine Report

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EMS Agenda for the Future

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American Academy of
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National Association of
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National Association of
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Additional CoAEMSP Interpretations Approved 


Recently the CoAEMSP Board approved new interpretations of the CAAHEP Standards, including: defining the requirements for articulation agreement, the composition of the Advisory Committee, and setting the program's minimums for patient encounters. The content shown in red was previously approved; the content shown in blue has been added to the interpretation.  


The document can also be accessed here.    


Standard:  I. A.1. Sponsoring Institution  

A sponsoring institution must be at least one of the following: 

1. A post-secondary academic institution accredited by an institutional accrediting agency or equivalent that is recognized by the U.S. Department of Education, and must be authorized under applicable law or other acceptable authority to provide a post-secondary program or to approve college credit, which awards a minimum of a certificate at the completion of the program.


3. A hospital, clinic or medical center accredited by a healthcare accrediting agency or equivalent that is recognized by the U.S. Department of Health and Human Services, and authorized under applicable law or other acceptable authority to provide healthcare, which is affiliated with an accredited post-secondary educational institution or equivalent or an accredited graduate medical education program, which awards a minimum of a certificate at the completion of the program.



1. This is a college, university, community college, junior college that is accredited by a regional or national institutional accrediting body. Vocational schools, proprietary schools, and religious schools may be accredited by regional accrediting agencies or specialized institutional accrediting bodies. A list of approved accrediting organizations can be found on the US Department of Education web site.     


If academic credits are not granted during the program offered in the academic institution (e.g., the program is offered through continuing education), there must be an articulation agreement for those who complete the program. 


3. A hospital, clinic, or medical center may be a sponsor under certain conditions. The hospital, clinic, or medical center must maintain permanent records, must insure quality of the program, and must assure that all fair practices are followed.


A hospital, clinic, or medical center, may be a sponsor under # 3:

-   It must be accredited by The Joint Commission or its equivalent, and authorized by the State to provide health care

-   It must have one of the following:

  • An accredited allied health program where the entity is the primary sponsor   OR

An office of graduate medical education with at least one:

  • residency program for post-graduate physician education  OR 
  • An articulation agreement with an accredited educational institution (Standard I.A.1) which can provide college credits for the training

An articulation agreement is an agreement between an educational institution and a training facility to provide college credit to individuals completing the training program. This agreement allows students to receive college credit if they enroll at the educational institution; it does not require that students who do not register receive college credit.     


The articulation agreement may be composed as a memorandum of understanding, transfer agreement, or other suitable instrument, as long as the requirements of articulation are met.


Standard:  II. B. Program Goals - Appropriateness of Goals and Learning Domains  

The program must regularly assess its goals and learning domains. Program personnel must identify and respond to changes in the needs and/or expectations of its communities of interest.


An advisory committee, which is representative of these communities of interest, must be designated and charged with the responsibility of meeting at least annually, to assist program and sponsor personnel in formulating and periodically revising appropriate goals and learning domains, monitoring needs and expectations, and ensuring program responsiveness to change.



B. The Advisory Committee must meet at least once a year and review the goals, outcomes for the classes in the last year and make recommendations to the program.


The Advisory Committee meetings should also include review of achievement of goals, analysis of the goals, action plan, and results of action where appropriate.


There must be an Advisory Committee roster indicating the communities of interest that the members represent.


Police and fire services would be represented, if they have a role in EMS in the community served by the program.


A key governmental official, where appropriate, could include an elected official, an appointed public official, an individual involved in emergency management, or other public official.


The public member of the Advisory Committee should be a person who has valuable input to the program. The public member should not be employed by the sponsor or a clinical affiliate and should not qualify as any other named sponsor representative.


The Advisory Committee meetings must have Minutes reflecting the attendees, and meaningful discussion and actions during the meeting.


Standard:  III. A. 2. Resources - Type & Amount - Hospital/ Clinical Affiliations and Field/Internship  Affiliations 

For all affiliations students shall have access to adequate numbers of patients, proportionally distributed by illness, injury, gender, age, and common problems encountered in the delivery of emergency care appropriate to the level of the Emergency Medical Services Profession(s) for which training is being offered.


2. The clinical resources must ensure exposure to, and assessment and management of the following patients and conditions: adult trauma and medical emergencies; airway management to include endotracheal intubation; obstetrics to include obstetric patients with delivery and neonatal assessment and care; pediatric trauma and medical emergencies including assessment and management; and geriatric trauma and medical emergencies.


The program must set and require minimum numbers of patient contacts for each listed category.  Those minimum numbers must be reviewed and approved by the Medical Director and the Advisory Committee with documented endorsement of those numbers.  The tracking documentation must then show those minimums and that each student has met them.  There must be periodic evaluation that the established minimums are adequate to achieve competency.


The objectives must clearly state the intent of the rotation and outcomes required. While the specific units/rooms may provide the type of patients to meet the objectives, there are likely other locations and creative activities that can provide the necessary type of patient encounters.


The access and availability of the patients is the critical issue. The location of the experiences is at the discretion of the program. For example, psychiatric patient exposures may occur in the emergency department.


Live patient encounters must occur; however, appropriate simulations can be integrated into the educational process to provide skills acquisition, develop skills proficiency, provide practice opportunities for low volume procedures, and ensure competency prior to exposure to a patient. The program must show that this method of instruction is contributing to the attainment of the program's goals and outcomes.


Evaluation of the clinical and field internship sites should be done by the program. They should ensure, through tracking (Standard III.C.2) that the clinical and field internship sites provide the minimum requirements for competency (See II.C and IV.A.1).


Standard:   II.B.a.1) Resources - Personnel - Program Director - Responsibilities [Preceptor Training]

The program director must be responsible for all aspects of the program, including, but not limited to:

1) the administration, organization, and supervision of the educational program,


1) As part of the administration, organization, and supervision of the program, the Program Director must ensure that there is preceptor orientation/training.


The training/orientation must include the following topics:

  • Purposes of the student rotation (minimum competencies, skills, and behaviors)
  • Evaluation tools used by the program
  • Criteria of evaluation for grading students
  • Contact information for the program

The training media may take many forms: written documents, formal course, power point presentation, video, on-line, or there could be designated trainers on-site that the program relies on. The program should tailor the method of delivery to the type of rotation (e.g. hospital, physician office, field).


The program must demonstrate that each field internship preceptor has completed the training. For example, there may be an on-line session documenting completion by the preceptor, or there may be a written packet provided by the program, which is read and signed by the preceptor at the start of the rotation, or a representative of the program may meet briefly with the potential preceptors at that location. 


For field internship experiences, the program should focus on the evaluation of the experience, but that evaluation must include an evaluation of each active preceptor.


There must be an orientation offered for at least key hospital and other clinical experience personnel. The program can then arrange to have those key personnel provide guidance to other hospital preceptors, if needed.


For clinical experiences, the program should focus on the evaluation of the experience, but that evaluation must include at least an overall, not necessarily individual, evaluation of the preceptors.

The program must provide evidence of the completion of the training of field internship preceptors by dated rosters of participants, on-line logs, signed acknowledgement by the internship preceptor.


The accreditation Standards are the minimum standards of quality used in accrediting programs that prepare individuals to enter the EMS Profession. The accreditation Standards therefore constitute the minimum requirements to which an accredited program is held accountable.


The CoAEMSP Interpretations of the CAAHEP Standards and Guidelines is a companion document that contains the interpretations adopted by CoAEMSP through policies. The interpretations are NOT part of the CAAHEP Standards document and are subject to change by CoAEMSP. Policy revisions may occur often, so this document should be reviewed frequently to ensure the most current version. Questions regarding the interpretations can be directed to the CoAEMSP Executive Office.


Site Visitor Update at NAEMSE Symposium 2011    


Please stop by the CoAEMSP Booth, #415, at NAEMSE Symposium 2011 to say hello to Doug, Deb, and George, ask the experts your questions one-on-one, and find out what is new with site visits and visitors. We look forward to seeing you!


Tweaks Coming to Self Study Report, Executive Analysis Documents...and More 

The QA Subcommittee is reviewing the self study report (ISSR, CSSR) forms and the executive analysis forms to identify areas that need tweaking. 


If you have suggestions for revisions, please email them to Patricia Tritt.  

Reviewing Electronic Student Records for CoAEMSP Site Visit


The CoAEMSP Board approved a new policy to assist site visitors and program directors during the site visit process with the review of electronic student records.



The purpose of this guideline is to provide a framework for the review of student records when they are in electronic format for a accreditation site visits.



Electronic record systems, while encouraged, provide some challenges for site visitors as the visitors may not have access to the records, may not be proficient at reviewing electronic records, or may not understand the structure of the record system.


Responsibilities of the Program

In advance of the site visit, the program must supply the CoAEMSP site visit team with a complete list of students who completed the last full program prior to the site visit. The program would also send a list of students who are incomplete or who are no longer in the program (disciplinary action, counseling?). CoAEMSP will select the names of three students successfully completing the program plus one or more of the students who did not complete the program. The program can choose one of the following four methods to allow the site visit team to review the electronic records.


Method 1 In advance of the site visit, the school can provide the site visit team with an ID and password that will allow access to the complete student record. The school must provide instructions to find each portion of the student record.


Method 2 The school can provide an electronic copy of the selected records by email, thumb drive, or CD. The school must provide instructions to find each portion of the student record.


Method 3 The school can allow the team to access the files at the time of the visit. If this option is used someone who understands the filing system must be present to assist the team in accessing various portions of the records.


Method 4 The school can print out the complete records on paper of the requested student files and either send them to the team in advance or have the paper records at the time of the site visit.


The electronic signature will be accepted as long as program has a policy and password protected.


Friendly Reminders 


By the end of 2011, you will have conducted nearly 120 site visits! That is a 50% increase over last year and three times more than the year before that! THANK YOU!


When you conduct your next site visit, please remember a few key items:

  • CAAHEP. CAAHEP. CAAHEP. Programs are seeking CAAHEP accreditation. Remember to refer to the CAAHEP Standards and the CAAHEP accreditation process. Not CoAEMSP. There are 20 Committees on Accreditation (CoA) that participate in the CAAHEP system of accreditation.  They work in cooperation with CAAHEP by managing the accreditation process in their respective professions and then forwarding recommendations for accreditation to CAAHEP. 
  • Possible accreditation status. CoAEMSP makes a recommendation for accreditation based on the program's accreditation record and the degree to which it meets the Standards. The recommendation options are different depending on if the program is seeking initial or continuing accreditation:
    - initial accreditation: initial accreditation, withhold accreditation
    - continuing accreditation: continuing accreditation, probationary accreditation
  • Site Visit Report. Are you using the most current version of the Site Visit Report? How do you know? The current version has a distinct change: a column on the far left was added with the Standard reference. In addition, the footer of each page will include the date 11/10. Download a blank Site Visit Report. (Look under 'Site Visit Tools' for 'Site Visit Report Blank').
  • Photos / Name Badges. For the past year the CoAEMSP has been phasing in new photo identification name badges. If you are missing your name badge, please email Jennifer to request one. If you still need to submit your photo, please do so to Jennifer.
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Jennifer Anderson Warwick, MA