September 20, 2011 
News from the CoAEMSP

In This Issue
Quick Links
CoAEMSP Website

CAAHEP Website

NREMT Website

Institute of Medicine Report

National EMS Scope of Practice

EMS Agenda for the Future

Education Standards

National EMS Core Content 
American Academy of Pediatrics (AAP)

American Ambulance Association (AAA)

 American College of Cardiology (ACC)

American College of Emergency Physicians (ACEP)


 American College of Osteopathic Emergency Physicians (ACOEP)

 American College of Surgeons (ACS)

 American Society of Anesthesiologists (ASA)

 International Association of Fire Chiefs (IAFC)

 National Association of Emergency Medical Services Physicians (NAEMSP)

 National Association of Emergency Medical Technicians (NAEMT)

 National Association of EMS Educators (NAEMSE)

 National Association of State Emergency Medical Services Officials (NASEMSO)

 National Registry of Emergency Medical Technicians (NREMT) 
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CoAEMSP Site Visits:
Before, During & After  


WebinarThursday, October 27, 2011
1PM Central


Learn the process for coordinating and hosting a CoAEMSP/CAAHEP site visit. You'll find out what to do to prepare, what to expect during the site visit, and what is expected after the site visit occurs. Time will be alloted for questions and answers. Take advantage of this free learning opportunity to make the site visit a successful process.




Curriculum: Does Sequencing Matter?    

by Patricia L. Tritt, RN, MA

Paramedic education consists of a vast amount of medical and related content relevant to the assessment and management of patients in the prehospital setting. The best, or most appropriate, method to sequence that content is more complex than it might first appear. Many programs offer between 35 - 45 college credit hours for just this specific content: not including anatomy and physiology or other general education courses offered through the college. Contact hour numbers vary widely but commonly fall between 1100 - 1500 hours. In addition, paramedic programs include four primary components: classroom or didactic; skills laboratory; clinical setting; and field internship experience. The amount of time required for program completion can vary from an accelerated, full-time format of six-months to 18 - 24 months. In addition, prerequisites vary from none (no experience as an EMT) to a minimum of one year experience as an EMT. Some programs have developed discrete content blocks into the traditional college two, three, or four hour credit hour courses. This approach has many advantages, including providing a mechanism for a student-content area to be able to repeat just the necessary course (for example pharmacology). The traditional college credit course approach also provides easier access to articulation of credits as the individual moves through the higher education process. Whatever your format or prerequisites, programs must determine how to sequence that content to maximize the development of competent, entry-level graduates.


How do you analyze sequencing? The National Standard Curriculum provided a general road map for progression that many programs followed. The National EMS Education Standards open the opportunities for more creative sequencing. The challenge is what content is required before other topics? This subject alone can provide animated, heated discussion among educators. A common sense approach is required to determine what works best for your institution and the schedule you follow: for example, does the class meet for three or four hours per session or all-day eight hour classes? And how often do classes meet each week?

But perhaps the larger question is how are the clinical (hospital, clinics, or other sources of 'clinical' experience) and the field internship integrated into the overall program? Unfortunately, some programs schedule clinical and field hours based on availability and convenience rather than how prepared the students are based on medical content already mastered in the classroom and skills labs. For example, how valuable is a hospital clinical in a pediatric setting if the student has not completed the pediatric course content? The clinical rotations should provide an opportunity to perform assessments on all types of patients and to practice skills after the student has satisfactorily completed the relevant course content.

In the field of medicine an internship follows completion of medical school. In other words, the individual has the core information necessary to apply the practical skills already gained, yet the individual is not ready for licensure. The intent of the field internship in the paramedic program is to provide the opportunity to assess and manage all types of calls and develop experience team leading. In other words, to pull the experience learned in the classroom, skills lab, and clinical areas together to assess, manage, and treat all types of patients in the prehospital setting. Per the Guideline in the Standards and Guidelines, "Enough of the field internship should occur following the completion of the didactic and clinical phases of the program to assure that the student has achieved the desired competencies of the curriculum prior to commencement of the field internship. Some didactic material may be taught concurrent with the field internship." Content that is concurrent with the field internship should not be core content but may be case reviews and case presentations, research presentations by students, completion of standardized courses (i.e. PHTLS or PALS), and other supportive content such as preparing resumes, interviewing for positions, etcetera.

A further challenge is how long should the field internship be? Internship is not only about hours, but must also consider the length of the shifts, the volume and types of patients encountered, and the opportunities for the student to meet all of the terminal competencies and objectives for graduate entry level competency. Another factor that significantly impacts the quality of the field internship is the structure of the preceptor/student experience. Ideally, the student should be assigned to a single preceptor for the duration of the field internship to provide optimal opportunity to develop a relationship of trust that promotes honest, objective assessment of the student and the maximum opportunity for the student to function as team lead. A second preceptor is also acceptable when scheduling issues provide challenges. In the preceptor de jour approach, this climate of familiarity and trust is typically lost and the rotations lose value.

Some programs choose to schedule field shifts throughout the program. Early on, these experiences are often observational only or with some assessment and skill opportunities. These rotations should be considered field experience and may not be included as field internship since it does not meet the definition/requirements of an internship. Carefully consider what part of your field hours actually meets the definitions/requirements of an internship.

Try taking your curriculum apart and putting it back together again. Assemble your faculty and medical director and: chunk objectives and course content into logical components; list specific clinical rotations; and identify types of field experiences. Write each one on a sticky note and arrange on a white board. Continue to move around until you have a logical progression. Or find another creative way to approach the process of assessing your curriculum. But always keep the goals and objectives of the four components of the program at the fore. Trial the revised format and evaluate and repeat the process until you are confident that your students are receiving the very best experience possible.


EMS Agenda Changes Will Affect You     

by Debra Cason, MS, RN, EMT-P and Kathy Robinson, RN, EMT-P



Over the next two or three years, you and your EMS colleagues will receive new professional names, knowledge, skills and recertification requirements. Change seems to be inevitable in EMS-and medical care in general. But these new changes that will affect you aren't new. They are, in fact, 11 years in the making.

Read the complete article originally appearing in the September, 2011 issue of JEMS 



Program Director - Personnel Change Update      

Updates related to changes in the Program Director's position are provided below in BLUE.     


Programs experiencing a change in the Program Director's position, whether it is a temporary change or a permanent change, must submit the following:


1. A completed Personnel Change Form which may be found on the CoAEMSP website here.     


2. Submission of the following documentation as outlined on the Personnel Change Form for a Program Director:

  • Letter of Appointment/Acceptance
  • CV showing formal education with a minimum of a Bachelor's degree and related experience
  • Copy of either the National Registry or State license
  • To demonstrate compliance with CAAHEP Standard III.B.1.b.1), an official sealed transcript is required to be mailed to the CoAEMSP Executive Office from the institution awarding the individual's highest academic degree.

3. The CoAEMSP Executive Office must be notified of the Program Director vacancy no later than fifteen (15) calendar days following the effective date of the vacancy.    


4. The Program Director vacancy must be filled either on a temporary, acting, or permanent basis within thirty (30) calendar days following the effective date of the vacancy


For a more detailed description of the CoAEMSP Policy and Procedures regarding a change in the Program Director's position, please review our Policy and Procedure Manual posted on our website here.  


Avoid a Potential Non-Compliance
Key Program Personnel Positions Cannot Be Shared

As the Paramedic profession continues to grow and more programs become accredited, some institutions find it difficult to secure qualified faculty and staff to manage their Paramedic education programs. Every program must have at least two "key" personnel and they are the Program Director and the Medical Director. With the requirement of a minimum of a Bachelor's degree for the Program Director, institutions may find themselves asking the Medical Director to step into that administrative role, either on a temporary or acting basis, while a national search is undertaken to fill the Program Director's position. Hence, the Medical Director now serves in two key personnel positions.


Following CoAEMSP Policy and Procedures (XII.2) "An individual cannot concurrently hold more than one Key Personnel position at that program." The CoAEMSP appreciates situations that may occur at times due to a vacancy in the program administrator's position. However, to avoid a situation which could jeopardize the program's accreditation, the CoAEMSP wanted to notify you of this policy in advance of a potential non-compliance. We encourage each program to review the personnel policies and procedures posted on our website here. 


Please contact the CoAEMSP Executive Office at 817.330.0080 any time if we may be of any further assistance.


One-on-One Sessions Now Available After the Workshop!
Attend the November Accreditation
Workshop in Atlanta 



Monday, November 14, 2011, 8:00 AM ET

to Tuesday, November 15, 2011, 12 noon ET


The Omni Hotel at the CNN Center

100 CNN Center 

Atlanta, GA  30303

(404) 659-0000


Accreditation Workshop: STEPS TO SUCCESS


Register Now  

This comprehensive one-and-a-half-day accreditation workshop will arm you with all you need for a successful accreditation experience. You will receive hands-on instructions and guidance. Plan to attend now.   


Join us for an informative workshop, which will include the:

  1. Concept and overview of accreditation 
  2. Process of accreditation 
  3. Steps to the self study report with examples 
  4. Site visit process--how to prepare for it and what happens during and after the visit 
  5. Common stumbling blocks to accreditation and how to overcome them

NEW! Following the conclusion of the workshop at noon on Tuesday, November 15, presenters Dr. Hatch, Ms. Cason and Mr. York will be available for individual 15-minute sessions from 1:00 to 3:00 pm. These special 15-minute sessions will be based on time availability and requests made in advance. A sign-up roster will be available at the beginning of the workshop.


EARLY BIRD REGISTRATION fee is $300 through October 14, 2011. Beginning October 15, 2011, the registration fee is $350. This fee includes the cost of the workshop plus breakfast, lunch and breaks each day.  




Program Director Responsibilities


by Linda V. Anderson, RN, BSN, Director Paramedic Education 

Santa Rosa Junior College/Public Safety Training Center,
Windsor, California


In a recent CoAEMSP article by Patricia Tritt, RN, MA, internship sites were compared to rare minerals: "sometimes hard to find, must be mined carefully and should be guarded jealously".


To continue Pat's analogy, who is the person responsible for these tasks? The miner and keeper of the minerals is the Program Director! The responsibility of managing a Paramedic program rests on the shoulders of the Program Director (PD) and the scope is far beyond mining the minerals. The CAAHEP Standards and Guidelines state that the PD must be responsible for all aspects of the program. The Standards outline six (6) very specific areas and ends with the "including, but not limited to" caveat. Access the interpretation and refer to:
III. Resources-B.Personnel-1.Program Director-a.Responsibilities.    

Let's review the responsibilities: 


The PD must be responsible for all aspects of the program including....    


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


This Standard says it all and encompasses the job of the PD; however, it is important to examine some of the specifics that are of particular importance. Among the responsibilities of managing a program, the PD is tasked with ensuring the hiring and evaluation of all faculty and staff; the organization, review and revision of curriculum; scheduling classes, internship rotations, overseeing admissions and record keeping of students, and maintenance of accreditation documentation including the Annual Report. The PD must be current with educational trends and assure that his/her program maintains the highest standards possible.


An area often overlooked speaks to the supervision of preceptor training and orientation. This can be a challenge, especially for programs that utilize multiple agencies that may have their own preceptor requirements. Some programs must also depend on agencies to assign preceptors; ensuring that all preceptors are trained to a specific standard can be daunting. The PD must also be aware of the differences between clinical (hospital) and field internship preceptor training requirements. Although all preceptors in a field internship environment must go through the preceptor training, a clinical (or hospital) site requires that only one key person be trained. The CoAEMSP interpretation of this CAAHEP Standard is a useful reference for addressing this. Access the interpretation and refer to:
III.Resources-B.Personnel-1.Program Director-a. Responsibilities.


2) The continuous quality review and improvement of the educational program.


As with any continuous quality improvement (CQI) program, a plan must be in place to trend issues and develop an action plan for continuous improvement. The Advisory Committee is a necessary component in identifying issues, determining an action plan, and evaluating the results.  

Minutes from the Advisory Committee meetings provide documentation of monitoring issues and the prescribed solutions. Your communities of interest (COI) are a valuable resource for CQI. Completion of the Program Resource Assessments by both personnel and students on an annual basis allows for documented mapping of a CQI plan as well.


3) Long range planning and ongoing development of the program.


Again, collaboration with the Advisory Committee and completion of the Resource Assessments Matrix (RAM) helps identify those areas that need to be changed or discontinued. The RAM becomes a basis for the important financial discussions with your Dean or CEO.


4) The effectiveness of the program and systems in place to demonstrate the effectiveness of the program.


This responsibility sounds very much like #2, however, the focus is ensuring students are meeting terminal competencies. All students who graduate must meet the terminal competencies. Does the program have an effective and reliable tracking system that documents the students' experiences and methods of evaluation? This is part of the overall program evaluation system that should involve faculty, students, Medical Director, Advisory Committee and all communities of interest.


5) Cooperative involvement with the Medical Director.


Medical Directors (MD) typically contract with programs because they have an interest and desire to further the quality of patient care in their system. However, some Medical Directors possess more passion and time for this worthy goal than others. Because the MD is responsible for all medical aspects of the program, the PD must ensure that these responsibilities are being met.  Interacting with students in the clinical environment and participating in classroom and lab activities is optimal. Saving all e-mails and other correspondence, and developing checklists or sign-off sheets for the MD are helpful for the CAAHEP accreditation process. View the Standards and interpretations for the Medical Director here.


6) Adequate controls to assure the quality of the delegated responsibilities.


It is clear that in order for the PD to meet all of the above, he/she must commit significant time and energy. The PD must be a good time manager who is able to delegate many of the vital tasks to trusted faculty and other colleagues and have an effective and continuous evaluation system. However, the PD must supervise individuals who are tasked with clinical coordination, preceptor training, skills labs, and all of the other "including, but not limited to" tasks.


This is a very short overview of a Program Director's responsibilities. Above all, a Program Director must have strong managerial skills with good knowledge of the educational process for EMS students. A sense of humor, tolerance and patience are equally important traits that will make a difference in the success of his/her EMS educational program.


Meet Board Member

Chief David S. Becker

David Becker


Chief David Becker currently serves as the EMS (Emergency Medical Services) Program Director at Sanford-Brown College in St Louis, Missouri. He is also an adjunct instructor for Colorado State University Fire and Emergency Services Administration Bachelors degree program.


Chief Becker received his initial EMS training and certification in 1975 and has held a current Paramedic license since 1977. Chief Becker has worked for twenty two years in the fire service with fifteen years as a Chief Officer.


For the past 14 years, Chief Becker has served on the Executive Committee of the EMS Section for the International Association of Fire Chiefs (IAFC). He is currently the Vice-Chair of the Section. In 2006 he was appointed to work on the Educational Standards Project as the Core Content Leader for Operations through a project for NHSTA. In addition to representing the IAFC for CoAEMSP, Chief Becker also serves on two other national committees including CAAHEP and EMS Management Degree Curriculum Development for FESHE at the National Fire Academy.


Chief Becker has been a speaker at several National Fire and EMS conferences and has published over 60 articles related to EMS and Fire Service operations. He is the author of a Prentice-Hall Brady book titled "Company Officer Promotional Case Studies".


Chief Becker has also conducted consulting on a part-time basis for EMS firms across the United States. He has experience in policy and protocol review and development, along with system design and improvement. 


Chief Becker received a B.S. in Administration from Lindenwood College, St. Charles, Missouri; and a M.A. in Health Services Management from Webster University, St. Louis, Missouri. 


Site Visitor Highlight:

Karen Pickard, RN, BSN, LP

Karen is the Faculty/CE/QA/QI Programs Director in Emergency Medicine Education at the University of Texas Southwestern Medical Center.  She has over 40 years of experience in emergency medicine, first becoming a staff nurse in the Emergency Department at Parkland Memorial Hospital in Dallas, Texas. Since then, Karen has gained significant experience as a Director of Nursing Services, EMS Education Coordinator, EMS Instructor, and Crisis Intervention and Management Coordinator. She has also been the Chairperson for the Main Street Project in Ovilla, Texas for 18 years, and served on the Executive Board of the North Texas Firefighters Association for 17 years. 

Karen is a member of numerous professional organizations including the Emergency Nurses Association, NAEMSE, NAEMSP, International Critical Incident Stress Foundation, North Texas Firemen and Fire Marshals Association, and National Society of Executive Fire Officers. Karen is also the Founder of the Dallas Area Crisis Response Team, Inc. and served as its Coordinator and President until 2003. 

Karen holds numerous certifications including Advanced Cardiac Life Support Provider, Advanced Cardiac Life Support Instructor, BTLS Provider and Instructor, and BTLS Regional Director. 


Karen has been the recipient of numerous honors and awards, and has made presentations on a variety of topics related to emergency medicine. 


Meet Our Sponsors:

American College of Emergency Physicians 



The American College of Emergency Physicians (ACEP) is the leading advocate for emergency physicians and their patients. ACEP promotes the highest quality of emergency care and is the leading advocate for emergency physicians, their patients, and the public. Founded in 1968, ACEP today represents more than 28,000 emergency physicians, residents and medical students. ACEP members are dedicated to high quality patient care, teaching, leadership, research, and innovation.

The ACEP Board of Directors represents a wide variety of backgrounds and work experiences in emergency medicine. And with new members joining every year, there are different perspectives and personalities year in and year out. Four standing committees are provided in the Bylaws and currently 26 others provide important leadership to ACEP members, its Board and Council. Each Committee is appointed by the President to assist with activities for the year.

ACEP has more than 30 committees and task forces working on issues such as ethics, emergency medicine practice, pediatric emergency care, disaster medicine and more.
 ACEP committees are members appointed by the President to assist the Board of Directors in its work and serve as work groups with specific responsibilities assigned by the President. Committee members serve for a specific period of time and are accountable to the President for achievement of assigned objectives. 

Chapters advocate for the rights of physicians and their patients to ensure the delivery of the highest quality emergency care.

ACEP provides its members opportunities for professional development, continuing education, advocacy and more. 




Medical Director Marvin Wayne, MD:
Impact of Accreditation to EMS                  

Marvin Wayne, MD


Having served as a pioneer in the development of educational standards for the education of paramedics it gives me pleasure to comment.

In the early days of paramedic education there were no standards, and a paramedic in one area may have been educated with no similarity to one in another. The teaching programs were either whatever a state demanded, or where no rules occurred-whatever the school or mom and pop organization decided upon.

With the advent of standardization, states now have a national standard to work from, and schools have a standard to meet. A paramedic in one accredited program should be able to meet the minimum standard of one trained in another accredited program.

No other organization has made as much of an impact on paramedic training as has CoAEMSP. Hopefully this accreditation process will serve the provider and patient long into the future."



Marvin A. Wayne, MD

Medical Program Director
Whatcom County
Bellingham, WA


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Jennifer Anderson Warwick, MA