As the EMS industry seeks to promote innovation amidst a quickly evolving health care system, it is essential to evaluate how Emergency Medical Services (EMS) should educate its next generation of prehospital providers. What are the competencies to which EMS providers should be trained? How will they be taught and by whom? Ultimately, where on the spectrum of health care educational requirements will EMS providers be represented along with medical assistants, technicians, nurses, pharmacists, physician assistants, therapists, nurse practitioners, physicians and others?
HISTORY AND CURRENT PROGRESS The United States (US) has a long history of pursuing solutions to EMS education. The National Registry of EMTs (NREMT) was created in 1970 in response to a recommendation by President Johnson’s Committee on Highway Traffic Safety that the U.S. establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance service. 67 In 2000, the EMS Education Agenda for the Future: A Systems Approach 68 proposed the creation of a national strategy to maximize efficiency, develop consistent instructional quality, and enhance student competence. Five essential education components were identified: a national core content, a scope of practice model, educational standards, a process of program accreditation, and EMS certification. Significant progress has occurred on all of these fronts. In 2005, the National Core Content was released 69 , and in 2006 the National Scope of
Practice Model 70 defined four nationally recognized levels of EMS providers (emergency medical responder, emergency medical technician (EMT), advanced EMT and paramedic) along with their respective minimum entry-level knowledge and skills. In 2009, the National EMS Education Standards 71 were published, which defined competencies, clinical behaviors and judgments required for entry-level EMS personnel. In 2013, the NREMT announced that paramedic applicants would henceforth be required to graduate from nationally accredited education programs. Further, states and territories that use the NREMT paramedic assessment exam for licensure were required to commit to implementing the national EMS program accreditation requirement by 2018 in order to retain access to the exam. 72 In 2014, the National Association of State EMS Officials (NASEMSO) National Model EMS Clinical Guidelines 73 were released by the NASEMSO Medical Directors Council. These guidelines will
67 “The History of the NREMT and EMS in the United States.” National Registry of Emergency Medical Technicians . Accessed June 28, 2017. https://www.nremt.org/rwd/public/document/history. 68 “Emergency Medical Services Education Agenda for the Future.” National Highway Traffic Safety Administration . Accessed June 28, 2017. http://www.nhtsa.gov/people/injury/ems/EdAgenda/final/ 69 “National EMS Core Content.” National Highway Traffic Safety Administration . Accessed June 28, 2017. http://www.ems.gov/education/EMSCoreContent.pdf 70 “National EMS Scope of Practice Model.” National Highway Traffic Safety Administration . Accessed June 28, 2017. https://www.nremt.org/nremt/downloads/Scope%20of%20Practice.pdf 71 “National Emergency Medical Services Education Standards.” National Highway Traffic Safety Administration. Accessed June 28, 2017. http://www.ems.gov/pdf/811077a.pdf 72 “The History of the NREMT and EMS in the United States.” National Registry of Emergency Medical Technicians. Accessed June 28, 2017. https://www.nremt.org/rwd/public/document/history.
73 “National Model EMS Clinical Guidelines.” National Association of State EMS Officials. Last modified November, 2014. https://nasemso.org/Projects/ModelEMSClinicalGuidelines/documents/National-Model-EMS-Clinical-Guidelines-23Oct2014.pdf
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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