assist state and local EMS systems to ensure a more standardized approach to prehospital care by integrating contemporary knowledge and evidence- based guidelines. CHALLENGES TO INNOVATION EDUCATION REQUIREMENTS One of the most common issues raised by EMS stakeholders during surveys and focus groups concerned whether it is time for EMS to raise the educational bar for its providers. The sort of learning outcomes that paramedics are now routinely expected to convert to their clinical practice, particularly in terms of decision-making, could be considered graduate level. Meanwhile, their education is often not even recognized at the associate’s degree level. The US now has a plethora of paramedic programs rooted in community colleges, or in programs affiliated with colleges or universities. Current research reveals that some colleges are providing enough credits or hours to actually confer at least an associate’s degree, but the colleges aren’t providing the degree option to the student. 74 they are confronted by the fact that our current curricula are narrowly focused on life-threatening emergencies and do not match the distribution of medical complaints, complex environments and other issues that EMS routinely encounters where a lot of innovation could occur. They often also encounter barriers due to education models that are unfamiliar or poorly understood outside the industry. Hospitals, payers and other health care professionals are unable or unwilling to partner with EMS without proof of critical thinking As many EMS agencies seek to further integrate with health care and explore new services,
skills or credentialing that resembles that of an independent licensed practitioner. There is concern that a high school diploma is no longer sufficient to be recognized by other health care professionals. Thus, many now believe that the US should require an associate’s or baccalaureate education as a requirement to function as a paramedic. England, Canada, South Africa, New Zealand and Australia are all redefining the training requirements for paramedics. The United Kingdom’s National Health Service now requires that British paramedic candidates either complete a four-year university paramedicine science curriculum or become a student paramedic and study while working for an ambulance company. 75 At the University of Sheffield, nursing, paramedic and physician students share a common curriculum during the first two years of training, fostering a rich inter-disciplinary experience. VARIABILITY IN EDUCATIONAL QUALITY The debate on whether to update educational content and increase educational requirements is made more difficult by variability in how states regulate the quality of EMS education across states, and in some cases within states. There is a lack of consensus on training center certification, medical oversight requirements, and low penetration of accreditation of educational institutions. The problem Is compounded by the shortage of funds needed to attract qualified educators. Currently, many EMS educators lack formal training in adult learning principles and the completion of even brief workshops can serve as evidence of competency or meet credentialing requirements. As a result, the quality of EMS education and involvement of medical directors in training programs can fluctuate greatly.
74 Phelps, Scott. “Length of professional education of paramedics and nurses at community colleges in the Northeast United States.” Journal of Paramedic Practice 7, no. 7 (2015): 336-343. 75 “Entry requirements and training (paramedic)”. Health Careers. Accessed June 28, 2017. https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/paramedic/entry-requirements-and-training-paramedic
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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