National ems education standards transition template

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National Emergency Medical Services Education Standards

National EMS Education Standards
Transition Template
A Comparison of EMS Knowledge and Skills to Assist the Transition and Implementation of the National EMS
Education Standards for the
EMT-Basic to Emergency Medical Technician
June 2011
National Association of State EMS Officials
Falls Church, VA
Background:
In 1996, the National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration (HRSA) published the national consensus document
titled EMS Agenda for the Future (Agenda.) The intent of the Agenda is to create a common vision for the future of EMS and is designed for use by government and private
organizations at the national, state and local levels to help guide EMS planning, decision making, and policy. In 2000, the Agenda was followed by the EMS Education Agenda
for the Future: A Systems Approach (Education Agenda). Since the release of the Agenda, the National EMS Core Content (Core Content), National EMS Scope of Practice
Model (Scope of Practice Model), and the National EMS Education Standards (Education Standards) have been completed and published along with Instructional Guidelines
geared to each practitioner level. States license EMS personnel and EMS agencies as a means of ensuring public health and safety. Because of this common and important
function, the National Association of State EMS Officials (NASEMSO) has taken the lead in coordinating implementation of the Education Agenda. Because states may need to
revise or develop processes to facilitate a smooth transition from the U.S. Department of Transportation National Standard Curricula (NSC) to the new Education Standards, the
National Association of State EMS Officials (NASEMSO) collaborated with a panel of experts and several national stakeholder groups to establish a Gap Analysis Template in
2009. States were encouraged to consider several important factors to implement of the Education Standards:
Individual states are encouraged to use the National EMS Scope of Practice Model as a foundation to establish state EMS practitioner levels.
Individual states are encouraged to use the Gap Analysis Template to help define system processes that support the transition of EMS practitioners to the state-adopted
scope of practice.
The Education Standards promotes increased flexibility, encourages creativity within each EMS education program and encourages alternative delivery methods. The
Education Standards do not represent a prescriptive sequence or content grouping for a class presentation. States and/or educational programs will need to determine
the sequence for teaching the materials.
Course outcome evaluations should be based on student competency, not the time to course completion, as this may vary. Time estimates may be provided to guide the
planning for presentation of course materials.
States and/or education programs should re-evaluate student qualifications, co-requisites, or pre-requisites for all EMS practitioner levels.
States and/or programs should consider co-requisites or pre-requisites for transition courses to help establish the depth and breadth of new content.
Individuals transitioning within a level (i.e. EMT-P to Paramedic) are responsible for the knowledge and skills that are implicit to all previous levels.
States retain the authority to credential individual practitioners in a way that best meets the needs of the state. Some states have already identified state-based learning
objectives and educational priorities that exist both above and below the Education Standards making it difficult to establish a "national curriculum" for transition. Because a
transition course per se would have a limited shelf life as the Education Standards are implemented, available resources have been focused on developing materials that will
support implementation of the new practitioner levels and pre-packaged educational materials geared specifically to the changes are generally unavailable. To assist this effort,
NASEMSO has utilized the Gap Analysis Template to help identify the generic "Gap Content" that can be used to enhance the knowledge and skills of existing practitioners that
Transition Template: EMT-Basic to Emergency Medical Technician
Page 2
desire certification/licensure at the level of the Education Standards. Proper learning objectives should be developed by end users and accompany an identification of methods
(i.e. medical literature, publisher materials, in-service programs, and Learning Management Systems) that can be used to achieve educational goals. Page guides have been
included to cross reference content with the Education Standards and more detail regarding content can be found within the Instructional Guidelines. Time frames (rough
estimates) have been provided to assist in planning and are not intended to serve as a mandate. For the purposes of the Transition Templates:
"Essential Content" is content or material that has been identified by an expert panel as having significantly changed (including expanded) from the NSC with sufficient
clinical relevance that review and/or instruction during the transition process is strongly recommended.
"Supplemental Content" is content or material that has been highlighted by the panel as changed (including expanded) from the NSC with sufficient clinical relevance
that review and/or instruction should be considered.
Content areas that do not include time frames likely contain content changes that were felt to be insufficient to warrant updating. These content areas should, at a minimum, be
reviewed by the state and added to transition learning requirements if deemed appropriate. Proper learning objectives should be developed by end users and accompany an
identification of methods (i.e. medical literature, publisher materials, in-service programs, and Learning Management Systems) that can be used to achieve educational goals.
Page guides have been included to cross reference content with the Education Standards and more detail regarding content can be found within the Instructional Guidelines.
Declarative time frames (rough estimates) have been provided to assist planning efforts and are not intended to serve as a mandate. In addition, the Education Standards
recognize the National Incident Management System (NIMS) and Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, 29 CFR 1910.120 as pre- or
co-requisite training requirements. Additional time may be needed to accommodate this content.
States will need to determine which content and/or skills must be tested and/or verified to complete state-based transition processes and communicate this information to
stakeholders.
A list of EMS publisher materials that support the implementation of the Education Standards is maintained by NASEMSO on our web site at . Education
Standards and Instructional Guidelines listed in this document serve as an example for convenience of the reader. Official documents published by NHTSA are available at
.
The NASEMSO Implementation Team is available to provide technical assistance to states with Education Agenda implementation efforts. State officials that desire additional
information can contact NASEMSO via info@ or call NASEMSO Program Advisor Kathy Robinson at (703) 538-1799 ext 1708.
Transition Template: EMT-Basic to Emergency Medical Technician
Page 3
Transition of EMT-Basic to Emergency Medical Technician
Section Title EMS Education Standard Gap Analysis of NSC to Education Standards EMT Instructional Guidelines Declarative Essential
E = Essential Content
S =
Supplemental
Preparatory Applies fundamental knowledge of the EMS system, Total for
safety/well-being of the EMT, medical/legal and Section
ethical issues to the provision of emergency care. E = 65 min.
(P. 11) S = 15 min.
EMS Systems EMR Material PLUS: More detailed discussion on patient safety issues, II. Roles, Responsibilities, and Professionalism of 15 min. Essential
Simple depth, foundational breadth decreasing medical errors, and required EMS Personnel
? EMS systems affective/behavioral characteristics A. Roles and Responsibilities
? History of EMS B. Professionalism
? Roles/ responsibilities/professionalism of EMS
personnel IV. Patient Safety
? Quality improvement A. Significant - One of the Most Urgent Health Care
? Patient safety Challenges
(P. 11) B. High-Risk Activities
C. How Errors Happen
D. Preventing Errors
(P. 1)
Research EMR Material PLUS: Limited information on evidence based decision making I. Evidence-Based Decision-Making 5 min. Essential
Simple depth, simple breadth A. Traditional Medical Practice
? Evidence-based decision making B. High-Quality Patient Care Should Focus on
(P. 11) Procedures Proven Useful in Improving Patient Outcomes
C. The Challenge for EMS Is the Relative Lack of
Prehospital Research
D. Evidence-Based Decision-Making Technique
(P. 4)
Workforce Safety EMR Material PLUS: Emphasizes the difference between body substance I. Standard Safety Precautions 10 min. Supplemental
and Wellness Fundamental depth, foundational breadth isolation and personal protective equipment A. Hand washing
? Standard safety precautions B. Adherence to Standard Precautions/OSHA Regulation
? Personal protective equipment Brief discussion on bariatric issues, neonatal isolettes and C. Safe Operation of EMS/Patient Care Equipment
? Stress management medical restraint D. Environmental Control
o Dealing with death and dying E. Occupational Health and Blood borne Pathogens
? Prevention of work related injuries II. Personal Protective Equipment
? Lifting and moving patients
? Disease transmission V. (Selected Topics in) Lifting and Moving Patients
? Wellness principles (P. 4)
(P. 12)
Documentation EMR Material PLUS: Content changes insufficient to warrant update (P. 12) 0
Fundamental depth, foundational breadth
? Principles of medical documentation and report writing
(P. 13)
Transition Template: EMT-Basic to Emergency Medical Technician
Page 4
Section Title EMS Education Standard Gap Analysis of NSC to Education Standards EMT Instructional Guidelines Declarative Essential
E = Essential Content
S =
Supplemental
EMS System EMR Material PLUS: Fundamental information about transferring patient care II. Communication With Other Health Care 5 min. Supplemental
Communication Simple depth, simple breadth to incoming EMTs Professionals
? EMS communication system (P. 14)
? Communication with other health care professionals
? Team communication and dynamics
(P. 13)
Therapeutic EMR Material PLUS: More detailed information about improving I. Principles of Communicating With Patients in a 15 min. Essential
Communications Simple depth, simple breadth communication with the patient Manner That Achieves a Positive Relationship
Principles of communicating with patients in a manner (P. 17)
that achieves a positive relationship
? Adjusting communication strategies for age, stage of
development, patients with special needs, and differing
cultures
Fundamental depth, foundational breadth
? Interviewing techniques
? Verbal defusing strategies
? Family presence issues
(P. 13)
Medical/Legal Ethics EMR Material PLUS: HIPPA (new content) II. Confidentiality 30 min. Essential
Fundamental depth, foundational breadth should include a state-specific discussion on A. Obligation to Protect Patient Information
? Consent/refusal of care privileged communication B. Health Information Portability and Accountability Act
? Confidentiality (HIPAA)
? Advanced directives Living Wills (added) C. Responsibility Arising From Physician - Patient
? Tort and criminal actions Surrogate decision makers (added) Relationship
? Evidence preservation Civil and criminal court cases (expanded) D. Privileged Communications
? Statutory responsibilities E. Breach of Confidentiality
? Mandatory reporting
? Ethical principles/moral III. Advanced Directives
Obligations A. Patient Self-Determination Act
(P. 13)
IV. Tort and Criminal Actions
A. Criminality
B. Civil Tort
C. Mandatory Reporting
(P. 21)
Anatomy and Physiology Applies fundamental knowledge of the anatomy and The respiratory information found in the 2000 II. Life Support Chain Total for
function of all human systems to the practice of EMS. Supplemental Airway and Ventilation Module should be A. Fundamental Elements Section
(P. 14) added; more detailed discussion on the life support chain B. Issues Impacting Fundamental Elements E = 60 min.
focusing on oxygenation, perfusion, and the cellular (P. 27) S = 0 min.
environment
Medical Terminology Uses foundational anatomical and medical terms and Content changes insufficient to warrant update (P. 29) Total for
abbreviations in written and oral communication with Section
Transition Template: EMT-Basic to Emergency Medical Technician
Page 5
Section Title EMS Education Standard Gap Analysis of NSC to Education Standards EMT Instructional Guidelines Declarative Essential
E = Essential Content
S =
Supplemental
colleagues and other health care professionals. E = 0 min.
(P. 14) S = 0 min.
Physiology Applies fundamental knowledge of the Expanded content on respiratory dysfunction and shock III. Respiratory Compromise Total for
pathophysiology of respiration and perfusion to A. Impaired Airway, Respiration, or Ventilation Section
patient assessment and management. IV. Alteration in Regulation of Respiration Due to E = 0 min.
(P. 14) Medical or Traumatic Conditions S = 45 min.
V. Ventilation/Perfusion (V/Q) Ratio and Mismatch
VI. Perfusion and Shock
VII. Microcirculation
VIII. Blood Pressure
IX. Alteration of Cell Metabolism
(P. 30)
Life Span Development Applies fundamental knowledge of life span New content (P. 34) Total for
development to patient assessment and Section
management. E = 0 min.
(P. 14) S = 5 min.
Public Health Uses simple knowledge of the principles of illness New information at this level; related to EMS Agenda for I. Basic Principles of Public Health Total for
and injury prevention in emergency care. the Future issues A. Role of Public Health Section
(P. 15) B. Public Health Laws, Regulations, and Guidelines E = 0 min.
C. EMS Interface With Public Health S = 5 min.
(P. 40)
Pharmacology Applies fundamental knowledge of the medications (P. 42) Total for
that the EMT may assist/administer to a patient Section
during an emergency. (P. 15) E = 0 min.
S = 15 min.
Principles of Simple depth, simple breadth N/A (P. 42) 0
Pharmacology ? Medication safety
? Kinds of medications used during an emergency
(P. 15)
Medication EMR Material PLUS: Five rights of medication administration 1. The "rights" of drug administration 5 min. Supplemental
Administration Fundamental depth, foundational breadth a. Right patient - prescribed to patient
Within the scope of practice of the EMT how to b. Right medication - patient condition
? Assist/administer medications to a patient c. Right route - patient condition
(P. 16) d. Right dose - prescribed to patient
e. Right time - within expiration date
(P.44)
Emergency EMR Material PLUS: Aspirin I. Specific Medications 10 min. Supplemental
Medications Fundamental depth, simple breadth (P. 46)
Within the scope of practice of the EMT
? Names
Transition Template: EMT-Basic to Emergency Medical Technician
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