By James Mitchell
The Mountain State is home to thousands of certified emergency medical responders.
According to the West Virginia Office of Emergency Medical Services (WVOEMS), the state has 3,553 emergency medical technicians; 2,026 EMTs; 1,242 paramedics; 620 emergency medical vehicle operators; 249 mobile critical care paramedics; 227 emergency medical responders and 165 mobile critical care nurses.
Despite these high numbers, Emergency Medical Services (EMS) education has a short history dating back less than 60 years. Since its conception in the 1960s, several things have changed, leaving EMS educators looking for answers concerning the future of EMS education.
The first significant change for EMS education is the amount of material that must be covered during initial certification for Emergency Medical Technicians (EMTs) and paramedics. According to WVOEMS, an EMT class must be at least 150 hours long, which supersedes the Commission on Accreditation of Allied Health Education Programs (CAAHEP) standard of a minimum of 110 hours.
WVOEMS does not set a minimum number of hours for a paramedic program, but it does require that a student be eligible for the National Registry of EMTs (NREMT) written examination, which in turn requires the student to have completed a program that is CAAHEP accredited. According to CAAHEP, a paramedic program should be a minimum of 1,000 hours on top of the time already spent to become an EMT.
Furthermore, paramedic classes beginning after August 1, 2016 must complete the NREMT’s portfolio project for every student. The portfolio project is a means of ensuring competency of 33 specific skills during the course of the program as opposed to ensuring competency of the same skills at the end of the program by the means of testing. Simply put, what once could be done in a matter of weeks is now taking close to a year, if not longer, to complete as a full-time student.
Not only do students have to attend longer courses than they once did, but they often have to work full-time during the course to make ends meet. Although this is not a problem isolated to EMS students, they are subject to schedules that are different than most other post-secondary students.
EMS employees are known for working shift work, including 12-, 16- and 24-hour shifts, night shifts and other schedules that make a traditional Monday through Friday job seem easy. Students often come to class a few hours after getting off of a shift with little to no sleep and are expected to retain a significant amount of vital information. Simply put, EMS students are nontraditional, even for nontraditional students.
Many EMS education programs have chosen to extend the length of courses so students are not required to do as much during each semester. However, the demand for advanced life support providers from the industry and community is high. While EMS educators try their best to serve both the industry and the students and have done so for the past 50 years, without the ability or willingness to alter the delivery format of EMS education, EMS programs may start to fail both the industry and students.
The fix for the issues facing EMS education may be a hybrid format. This would allow for a majority of the didactic content to be delivered in an online format and also allow time to complete material review, skill competency, case studies and scenarios during face-to-face meetings.
Unfortunately, like many solutions to issues facing the Mountain State, this change could be hard to implement. The single greatest struggle for hybrid EMS education may be the EMS educators themselves, hesitant to venture into the unknown.
While EMS education will most likely never make it to an entirely online delivery format, blending a traditional and online format may present the students with the best of both worlds. Because of the psychomotor skills required in this industry and its primarily kinesthetic learners, skills such as intubation must be practiced by the student in person for learning and competency.
Despite the fear of the unknown for EMS educators and students alike, the hybrid delivery format has been tested and appears to be effective when done correctly. It should be considered to better sustain and satisfy the needs of both students and the EMS industry in West Virginia.
About the Author
James Mitchell is an assistant professor in the EMS education department at Mountwest Community and Technical College in Huntington, WV. He has worked in the emergency services education field for 12 years, including county 911 agencies and volunteer organizations.
