The first paramedics credentialed under the 2009 National EMS Educational Standards are completing their 5th year as caregivers. They are moving into mentor, supervisor and managerial roles. They have a leadership advantage over those trained before Fall 2014.

The paramedic trained to the 2009 National EMS Educational Standard received a more intense medical education, especially pathophysiology. They have received training to respond to situations as a safe and effective critical thinker.

That same evidence and science based background will serve them well as they move into roles as evaluators, coaches and supervisors. Let’s see why.

History of EMS Credential Training

We have progressed through four versions of the federal EMS educational standards. Here is a summary of the timeline:

• 1977 National Standard Curriculum (NSC) for EMT-Paramedic. Published by the National Highway Transportation Safety Administration (NHTSA). 15 modules based in part on the University of Pittsburgh’s Freedom House training program.
• 1985 National Standard Curriculum revised. At the state’s request, lowered the requirements to obtain EMT-Ambulance credential, EMT-Paramedic curricula is reformatted into 6 divisions.
• 1994 National Standard Curriculum revised. EMT-Basic (1985) replaced with more comprehensive EMT-Ambulance. Other levels of caregiver training revised later in the 1990s.
• 2009 National EMS Educational Standards is a major revision. Stakeholder Task force established to implement standards by Fall 2014

2009: Expanded Depth and Breadth of Knowledge

The Paramedic is an allied health professional whose primary focus is to provide advanced emergency medical care for critical and emergent patients who access the emergency medical system. This individual possesses the complex knowledge and skills necessary to provide patient care and transportation.

National Emergency Medical Services Education Standards, Page 10

Pathophysiology was added to the EMT curricula to provide a basis for clinical critical thinking. An EMT who is a thinking clinician is able toidentify patients who are stable or unstable and require prompt transport. (Limmer)

This was such a significant change in the curricula that it took hundreds of leaders, educators, physicians, subject matter experts, regulators, publishers, medical writers and caregivers five years to get the 2009 National EMS Standards ready for implementation.

2014 Delivery Of The New Standard

The results of this massive multi-year effort is:

• 375 community/technical college paramedic certification programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP).
• 171 jurisdictional/private accredited paramedic certification programs that are CAAHEP accredited and have an academic partner in a consortium.
• The National Registry of EMTs initial paramedic credentialing procedure and knowledge exam adopted by 46 states

The Associate Degree Requirement

Much heat and angst were released when a position paper advocating a degree requirement for paramedics was published in Prehospital Emergency Care in 2018 (Caffrey, et. al.) The issue may not be as disruptive as feared.

A rumor started that said, if approved, every single paramedic would be required to obtain an associate degree. This was false, but created anger and anxiety for the hundreds of regulators, administrators and leaders that were credentialed long-before the 2009 standards went into effect.

In a study by Rivard, et. al (2020) that looked at the educational background of  nationally certified EMS professionals in the U.S. that re-certified through the National Registry between October 1, 2017 and March 31, 2018 and October 1, 2018 and March 31, 2019 showed that 28.5% of the paramedics rectifying had an associate degree.

The caregivers surveyed reported 3-7 years experience with 72% of the respondents working full-time. I anticipate that we will continue to see a rise in associate degreed paramedic caregivers taking recertification exams as those who were initially credentialed before Fall semester 2014 age out or let their EMS credentials expire.

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Limmer, D., et al. (2008) Beyond the basics, the art of critical thinking, Part 1. EMS Magazine 37(4) p. 87.

Caffrey, S. M., Barnes, L. C. & Olvera, D. J. (2018): Joint
Position Statement on Degree Requirements for Paramedics, Prehospital Emergency Care, DOI:10.1080/10903127.2018.1519006

Rivard, M.K., Cash, R.E., Mercer, C. B., Chrzan, K. & Panchal, A. R. (2020): Demography of the National Emergency Medical Services Workforce: A Description of Those Providing Patient Care in the Prehospital Setting. Prehospital Emergency Care. DOI: 10.1080/10903127.2020.1737282

CAAHEP (2019) Emergency Medical Services – Paramedic. Clearwater, FL: Commission on Accreditation of Allied Health Education Programs https://www.caahep.org/Students/Program-Info/Emergency-Medical-Technician-Paramedic.aspx Accessed November 15, 2019.

Featured Image: Wake County EMS, North Carolina. Mike Legeros