The effects of EMS Education Standards
in the EMS classroom

Define Educational Standard

Review the journey

Identify the components of the EMS Education
Standards

Discuss the transition from NSC to SBE

Discuss ways to implement the Education Standards in
the EMS Classroom
 Level
A
of quality or achievement
measure
 Definition
 Defines
body of knowledge
competencies
 1996
 2000
EMS Agenda for the Future
EMS Education Agenda for the Future: A
Systems Approach
 Five
integrated elements

National EMS Core Content
National EMS Scope of Practice
National EMS Education Standards
National EMS Certification
National EMS Program Accreditation

Additionally:






Gap Analysis
Education Guidelines
 Replace
DOT National Standard Curricula
 Meet
practice guidelines within the Scope of
Practice
 Contain
 Define



concepts of the EMS Core Content
entry level
Competencies
Clinical behaviors
Judgments
 Recognition
of EMS
as a healthcare profession !
 DOT






National Standard Curriculum
All levels of EMS Provider
Prescribed content curriculum
Lesson plans
Classroom activities
Hourly recommendations
Final assessment measures
First Responder:
National Standard
Curriculum
United States Department of Transportation
National Highway Traffic Safety Administration
United States Department of Health and Human
Services Maternal and Child Health Bureau

Complexity of Prehospital Emergency care



Patient Criticality
Complexity of management options
Complexity of Prehospital Emergency care
Education


Depth
Breadth

Student learning measured by “competencies”

Shift from instructor – teaching to student –
learning

Traditional lesson planning









What content will I teach?
How will I teach it?
What materials will I need?
What assignment will I give the students?
What activities will I do in class?
What homework will I assign?
How will I test whether or not they learned it?
How will I grade it?
What is the next unit?
Developed by the SBE Design Team, Northern Colorado BOCES, through a Partnership Goals 2000 Grant

Standards –based education approach

What is the content standard [competency]?

How will students show what they know and can do?

What essential learning or components do students
need?

What teaching strategies work best ?
Developed by the SBE Design Team, Northern Colorado BOCES, through a Partnership Goals 2000 Grant
 Standards
–based education approach
(cont’d)

Are students developing knowledge and skills
aligned to the standard?

What are the outcome measures?

What should be refined, revised, or retaught ?

Is change needed?
Developed by the SBE Design Team, Northern Colorado BOCES, through a Partnership Goals 2000
Grant

Whereby learning is achieved through a process
 Comprised
of four components

Standard/Competency (yellow)

Required knowledge (blue)

Clinical behaviors/judgments (green)

Educational infrastructure (white)
Table 2: Format of National EMS Education Standards
EMR
EMT
AEMT
Paramedic
Content
Area
Competency
Competency
Competency
Competency
Elaboration
of
knowledge
Additional
knowledge
related to the
competency
Additional
knowledge
related to the
competency
Additional
knowledge
related to the
competency
Additional
knowledge
related to the
competency
Clinical
behaviors and
judgments
Clinical
behaviors and
judgments
Clinical
behaviors and
judgments
Clinical
behaviors and
judgments
Educational
Infrastructure
Educational
Infrastructure
Educational
Infrastructure
Educational
Infrastructure
Special Patient
Populations
EMR
EMT
AEMT
Paramedic
Recognizes and
manages life
threats based
on simple
assessment
findings for a
patient with
special needs
while awaiting
additional
emergency
response.
Applies a
fundamental
knowledge of
growth,
development,
and aging and
assessment
findings to
provide
basic
emergency care
and
transportation
for a patient
with special
needs.
Applies a
fundamental
knowledge of
growth,
development,
and aging and
assessment
findings to
provide
basic and
selected
advanced
emergency care
and
transportation
for a patient
with special
needs.
Integrates
assessment
findings
with principles
of
pathophysiology
and
knowledge of
psychosocial
needs to
formulate a
field
impression and
implement a
comprehensive
treatment/dispo
sition plan for
patients with
special needs..
Obstetrics
EMR
EMT
AEMT
Paramedic
Simple depth, simple
breadth
Recognition and
management of
• Normal delivery
• Vaginal bleeding in
the pregnant patient
EMR Material Plus:
Fundamental depth,
foundational breadth
• Anatomy and
physiology of
normal pregnancy
• Pathophysiology of
complications of
pregnancy
• Assessment of the
pregnant patient
• Management of
o Normal delivery
o Abnormal delivery
•Nuchal cord
• Prolapsed cord
• Breech delivery
o Third trimester
bleeding
• Placenta previa
• Abruptio placenta
o Spontaneous
abortion/miscarriage
o Ectopic pregnancy
o Preeclampsia,
Eclampsia
Same as Previous
Level
AEMT Material Plus:
Complex depth,
comprehensive
breadth
• Anatomy and physiology
of
pregnancy
• Pathophysiology of
complications of
pregnancy
• Assessment of the
pregnant
patient
Psychosocial impact,
presentations, prognosis,
and
management of
• Normal delivery
• Abnormal delivery
• Nuchal cord
• Prolapsed cord
• Breech
• Spontaneous
abortion/miscarriage
• Ectopic pregnancy
• Eclampsia
• Antepartum
hemorrhage
• Pregnancy induced
Hypertension
Cont’d……
EMR
Assessment
Perform a simple assessment to
identify life threats (vaginal Bleeding), identify
injuries requiring immobilization and conditions
requiring treatment within the
scope of practice of the EMR:
including foreign substance in
the eyes and nerve agent
Poisoning
Psychomotor Skills
• Assisted normal delivery
• Bleeding control
Decision Making
Initiates simple interventions
based on assessment findings
(Braxton Hicks)
Educational
Infrastructure
EMR/EMT
Educational Facilities:
•Facility approved by
sponsoring agency
•ADA compliant facility
•Sufficient space for class size
•Controlled environment
Course length
•Course length is based on
competency, not hours
•Course length is estimated to
take approximately 48-60
didactic and laboratory clock
hours
Program Evaluation
•Provide evaluation of program
instructional effectiveness
•Provide evaluation of
organizational and
administrative effectiveness of
program
Student Space
•Provide space sufficient or
students to attend classroom
sessions, take notes and
participate in kinematic learning
and practice activities
Student Assessment
•Perform knowledge, skill and
professional behavior
evaluations based on
educational standards and
program objectives
•Provide several methods of
assessing achievement
•Provides assessment that
measures, as a minimum, entry
level competency in all
domains
Field Experience (EMT):
•The student must participate in
and document patient contacts
in a field experience approved
by the medical director and
program director
Instructional Resources
•Provide basic instructional
support material
•Provide audio, visual, and
kinematic aids to support and
supplement didactic
instructions
Hospital Experience (EMT):
•Students should observe
emergency department
operations for a period of time
sufficient to gain an
appreciation for the continuum
of care.
•Students must perform ten
patient assessments. These
can be performed in an
emergency department,
ambulance, clinic, nursing
home, doctor’s office, etc., or
on standardized patients if
clinical settings are not
available
 Stages
in the Backward Design Process
1. Identify Desired
Results
2. Determine
acceptable evidence
3. Plan learning experiences
and instruction
 Step

Identify the standard
 Step

Two
Identify the assessment method and scoring
criteria
 Step

One:
Three
Develop the lesson plan and delivery method
Class:
Content area (Standard) – Competencies:
Prerequisite Knowledge – Elaboration
Required Knowledge - Elaboration
(lesson plan)
Clinical Behaviors & Judgments
Instructional Strategies (student- centered)
Educational Infrastructure
Assessment Measures
Benchmarks
Instructional Planner
Class: Cardiovascular Emergencies
Standards/Content area – Competencies:
Prerequisite Knowledge – Elaboration
Recognizes and manages life threats based on
assessment findings of a patient with a medical
emergency while awaiting additional emergency
response.
Scene Size up
Primary Assessment
History taking
Secondary Assessment
Reassessment
Airway Management
Vital Signs
Pathophysiology of Shock & Respiratory compromise
CPR/AED
Therapeutic Communication techniques
Documentation
Uses assessment information to recognize shock,
respiratory failure or arrest, and cardiac arrest based on
assessment findings and manages the emergency while
awaiting additional emergency response
Required knowledge -Elaboration –
(Lesson Plan)
Clinical Behaviors & Judgments
Simple depth and simple breadth Anatomy, signs,
symptoms and management
•Chest pain (deeper discussion on CP & Heart
attack)
•Cardiac arrest
Perform a patient assessment and provide prehospital
emergency care for patient complaints:

Cardiac arrest, chest pain

Manual CPR

AED

Decision making
Instructional Planner (Cont’d)
Cardiovascular – Cont’d
Instructional Strategies (student- centered)
Classroom lecture
Homework assignments
Scenario discussion
Role playing
Skills lab for CPR, AED, V/S
Educational Infrastructure
Sponsorship
Programmatic Approval
Faculty
Medical Director
Oversight
Hospital/Clinical Experience
Field Experience
Course length
Course Design
Student Assessment
Program Evaluation
Assessment Measures
Benchmarks
Informal checks for understanding during lecture
Observation of student engagement with directed
dialogue
Formative Quizzes
Final Summative Exam
Final Practical skills testing - CPR/AED scenario
Students able to answer informal questioning
Students awake, eye contact, note taking, asking
questions
Identified content questions - 80% accuracy
Identified content questions – 80% accuracy
Demonstrates ability to manage Chest pain – Cardiac
Arrest patient scenario meeting all competencies
Assessment
EMR
EMT
AEMT
Paramedic
Use scene
information and
simple patient
assessment to
identify and
manage
immediate life
threats and
injuries within the
scope of practice
of the EMR
Applies scene
information and
patient
assessment
findings (scene
size up, primary
and secondary
assessment,
patient history,
and reassessment)
to guide
emergency
management
Same as previous
level
Integrate scene
and patient
assessment
findings with
knowledge of
epidemiology and
pathophysiology
to form a field
impression. This
includes
developing a list
of differential
diagnosis through
clinical reasoning
to modify the
assessment and
formulate a
treatment plan
Instructional Planner
Class: Assessment (EMR)
Standards/Content area – Competencies:
Prerequisite Knowledge – Elaboration
Use scene information and simple patient assessment to
identify and manage immediate life threats and injuries
within the scope of practice of the EMR
Scene Size up
History taking
Therapeutic Communication techniques
Documentation
Elaboration - Required Knowledge
(Lesson Plan)
Clinical Behaviors & Judgments
Primary Assessment: simple depth, simple breadth
Primary assessment for all patient situations
Level of consciousness
ABCs
Identify life threats
Assessment of vital functions
Begin interventions as needed to preserve life
Secondary Assessment: Simple depth, simple breadth
Performing a rapid full body scan
Focused assessment of pain
Assessment of Vital signs
Perform simple Assessment to identify life threats
Basic Airway Maneuvers
Assessment
Manual BP
Instructional Planner (Cont’d)
Instructional Strategies (student- centered)
Classroom lecture
Homework assignments
Scenario discussion
Role playing
Skills lab : patient assessment, BP, airway management
Educational Infrastructure
Sponsorship
Programmatic Approval
Faculty
Medical Director
Oversight
Hospital/Clinical Experience
Field Experience
Course length
Course Design
Student Assessment
Program Evaluation
Assessment Measures
Benchmarks
Informal checks for understanding during lecture
Observation of student engagement with directed dialogue
Formative Quizzes
Final Summative Exam
Final Practical skills testing - Assessment, Vital Signs
Students able to answer informal questioning
Students awake, eye contact, note taking, asking questions
Identified content questions - 80% accuracy
Identified content questions – 80% accuracy
Demonstrates ability to do a patient assessment
Class: OB (EMR)
Content area (Standard)– Competencies:
Prerequisite Knowledge – Elaboration
Recognizes and manages life threats based on
simple assessment findings for a patient with
special needs while awaiting additional
emergency response.
Assessment
Airway Management
Vital Signs
Management of Shock (hemorrhagic)
Communication
Scene Management
Required Knowledge – Elaboration (lesson plan) Clinical Behaviors & Judgments
Obstetrics
Simple depth, simple breadth
Recognition and management of
• Normal delivery
• Vaginal bleeding in the pregnant patient
Assessment
Perform a simple assessment to identify life threats,
identify injuries requiring immobilization and
conditions requiring treatment within the scope of
the EMR (Vaginal Bleeding )
Psychomotor Skills
• Assisted normal delivery
• Bleeding control
Decision Making
Initiates simple interventions based on assessment
findings (Braxton Hicks)
Instructional Strategies (student- centered)
Educational Infrastructure
Interactive Classroom lecture
Homework assignments
Scenario discussion
Role playing
Skills lab for labor assessment and delivery
Sponsorship
Programmatic Approval
Faculty
Medical Director
Oversight
Hospital/Clinical Experience
Field Experience
Course length
Course Design
Student Assessment
Program Evaluation
Assessment Measures
Benchmarks
Informal checks for understanding during lecture
Observation of student engagement with directed
dialogue
Formative Quizzes
Final Summative Exam
Final Practical skills testing - laboring patient
w/excessive bleeding through to delivery
Students able to answer informal questioning
Students awake, eye contact, note taking, asking
questions
Identified content questions - 80% accuracy
Identified content questions – 80% accuracy
Meets criteria on skill sheet for scenario
 1.
Objectives
 2.
Elaboration/outline
 3.
Behavior/psychomotor skills
 4.
Class activities
 5.
Student outcome measures
 6.
Revisions
1. Objectives: At the completion of this module the student
will:







Identify pertinent anatomy to the obstetric patient
Discuss physiological changes that occur with pregnancy
Discuss assessment of the pregnant patient
Discuss Stages of labor
Discuss true versus false labor

Braxton Hicks
Discuss Vaginal bleeding
Discuss management of excessive vaginal bleeding
2. Elaboration/outline








Anatomy & Physiology
Physiological changes
Stages of labor
Patient assessment
Assessment of Labor
Vaginal bleeding
Delivery process
Patient Management

Mother

Newborn
3. Behavior/Psychomotor Skills
 Patient assessment
Laboring patient
 Post delivery
 New born
 Vaginal Bleeding
 Airway management
 Vital signs

4. Class Activities



Interactive lecture
Scenario based discussion
Lab practice w/ delivery manikin
5. Student outcome assessment measures
Quizzes/exam questions
 Class discussion participation
 Practical exam
 Laboring mom w/ excessive vaginal bleeding
 Laboring mom with normal delivery

6. Revision
 Evaluate
yourself and ask

Do my students understand what I expect them
to know?

Does the content and teaching methods I am
using match and work with the stated objectives
and standard?

Do my quizzes, exams, psychomotor skill
evaluations, clinical assessment tools provide a
means to measure the objectives and standard?
 If
you answered yes to all – you are good to
go
 If
you answered no to any of those questions
something needs to be fixed. Either



Fix, add or delete
Change the content or methods
Modify the evaluation tools
 Start
with the standard
 Identify measurable learning outcomes
 Approach from “students’ perspective”
 Develop approach to lesson/class
 Measure outcomes
 Adapt change as needed
 It
is a process
 It will take time
 Keep sight of the goal
 Take the time
 Start where you plan to end
 Think like an assessor
 Remember the student-centered approach
 Terry



DeVito
860-906-5153
tdevito@ccc.commnet.edu
Capital Community College
950 Main St.
Hartford, CT 06103
Drake, S., Burns,R. (2004). Meeting Standards Through integrated Curriculum. Alexandria,
VA.: ASCD Publications.
Marzano, R.(1996) Eight Questions about Implementing Standards-Based Education.
Retrieved: 2/22/2009 from: http://pareonline.net/getvn.asp?v=5&n=6
NAEMSE (2006) Foundations of Education. Mosby, St. Louis, MO.
NHTSA (2002) National Guidelines for Educating EMS Instructors.
Schmoker,M., Marzano, R.(1999) the Promise of the Standards Movement. Retrieved 6/4/2010,
from http://mikesschmoker.com/promise.html
Sasson, D. (2008) Working with Education Standards. Retrieved 6/4/2010, from: http:/lessonplan-help.suite101.com/article.cfm/working_with_educational_standards
United Sates Department of Transportation, National Highway Traffic Safety Administration &
United States Department of Health Resources & Services Administration, Maternal & Child
Health Bureau (1996) Emergency Medical Services Agenda for the Future
United Sates Department of Transportation, National Highway Traffic Safety Administration &
United States Department of Health Resources & Services Administration, Maternal & Child
Health Bureau (2000) Emergency Medical Services Education Agenda for the Future

Schultz,D. (2005). Standards in the Classroom. Retrieved 6/4/2010. From:
http://www.astm.org/SNEWS/JULY_2005/schultz_jul05.html

Wiggins, G., McTighe, J. (1998). Understanding by Design. Upper Saddle River, NJ.:
Prentice Hall Publishing.

What are Academic Standards:
http://www.thirteen.org/edonline/concept2class/standards/index.html

National EMS Scope of Practice Model:


EMS Education Agenda for the Future


http://www.nhtsa.gov/people/injury/ems/EMSCoreContent/images/EMSCoreContent.pdf
National EMS Education standards


http://www.naemse.org/data/content/positionpapers/2009%20NASEMSO%20Gap%20Analysis%20Templa
te.pdf
National EMS Core Content


http://www.nasemso.org/Projects/EMSEducation/documents/FinalEducationAgenda.pdf
2009 EMS Ed standards Gap Analysis Template


http://nasemso.org/Projects/ScopeOfPractice/FINALEMSSept2006_PMS314.pdf.pdf.pdf
http://www.ems.gov/pdf/811077a.pdf
Link to Instructor Guidelines

http://www.ems.gov/education/nationalstandardandncs.html