The Continuing Education Certification Board For Emergency Medical Services
Standards and Requirements for
International Organizational
Accreditation
3/8/2011
International Accreditation
3/8/2011
Page 1
CECBEMS Standards and Requirements for
International Organizational Accreditation
Definitions
Program refers to the overall EMS continuing education effort of the organization.
Activity refers to an individual educational session or topic.
Accredited refers to an organization, either national or international, that has been
approved by CECBEMS under the CECBEMS organizational accreditation process.
International Organization (IO) refers to organizations whose main headquarters is
located outside the United States.
International Accredited Organization refers to an organization whose main headquarters
are located outside the United States that has been approved by CECBEMS under the
CECBEMS international organizational accreditation process.
International cosponsoring organization refers to organizations that submit activities for
accreditation to organizations approved through accreditation process.
Member organization refers to those organizations represented on the CECBEMS Board
of Directors (National Association of Emergency Medical Technicians, the American
College of Emergency Physicians, the National Association of Emergency Medical
Services Physicians the CECBEMS international organizational, the National Association
of State Emergency Medical Services Officials, and the National Registry of Emergency
Medical Technicians, the National Association of EMS Educators and the American
College of Osteopathic Emergency Physicians).
Participant is synonymous with student and refers to the EMS professionals who attend
continuing education activities.
Conditions of Accreditation refers to all published rules, regulations, terms of
accreditation, policies and procedures of CECBEMS.
Introduction
CECBEMS recognizes that the role of the pre-hospital care provider is dynamic and
evolving. To meet the challenge of delivering quality care in this changing environment,
EMS personnel must update their knowledge and skills frequently. Well-planned and
implemented continuing education addresses this need, but prospective participants may
have difficulty assessing the quality of an educational offering.
CECBEMS was chartered to help prospective participants make informed decisions.
CECBEMS’ charter mission included provisions for the establishment of an accreditation
process for organizations, but the CECBEMS Board of Directors felt it was more
pragmatic to begin with accrediting individual activities. Thus, in its early years,
CECBEMS served as an accrediting body for individual activities, ensuring participants
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in live one-time event activities, multiple-event activities and distributed learning
activities that these activities involved qualified faculty, had appropriate content, and met
certain minimum criteria for educational planning.
After CECBEMS’ inception, the number of EMS continuing education offerings grew
rapidly and the CECBEMS activity approval process demonstrated that organizations
providing quality continuing education usually did so consistently. Thus, in 2000,
CECBEMS felt that the time was right for fulfilling the terms of its charter that provided
accreditation for organizations that offer EMS continuing education. In 2008, CECBEMS
began to receive requests from EMS entities in the international arena. These
international organizations (IOs) felt that the CECBEMS accreditation process would
provide a valuable peer-reviewed self study. They also felt that the resulting accreditation
would increase their credibility and acceptance as providers of quality CE.
In 2010, CECBEMS launched the international organizational accreditation process to
recognize entities outside of the United States that conduct ongoing EMS continuing
education programs and are willing to make a commitment to planning and implementing
activities of a consistently high quality. International organizational accreditation also
allows these entities to review and accredit courses planned in conjunction with
cosponsoring organizations. CECBEMS continues to review and accredit individual
courses submitted by entities that are not organizationally accredited.
The international organizational accreditation process focuses on the philosophy and
resources of organizations and relies on them to ensure that activities offered by the
accredited organization itself or by a cosponsoring organization will be quality
educational offerings. After initial approval and subject to the initial site visit,
CECBEMS international accredited organizations may grant CECBEMS continuing
education hours (CEH) for all of their own EMS continuing education offerings and for
those activities offered by cosponsoring organizations that meet CECBEMS’ standards
and requirements
Purpose
CECBEMS international organizational accreditation assures participants that all EMS
continuing education offered by the entity has undergone a sound, rigorous planning
process and will be implemented and evaluated to ensure a quality educational
experience.
CECBEMS international organizational accreditation further assures participants that all
EMS continuing education offered by a cosponsoring organization that is approved by a
CECBEMS international accredited organization has undergone a sound, rigorous
planning process and will be implemented and evaluated to ensure a quality educational
experience.
Note: CECBEMS international organizational accreditation is not intended to validate the
specific medical content of any continuing education activity.
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Goals
 To promote, through its accreditation of international EMS continuing education
organizations and the subsequent approval of the activities offered by
cosponsoring organizations, the availability of activities that will help EMS
providers, educators and administrators maintain the competency required to
deliver excellent care and enhance their professional development.

To establish a national and international standardized process for accrediting EMS
continuing education provider organizations.
Confidentiality
No CECBEMS member, staff, reviewer or other individual affiliated with CECBEMS, its
accredited organizations or any of its member organizations may release to any person
any materials or information submitted to or produced by CECBEMS, its members, staff,
or reviewers in connection with a continuing education activity review conducted by
CECBEMS without approval from CECBEMS and the express written consent of all
parties to the review. This includes the identity of reviewers acting on behalf of
CECBEMS. All reviews and decisions are the product of CECBEMS and not of
individual reviewers.
No CECBEMS member, staff, reviewer or other individual affiliated with CECBEMS,
its accredited organizations or any of its member organizations may release to any person
copyrighted material received in connection with a CECBEMS international
organizational accreditation application without approval from CECBEMS and the
express written consent of the copyright holder.
All CECBEMS reviewers must sign an agreement assuring that they will comply with
these stipulations.
For research purposes, data may be collected from materials submitted to CECBEMS.
This data will not be released in any format in which any particular data can be linked to
a specific organization.
Organizational Accreditation Reviewers
Reviews for organizational accreditation are conducted by a review team that includes
representatives of CECBEMS’ member organizations.
After receipt of an application, CECBEMS staff distributes the application to three
reviewers. Whenever possible, the reviewers for any particular application include a
physician and a CECBEMS board member. No reviewer may participate in the
assessment of an organization with which the reviewer is affiliated. In the case of an
association that is an accredited organization, a reviewer may be a member of that
association, but not a board member, officer or paid employee of that association.
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Reviewers may have no direct contact with the applicant organization during the review
process. All communications between the applicant organization and the review team are
relayed by CECBEMS’ staff
Audit and Review
Accreditation carries with it the responsibility for maintaining the Conditions of
Accreditation. CECBEMS reserves the right to audit any activity and to verify all
appropriate documentation at any time during the accreditation period and will revoke the
accreditation of any organization denying a request for verification of compliance.
CECBEMS also maintains to right to impose a penalty of up to $5,000 US currency for
such infractions. See the CECBEMS Complaint, Review, Suspension, and Revocation of
Accreditation Policy.
Explanation of Requirements for
International Organizational Accreditation
1) Eligibility
a. Type of Organization
The international accredited organization must be an educational institution; a
national, state, regional or local agency or association; a nonprofit or for-profit
corporation; a hospital; any combination of the above, or other appropriate CE
provider; and must meet all the requirements for sponsorship of any CECBEMS
activity as outlined in the CECBEMS Conditions of Accreditation.
b. Approval of Appropriate Government Entity
The IO must submit a letter from the government authority responsible for EMS,
i.e. Department of Health, Ministry of Health, etc. This approval may be in the
form of a letter or any other appropriate documentation signed by an appropriate
person and will be kept in the organization’s CECBEMS accreditation file.
CECBEMS may, at its sole discretion, require accredited organizations to verify
this reference on an annual basis.
c. Maintenance of Accreditation
The IO must appoint an individual who will be responsible for maintaining
CECBEMS accreditation. This person should be the CEO, Dean, or other person
with the authority to coordinate the work of various departments in the
organization to address the CECBEMS standards and requirements.
CECBEMS will perform an initial site visit after the IO has successfully
completed the self-study and before the accreditation is finalized. Further,
CECBEMS reserves the right to perform random site visits at its sole discretion to
verify compliance with the Conditions of Accreditation and the Standards and
Requirements. The IO applicant should be prepared to pay travel expenses as
described in the Policy for International Organization Accreditation for the initial
visit and for random site visits with a frequency of once during every three-year
accreditation period.
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CECBEMS also reserves the right to perform for-cause site visits at its sole
discretion to verify compliance with the Conditions of Accreditation and
Standards and Requirements. In the event that the program is found in violation
of its accreditation terms and conditions, including those activities conducted with
cosponsoring organizations, the IO is subject to payment of reasonable travel
expenses as described in the above paragraph and other expenses associated with
the investigation and remediation, including refunding participant fees for
participants in improperly approved activities as well as immediate termination of
CECBEMS accreditation. If the IO is found to be in compliance, all expenses will
be paid by CECBEMS.
d. Experience in Delivering CE to EMS Professionals
The IO or CEO or person responsible for ensuring that the IO meets CECBEMS’
requirements must have one year’s experience providing EMS continuing
education to EMS professionals.
2) Support
The IO must have a written statement approved by its governing body that supports
its EMS continuing education mission. The IO must show documentation of at least
one year of providing EMS continuing education activities including dates, title,
location, number of participants, etc. Further, the IO applicant must demonstrate
how EMS continuing education activities and content are related to a needs
assessment relevant to EMS service, practice, education or administration.
Documentation must include dates and titles of activities offered over at least a oneyear period prior to application.
In addition, the IO program coordinator and/or someone in the organization directly
involved in the educational planning process must be responsible for developing the
budget for the organization’s overall EMS educational program and for developing
the budget for the individual activities in the organization’s EMS educational
program.
An appropriate percentage of the budget for the EMS educational program must be
allocated to salaries for the program’s administrative personnel.
3) Needs Assessment
Needs assessment is a key component of any well-planned educational activity. The
international accredited organization must perform ongoing needs assessment. One
goal of continuing education is to motivate participants to continue learning and
updating their skills. Meeting students’ perceived needs is a powerful motivator.
While participants usually are aware of gaps in their knowledge, sometimes they are
not. Another goal of continuing education is to make participants aware of
educational needs that they may not have identified on their own.
Needs assessment methods should target both perceived and unperceived needs.
Below are examples of needs assessment methods. These examples are not inclusive.
An IO should not limit its needs assessment efforts to the examples on this list nor is
it obligated to engage in all of the methods listed.
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a. A written survey of a random sample of potential participants.
b. An intercept or walk-up survey in which the surveyor approaches an individual
and asks questions.
c. A focus group.
d. Questions and comments on evaluations from activities offered by the accredited
organization itself and from activities offered by the cosponsoring organizations.
e. Quality assurance data, incident reports, etc.
f. A literature search
g. Consensus of recognized experts in the EMS environment
h. A review of past EMS continuing education offerings available to the target
audience identifying gaps in content
i. Consensus of an educational planning committee that includes potential
participants
j. Data from standardized tests
k. Any local or national government requirements
4) Physical Infrastructure:
The IO must have the physical infrastructure to provide and administer an
educational program consistent with educational standards outlined in the NHTSA
EMS Education Standards Document or the 2011 EMS Educational Standards and
Scope of Practice, and consistent with its EMS educational mission.
a. Distributed Learning Activities
If an activity or session will use interactive video/television, online or computerbased activities or continuing education articles as a delivery medium, the
organization shall meet the following criteria:
(1) Ensure that the site and participant coordinators are appropriately trained in
the technical aspects of operating the specific equipment at the site location
or activity support site. For online activities, ensure that technical assistance
is available within a reasonable time frame.
( 2) In the case of interactive television, ensure that each originating site and each
receiving site has two-way voice capability so that participants and faculty
may communicate throughout the session. In the case of computer-based
activity or continuing education articles, ensure that timely communications
are available to address participant concerns.
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(3) Ensure that each originating interactive television or video site and each
receiving site has VCR playback capability.
(4) Ensure that each originating interactive television or video site and each
receiving site has projection equipment suitable for transmitting projected
images without loss of reproduction quality.
(5) Ensure that instructors supporting all sites or participants have technical
support readily available during the time period that the activity is scheduled
or valid. If the organization offers Virtual Instructor-Led Training (VILT),
the CECBEMS Executive Committee must review and approve a
demonstration topic before the IO may offer credits for such training.
(6) Comply with CECBEMS Distributed Learning Policy, CECBEMS Item
Writing Standards, CECBEMS CEH Assignment Guidance, CECBEMS
Virtual Instructor-Led Training Policy, and all other published policies
related to the delivery of distributed learning.
b. Traditional Live Activities
(1) Equipment and Supplies
The IO shall have dedicated equipment and supplies necessary to develop the
participant competencies defined by the training session objectives.
Facilities shall provide adequate restrooms and common areas, adequate
environmental controls to maintain participants’ comfort and safety, adequate
facilities and access for participants with disabilities, and reasonable level of
personal safety for all individuals involved in all aspects of the activity.
Medical devices shall be kept clean and in good working order. These
devices and the consumable supplies that are used with them shall be
available in sufficient quantity to maintain a minimum participant-toequipment ratio of six-to-one.
CECBEMS requires that an inventory of equipment and supplies along with
the cleaning and replacement policies be submitted with the application and
kept on file in the accredited organization’s offices for at least three years.
All appropriate audiovisual equipment shall be dedicated to the EMS
continuing education program. At a minimum, this equipment shall include a
slide projector and screen, a VCR and monitor, an overhead projector, and
marking board. This equipment shall be kept clean and maintained in good
working order. CECBEMS requires that an inventory of audiovisual
equipment with the cleaning and replacement policies be submitted with the
application and kept on file in the accredited organization’s office for at least
three years.
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(2) Clinical and Field Training Facilities
If the IO approves clinical and field training continuing education, it must
provide facilities to ensure that sufficient medical and trauma patient-contactspecific experiences are provided to meet the objectives for participant
competency as verified by the physician medical director. Contracts with
these facilities shall include requirements for a quality assurance system,
sound medical control and appropriate medical feedback to participants.
All participants in clinical and/or field training continuing education must be
accountable to a defined preceptor. Clinical training and field training
objectives and evaluation tools must be provided and reviewed with each
preceptor. Documentation of this review must be kept in the accredited
organization’s office for a minimum of three years.
5)
Human Resources
The accredited IO must verify that it has human resources consistent with its
educational mission relative to EMS continuing education such as administrative
support and a full-time educational program coordinator or equivalent who will be
responsible for the duties listed below. The job description of this coordinator or
equivalent, including EMS-specific responsibilities, shall be kept on file in the
office of the IO and shall be included in this application. Equivalent refers to those
positions in the IO that perform the duties describe below.
The program coordinator or equivalent shall perform the following duties:
a. Serve as the liaison to CECBEMS for all matters involving the IO’s
accreditation.
b. Work with the physician medical director and instructional personnel to
accomplish the following requirements: needs assessment, program planning,
program implementation, program evaluation and revision, selection of
instructional personnel.
c. Develop the program budget.
d. Develop and maintain all necessary contractual agreements.
e. Develop appropriate program syllabi.
f. Supervise the cleaning and maintenance of all medical devices and audio-visual
equipment necessary for implementing the IO’s activities.
g. Keep appropriate records that include all of the required information (see # 11
below).
h. Monitor adherence to CECBEMS requirements.
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i.
Ensure that each clinical preceptor has the appropriate combination of
education, related work experience, and teaching experience to address the
objectives of the preceptorship effectively.
j. Keep the job description and curriculum vitae for each clinical preceptor on
file in the office of the international accredited IO for a minimum of three years.
k. Ensure that the number of clinical preceptors will be appropriate for the clinical
training facility utilized.
l.
Secure approval of the medical director and the clinical facility for each clinical
preceptor.
m. Ensure that each field preceptor is appropriately registered or certified at the
appropriate level of training and is scheduled as required by the appropriate
EMS agency.
n. Secure approval of the medical director and the program coordinator for each
field preceptor.
o. Keep the job description and curriculum vitae for each field preceptor on file in
the office of the accredited IO for a minimum of three years.
6)
Medical Oversight/Physician Medical Director
The IO must verify that it has a current agreement with physician medical
director(s) to provide direction to the CECBEMS program committee(s) and that
this physician meets the following EMS requirements:
a. Is a currently a licensed MD, DO, or other qualified professional physician
b. Is currently active in the delivery of EMS or has significant prior EMS
experience such as board certification in emergency medicine and experience as
an emergency physician; experience as the medical director for an ambulance
service; experience in EMS research, teaching or administration
The medical director shall perform the following duties:
a. Review and approve all activities offered by the accredited organization or
cosponsoring organizations including objectives, instructional personnel, and
evaluation tools
b. Provide clarification on all appropriate medical issues
c. Ensure accuracy of all medical content
d. Serve as a liaison with the local medical society
e. Assist as appropriate with participant outcome recommendations
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f. Review all program evaluation processes and make recommendations to
improve the activity
Contractual agreements between the IO and the physician medical director and a
job description shall be submitted with the application for
international organizational accreditation and kept on file at the IO’s office.
Changes in the name of the physician medical director or in the job description shall
be submitted to CECBEMS within 30 days. IOs that allow the agreement with a
physician medical director to lapse for more than 30 days will be subject to
withdrawal of CECBEMS accreditation.
7)
Program Committee
The IO must maintain a program committee that reviews and approves all
activities offered by the IO and by cosponsoring organizations. This committee
must include at least one physician with significant EMS experience. This
physician may be the EMS medical director (see #6 above). The committee shall
perform the duties listed below with regard to activities submitted to it by the IO
and cosponsoring organizations:
a. In the case of activities developed for a specific EMS service, has direction
from the physician medical director of that service.
b. Ensure that EMS CE activities are consistent with the continuing education
needs of EMS personnel as indicated by needs assessment.
c.
Ensure that all accredited CE activities are reviewed and updated at least
every three years (more often if appropriate), assigned a current activity
number (a number that has as its first two digits the year in which the update
is done), and entered as a new course in the CECBEMS Accreditation
Management System (AMS).
d. Have at least one member who is a physician with EMS experience.
Physician(s) may be regular or ad hoc members of the committee.
e. For planning/approval of programs primarily intended for non-EMS
participants have at least one EMS provider who reviews the activity for its
applicability to EMS.
f. Must meet at least once annually face-to-face to review the IO’s overall EMS
continuing education program in the light of CECBEMS international
organizational accreditation requirements.
g. Must approve all EMS activities submitted for review in a meeting of a
minimum of three members of the committee, one of which must be an EMS
physician and may be the medical director.
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h. May have as an ex officio member, the full-time activity coordinator from the
accredited IO and/or the cosponsoring organization who may not be counted
as one of the three members necessary for approving an activity and may not
vote or influence the approval of any activity.
i.
Must require that each application for approval from a co-sponsoring
organization be submitted on the appropriate CECBEMS application form and
kept on file in the office of the accredited institution.
j.
Must require that appropriate documentation is kept on file for all activities
submitted for approval by the IO.
k. If EMS providers or physicians constitute a minority of the committee, these
rules must include provisions to record a separate vote for CECBEMS
approval. To receive approval for CECBEMS credit, programs must receive a
majority of voting EMS providers and all voting EMS physicians in addition
to the support of the committee as a whole. In the case of voting on a
previously rejected activity, any EMS provider/physician previously voting
“no” must vote on any reconsideration even if his/her term is expired. Any
situation, such as the death of a committee member, preventing this
requirement must be reported to CECBEMS within five business days.
l.
Must ensure that the applicant IO has met the requirements listed below with
regard to EMS activities submitted. These requirements apply to all
applicants, whether they are an accredited or a cosponsoring organization.
(1) Ensure activities submitted for approval have a process in place for
identifying objectives for each individual educational activity.
A successful educational activity must present faculty and participants
with clearly defined objectives. Objectives should take into consideration
the target audience for the activity and the needs and knowledge level of
that audience.
(2) Ensure that the activity coordinators have access to appropriate resources
for implementing educational activities in a manner consistent with the
activity’s content and format.
(3) Ensure that all instructional personnel are qualified and have appropriate
resources for meeting activity objectives.
(4) Ensure that each faculty member has the appropriate combination of
education, related work experience and teaching experience to address
the activity’s objectives effectively.
(5) Ensure that each lab assistant, adjunct instructor or preceptor has training
appropriate for the assigned educational activity including training in
teaching and evaluating psychomotor skills.
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(6) Keep the curriculum vitae of each faculty member, lab assistant and
adjunct instructor in the activity file for at least three years.
(7) Ensure that all laboratory sessions have at least one lab assistant or
adjunct instructor for each six participants.
(9) Ensure that there is a sound evaluation process for each activity and that
the results of evaluations are used in planning future EMS continuing
education.
8)
Evaluation
a. Participant test materials shall meet the following requirements:
(1) All test materials shall be directly related to the activity objectives.
(2) Evaluation of participants’ ability to demonstrate competencies in the
field should be measured using an simulation evaluation instrument
specifically designed for assessing a simulation and
preceptor evaluations.
(3) Evaluation of participants’ ability to integrate cognitive and
psychomotor skills to care for sick and injured patients should be
measured using simulation evaluation instruments and preceptor
evaluations.
(4) Evaluations of participants’ ability to integrate cognitive and
psychomotor skills along with evaluation of clinical and laboratory skills
should include distributed practice on infants, children, adults and
geriatric patients and include a variety of common medical and
traumatic conditions found in each age group.
(5) Evaluation of laboratory skills shall be by demonstrated simulation
mastery.
(6) Evaluation of cognitive material shall be tested at all levels of taxonomy
practical from the “knowledge” level through the “evaluation” level.
(7) Any tests given to course participants at the end of an activity to assess
mastery of the material presented must conform to the CECBEMS Item
Writing Policy.
(8) All tests and related data shall be kept on file in the office of the
accredited organization for a minimum of three years.
(9) Test items are required for distributed learning materials; test items are
optional for cognitive material presented as part of live activities.
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b. Overall activity evaluation materials shall solicit feedback from participants
about the following:
( 1) The overall organization of the activity.
( 2) The overall effectiveness of instructors.
(3)
c.
The quantity and quality of the medical devices and audiovisual
equipment used to address the activity objectives.
Evaluations for individual sessions shall solicit feedback about the
following:
(1) The effectiveness of the session.
(2) The ability of the instructor to deliver the content.
(3) The ability of the instructor to motivate the participant.
(4) The ability of the instructor to answer questions.
(5) The professionalism of the instructor.
(6) The quantity and quality of the medical devices and audio-visual
equipment for the session.
(7) The quality of the handouts and audio-visual materials for the
session.
9) Marketing
All marketing materials for an activity shall contain complete activity information
including activity description, objectives, format, invited faculty, prerequisites, date,
time, location, schedule, number and category of continuing education hours (CEH),
fees and statement of accreditation by CECBEMS. Note: CEH time is awarded
according to the CEH Assignment Guidance attached as appendix one. Marketing
materials should include an accurate description of the activity and be free of any
statements that are misleading in any way. For purposes of the application these
materials should be submitted in English and any other language that may be used for
marketing purposes. The applicant will be expected to pay a fee for a translator if
necessary.
All marketing materials for an activity shall communicate the following:
a.
A clear, concise description of the activity.
b.
A list of the overall objectives for the activity.
c.
Prerequisites, if appropriate.
d.
Date, time and location including directions and maps if appropriate.
e.
All confirmed instructional personnel.
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f.
g.
Fees for the activity.
An appropriate statement about the IO's or cosponsoring organization’s
application for CECBEMS accreditation and final accreditation appears below.
No other references to approval or endorsement of the activity by CECBEMS
or its sponsoring organizations may appear on materials for the activity:
If activity materials go to print before approval is final:
Continuing education hours (CEH) have been applied for through (accredited
organization’s name), an organization accredited by the Continuing Education
Coordinating Board for Emergency Medical Services (CECBEMS).
If activity materials go to print after approval is final:
This continuing education activity is approved by (accredited organization’s
name), an organization accredited by the Continuing Education Coordinating
Board for Emergency Medical Services (CECBEMS).
The following is an optional statement that may be used in addition to either of
those above. If used, this statement must appear in its entirety:
CECBEMS is an organization established to develop and implement policies to
standardize the review and approval of EMS continuing education activities.
The cosponsoring organizations of CECBEMS are the National Association of
Emergency Medical Technicians, the American College of Emergency
Physicians, the National Association of Emergency Medical Services
Physicians, the National Association of State Emergency Medical Services
Directors, the National Council of State Emergency Medical Services Training
Coordinators, and the National Registry of Emergency Medical Technicians,
the American College of Osteopathic Emergency Physicians, and the National
Association of EMS Educators.
h.
Information about travel, lodging and meal services, if appropriate.
Brochures and marketing materials shall contain no deceptive or misleading
material.
i.
Potential participants must receive a complete activity schedule prior to the
activity. This schedule shall clearly identify the overall activity topic, location
and date(s), the title for each session with date and time, all confirmed speakers
and other instructional personnel, and the overall objectives for the activity.
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10) Certificates
Certificates of attendance are important items for participants’ professional files.
Each certificate of attendance should clearly present the following information:
Name of CE provider and CE provider number
Student’s name
Activity title
Date(s) of activity
Location of activity
Number and category of CEH
CECBEMS activity number
Name and signature of the program coordinator
Student’s license number, state of licensure
Student’s NREMT number (if student is NREMT)
The following statements:
This continuing education activity is approved by (name of accredited organization), a CECBEMS
accredited organization.
You have participated in a continuing education program that has received CECBEMS approval for
continuing education credit. If you have any comments regarding the quality of this program and/or
your satisfaction with it, please contact CECBEMS at: CECBEMS -12200 Ford Road – Suite 478
Dallas, Texas 75234 – Phone: 972.247-4442 - lsibley@cecbems.org.
CECBEMS represents only that its accredited programs have met CECBEMS’ standards for
accreditation. These standards require sound educational offerings determined by a review of its
objectives, teaching plan, faculty, and program evaluation processes. CECBEMS does not endorse or
support the actual teachings, opinions or material content as presented by the speaker(s) and/or
sponsoring organization. CECBEMS accreditation does not represent that the content conforms to
any national, state or local standard or best practice of any nature. No student shall have any cause of
action against CECBEMS based on the accreditation of the material.
The following statement and logo combination may also be used:
CECBEMS Accredited
11) Attendance Verification, Records Maintenance, and Reporting:
The international accredited organization must ensure that there is a mechanism for
verifying EMS participant attendance. Attendance must be verified using a method
that will meet the requirements of the professional organizations to which participants
must report their continuing education. This information must be transmitted to the
educational program coordinator for upload to the CECBEMS Accreditation
Management System (AMS) within 30 days after completion of the activity. All
information reported must be accurate in every detail including case, punctuation and
spelling; otherwise, participants may not receive credit. At a minimum, the
information described in the next paragraph must be included with each course
completion reported to the CECBEMS AMS. The IO must keep a hard copy of this
information on file in its office for a minimum of three years.
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Participant list must be submitted online via www.cecbems.org. This online
submission will require that you input the following information about each
participant: CECBEMS activity number, date of course completion, first name, last
name, email address (if available), city of residence, state/region/country of licensure,
license number, type/level of license, license expiration date, NREMT registration
number (if student is NREMT), NREMT re-registration date (if student is NREMT),
Number of CEH, Category of CEH. Collecting this information is not optional. You
are required to collect and submit this information for every EMS professional that
registers for the activity. Failure to submit accurate, complete, and timely course
completion records for each and every EMS participant in a CECBEMS accredited
activity may result in withdrawal of accreditation.
This reporting is a very important step. Once entered, the data in the password
encrypted Accreditation Management System (AMS) can be accessed only as an
individual provider file, except by the submitting organization and the CECBEMS
office. This posting allows the individual, the National Registry, and the appropriate
state EMS office(s) to access and verify attendance information.
The CECBEMS Web page may be queried by authorized users for information on
individual providers’ continuing education history. Authorized users include the
National Registry, state EMS offices and the individual provider.
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Submitting Course Completion Records to the CECBEMS
Accreditation Management System (AMS)
As a condition of being granted accreditation from CECBEMS all providers agree to comply with
several requirements, including the collecting and reporting of specific pieces of data.
CECBEMS is committed to the provision of quality continuing education activities. We feel
strongly that maintenance of reliable records is a vital factor in the maintenance of an EMS
license and/or EMS certification
CECBEMS Accreditation Management System (AMS) is designed to make recertification easier
for EMS professionals. The CECBEMS AMS allows continuing education (CE) providers to
report data in three ways: manual entry, XML file or real-time reporting (rtr). Real-time
reporting is preferred; we encourage you to make every effort to put RTR in place as quickly as
possible. All methods require the same data be reported, differing only in the method in which the
data are reported.
Over the past seven years, we have identified the top three problems encountered with data
submissions. We have analyzed these problems and have found the following common issues:
1. Some providers have failed to collect the required data.
All providers are required to collect and report the same data for each and every EMS
professional who registers and completes a CE activity. CECBEMS accreditation should not
be made optional to students. Any EMS professional who registers for a CECBEMSaccredited activity should received credit by providing the required information. The most
common pieces of data that providers have not collected include state license number, state
license expiration date, NREMT number and re-registration date, and date and, for online
activities, time of course completion. These are key pieces of data that are necessary to
ensure EMS professionals receive credit for their CE activities.
One reason providers have failed to collect this data is that they do not have a learning
management system (LMS) in place that is designed to meet the special requirements
necessary to deliver CECBEMS-accredited continuing education. Distributed learning
providers, VILT providers, and providers of live CE activities must ensure all required data is
collected prior to delivering a course with a CECBEMS accreditation. Likewise, providers of
live courses must ensure their procedures collect all required data during the registration
process.
2. Providers have collected data in ways that make retrieval and reporting difficult.
Regardless of how you collect data, you must maintain it in accordance with CECBEMS’
requirements. If the student’s name, state of licensure, and license number are not entered
accurately each and every time a course completion is entered for that person, the course
completion information will not appear on the student’s course completion record when it is
uploaded to the AMS. Providers of live activities sometimes use handwritten forms for
collecting data. Our experience is that handwritten information is frequently illegible. If you
use this method, you need a back-up method in place for verifying information submitted.
CE providers frequently allow a student to complete an activity whether or not the student has
entered the required information. We strongly recommend that you program your system or
your process to require a student provide all required information before launching an online
activity, participating in VILT, or attending a live activity.
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Of those providers using electronic methods of capturing and storing data, some use a
spreadsheet program such as Excel. Excel is not a database program and is designed for the
manipulation of numbers, not data. Its ability to output and share data is very limited.
A true enterprise class Database Management System, such as Microsoft SQL Server, Oracle,
or IBM DB2 is the ideal tool for capturing data. If you are using a database, be sure it is
robust enough to handle the types and amounts of data you are required to collect. Be sure it
collects and stores all required pieces of data and is set up to retrieve those pieces of data.
3. Providers do not have (or have not dedicated) sufficient or appropriate resources to
collect and submit the data to the CECBEMS AMS.
The CECBEMS AMS is built on the newest platform that is designed to share data between
systems via the Internet. The easiest and most efficient tool for this transfer is an Extensible
Markup Language (XML) file. XML is a W3C initiative that allows information and
services to be encoded with meaningful structure and semantics that both computers and
humans can understand. In the simplest possible terms, an XML file is a text file in a
specific format that contains individual pieces of data written to conform to a specific set of
rules or “schema.”
There are many ways to create this kind of text file, including simply typing it into notepad
(although this is not efficient for large amounts of data). Ideally, a programmer can create a
tool that will essentially copy the required data from your database and then write the XML
file in the correct format and syntax. Once you have this tool it can be used repeatedly by
any non-programmer to create and submit the required reports to CECBEMS. For example,
one CECBEMS-approved provider has such a tool that allows any non-tech person to simply
enter the beginning and ending date of the report, enter their CECBEMS AMS log-in name
and password, and click one button to create and submit the XML file to the AMS. This is
the beauty of the XML reporting tool – build one small application and reporting will not
require technical resources from then on.
Our analysis of the troubles providers have experienced in successfully writing the XML files
shows that the single biggest problem is that the technical resources assigned to create the
XML file are not sufficiently trained in XML syntax.
We want to be sure that you understand that we are not commenting on any individual’s
abilities, but rather have found that many Web Designers have not had the benefit of training
or experience in XML. Our goal here is simply to try to help CE providers understand that
the resources you may successfully use on a daily basis may not be the best resources to use
when confronted with the demands of business to business data transfer.
If you are having difficulty finding a resource that can successfully produce your XML file,
we suggest you ask a prospective XML programmer the following questions:
A.
B.
C.
D.
E.
F.
What database experience do you have?
What development environment(s) do you use? (“translation program”)
Can you write code directly without the development environment?
What training/experience have you had with XML?
Are you familiar with XML syntax?
Have you ever transferred data between Database Management Systems using XML?
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Providers have failed to utilize the resources we have provided them, including the AMS
Providers Manual and Supplement, a sample template, and an XML file example. We encourage
you to download these resources, make them available to your XML programmer, and refer to
them when building files for submitting data to the AMS. These resources can be found on the
Providers Only screen at cecbems.org. You must contact CECBEMS headquarters to set up
access.
Our records show that when we the CE provider is dealing with an experienced XML
programmer who has read the CECBEMS AMS Manual, we only need to answer a few questions
and/or review a small test upload to identify potential problems. If you would like for CECBEMS
to provide services beyond this one-time consult, we will be happy to contract for these services
at the appropriate programming fee. We will not offer ongoing technical assistance free of
charge.
Experienced, XML programmers able to write a program that will upload error-free data quickly
and effectively. In the very near future, CECBEMS will make a test tool available to CE
providers for a fee. All uploads must be tested using these tools and receive an “error free” rating
BEFORE they will be uploaded to the AMS.
CECBEMS also offers limited technical assistance to providers who are submitting data via
manual entry. Again, when we are dealing with someone who has read the manual carefully, we
are able to identify potential problems quickly and subsequent submissions have uploaded
smoothly. As with XML users, if you would like for CECBEMS to provide services beyond this
limited amount, we will be happy to to contract with you for these services; however, we will not
offer ongoing technical assistance free of charge.
Summary
1.
Be prepared to report the following information for each student. This is not
optional. Failure to collect and report each piece of data for every EMS professional
could result in loss of accreditation.
CECBEMS activity number, date of course completion, first name, last name, email
address city of residence, state of licensure, state license number,
type/level of license, license expiration date, NREMT registration number (if
student is NREMT), NREMT reregistration date (if student is NREMT), Number of
CEH, Category of CEH.
2.
Put a process in place to ensure that data is complete and accurate.
3.
Read the CECBEMS AMS manual carefully and forward it to your technical
support people and anyone else in your organization who will be involved in data
collection and/or submission.
4.
Utilize the limited technical support offered by CECBEMS to resolve initial
technical issues.
5.
Schedule regular data uploads to comply with deadlines for reporting post-activity
materials.
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COMPLAINT REVIEW AND DISCIPLINARY POLICY
DEFINITIONS
“Activity” means any type of continuing education offering.
“Activity Sponsor” means the sponsoring institution, organization, agency, association, corporation,
hospital, or other appropriate continuing education (CE) provider offering CECBEMS-accredited
continuing education (CE) “CECBEMS.
“Criteria” means any other published rules, regulations, conditions, standards, criteria, terms of
accreditation, policies or procedures of CECBEMS, however titled.
“Conditions of Accreditation” means that Section of the application entitled “Conditions of Accreditation”
and signed and submitted by the Activity Sponsor.
“Day” means a calendar day, including weekends.
“Executive Committee” means the Executive Committee appointed by the Chairman of the CECBEMS’
Board of Directors as set forth in the CECBEMS’ Bylaws.
PENALTY PROVISIONS
The CECBEMS’ Board of Directors reserves the right to review and investigate any complaint or credible
evidence of any alleged violation of the Conditions of Accreditation, signed by the Activity Sponsor upon
submission of an application for accreditation, or any other CECBEMS’ Criteria. When a violation has
been found to have occurred, the CECBEMS Board of Directors reserves the right to deny, suspend, or
revoke the relevant accreditation. In lieu of revocation, the CECBEMS Board of Directors may provide the
Activity Sponsor an opportunity to enter into an agreement that would include a plan for compliance and
payment of one of the following penalties. Failure of the Activity Sponsor to successfully complete the
terms of agreement, including payment of the penalty, shall result in revocation.
1.
A penalty payable within 30 days of billing, in an amount not to exceed $5,000 US currency to
cover the costs to CECBEMS to correct any problem caused by the violation, or
2. A penalty, payable within 30 days of billing, of 1.5% interest per month on the amount of fees
owed if the violation is failure to pay the appropriate fees, or
3. A penalty, payable within 30 days of billing, of .10 cents US Currency per participant fee owed
for failure to report CECBEMS’ accredited CE Activity participants.
The CECBEMS’ Board of Directors shall utilize the following procedure when determining whether any
such disciplinary action is appropriate.
COMPLIANCE WITH REVIEW BY CECBEMS
Each Activity Sponsor shall comply with a written request for information from a member of the
CECBEMS Board of Directors and agree to participate in a review of any complaint or alleged violation of
CECBEMS’ Conditions of Accreditation or Criteria in order to assist the CECBEMS Board of Directors in
determining if there exists a violation of the Conditions of Accreditation or Criteria. In the absence of any
response from the Activity Sponsor within 30 days of the CECBEMS Board Member’s written request, the
CECBEMS Board of Directors will assume such complaint or alleged violation has merit and initiate the
investigation and review process noted below. Failure to respond adequately to any review or request for
information shall be considered as additional evidence in support of the complaint or alleged violation.
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REASONS FOR REVIEW, DENIAL, SUSPENSION, REVOCATION OR FINE
The CECBEMS Board of Directors shall utilize its professional judgment in determining whether denial,
suspension, revocation of accreditation, or a fine in lieu of revocation is appropriate. Reasons for such
action shall include, but not be limited to, the following:
1.
2.
3.
4.
5.
6.
7.
8.
9.
A material misrepresentation, whether intentional or unintentional, in the application which, if
known at the time of review, would have resulted in denial of accreditation.
Fraud in written information provided to CECBEMS during the procurement of any CECBEMS’
accreditation as an Activity Sponsor (examples include, but are not limited to, falsifying history as
an Activity Sponsor falsifying credentials, etc.).
Fraud in course content during the procurement of any CECBEMS’ accreditation of a continuing
education Activity (examples include, but are not limited to, plagiarism of Activity materials).
Intentional or unintentional failure to comply with any Conditions of Accreditation and Attesting
Statement, as specified in the signed application.
Failure to submit timely to an audit or review as requested by the CECBEMS Board of Directors;
such request shall allow a reasonable time for scheduling and completion.
Failure to remit fees as required by CECBEMS and as agreed upon by the Activity Sponsor in the
signed application.
Refusal to participate in a review to determine whether the Activity Sponsor is complying with the
Conditions of Accreditation and Attesting Statement as agreed upon in the signed application.
Refusal to submit a plan of correction when requested by the CECBEMS Board of Directors after
the Investigation and Complaint Review process or completion of the Disciplinary Process.
Failure to remit any fine(s) or adhere to any corrective measures or failure to complete the
disciplinary process.
INVESTIGATION AND COMPLAINT REVIEW
1. The CECBEMS Board of Directors may conduct an investigation upon receipt of a complaint or
credible evidence of a violation of the Conditions of Accreditation. The investigator shall be a
member of the CECBEMS Board of Directors or their designee. A designee shall not include (1)
any person who is a competitor of the Activity Sponsor whose Activity or accreditation(s) is under
review for possible suspension or revocation, (2) any employee of CECBEMS, (3) any individual
that has received fees or payments from CECBEMS during the prior three years, or (4) anyone
else who has a conflict of interest with the Activity Sponsor.
2. An investigation may include, and in no specific order: notifying the Activity Sponsor in writing
by overnight delivery of such complaint or alleged violation requesting a response within 30 days
of the date of CECBEMS’ letter; requesting an explanation of the matter; requesting the provision
of information concerning the complaint or alleged violation; and offering the Activity Sponsor an
opportunity to discuss and resolve the complaint.
3. The investigation and communication shall provide both CECBEMS’ investigator and the Activity
Sponsor an opportunity over a period of 90 days to understand the issue(s) and to explore potential
resolutions of the issue(s).
4. At the completion of the investigation, the CECBEMS Board of Directors shall provide the
Activity Sponsor with a summary letter indicating the resolution of the issue or, if not resolved,
detailing at a minimum the complaint or concern, the investigator’s findings, suspicions and/or
conclusions, and a list of the relevant information that was requested and was then provided,
denied, or not obtained.
5. If a resolution has been agreed to by the Activity Sponsor and CECBEMS’ Board of Directors, the
letter shall restate the resolution and the matter shall then be closed with no further action
necessary. The Activity Sponsor shall be advised of this fact.
6. If resolution is not reached, the Activity Sponsor shall be given 30 days from the date of the letter
from the CECBEMS Board of Directors to submit a written response to CECBEMS’ letter and
conclusions. CECBEMS need not wait for such written response before providing information to
the Chair of the Board.
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7.
8.
9.
If the investigator determines that discipline or other corrective action may be required, the
investigator shall provide the summary letter and any supporting documentation to the Chair of the
Board, who shall then provide such documents to the Executive Committee.
The Executive Committee shall review the same and shall then decide whether or not (1)
CECBEMS has followed its required policies leading to their involvement; (2) the alleged
violation warrants further discussion by the full Board; (3) if there has been adequate resolution to
the violation; and (4) whether any mitigating factors should be considered. The Executive
Committee may terminate the process at any time if, in the judgment of the Executive Committee,
the alleged violation does not warrant a hearing or if adequate resolution has been reached;
otherwise the Executive Committee may proceed to the Disciplinary Process.
If the Executive Committee desires to proceed, all documents will be provided to the full Board of
Directors.
DISCIPLINARY PROCESS
After review or investigation of the complaint, allegation, or credible evidence, if the CECBEMS Board of
Directors determines that a suspension or revocation should be imposed, the CECBEMS Board of Directors
shall take the following actions in an effort to provide due process to the accredited Activity Sponsor.
1. CECBEMS shall provide written notice to the Activity Sponsor that the Activity Sponsor is being
charged with a violation of the Conditions of Accreditation and/or any other CECBEMS Criteria.
The notification shall state the violation in terms which should be understood by the Activity
Sponsor. The written notice shall also provide the process to be followed, including the following
rights:
A. To be present in person or by conference phone or other mutually agreeable form of
communication at the hearing,
B. To present and cross examine witnesses,
C. To present evidence in support of its defense or in an effort to mitigate the consequences
of the violation.
Such written notice shall provide the Activity Sponsor with 15 days from the date of mailing as
evidenced by the postmark date to appear before a hearing panel and may be adjourned for good
cause shown upon the sole discretion of the CECBEMS Board of Directors. CECBEMS shall have
the right to determine the location of the hearing, however, a telephone conference call will always
be available. In the event a meeting site is selected, hearing members to include the Activity
Sponsor may attend by phone if desired, except that the CECBEMS Chair shall appear in person.
2.
CECBEMS’ Board of Directors shall provide a hearing to the Activity Sponsor. The hearing panel
shall be the fact finder and shall determine whether or not (1) CECBEMS has followed its
required policies leading to the hearing; (2) the facts of the underlying allegation(s); (3) the
alleged violation(s) has merit; (4) if there has been adequate resolution to the violation(s); and (5)
mitigating factors, if any. The hearing panel may recommend but not impose a penalty. There shall
be no rules of evidence for the hearing. The hearing shall provide the opportunity for the charges
to be presented, for testimony to be taken if necessary, and for the Activity Sponsor to present a
defense if the Activity Sponsor desires to do so.
3.
The Chair of the Board or the Chair’s designee, who shall be one of the Executive Committee
Members excluding any CECBEMS’ employees, shall chair and appoint a hearing panel of up to
three persons, comprised of the Chair or his/her designee and either CECBEMS’ reviewers or
other persons knowledgeable in the related field or in the CECBEMS accreditation process. The
members of the hearing panel shall not consist of (1) any person who is a competitor of the
Activity Sponsor whose Activity accreditations are under review for possible suspension of
revocation, (2) any employee or director of CECBEMS, or (3) any individual that has received
fees or payments from CECBEMS during the prior three years. There shall be no appeal as to the
members of the hearing panel.
4.
After the conclusion of the hearing, the hearing panel shall render a proposed statement of facts
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within seven (7) days of the date of the conclusion of the hearing. The proposed statement of facts
shall state the violation and any related findings of the panel. The proposed statement of facts shall
be provided to the Activity Sponsor in writing sent certified mail, who shall then have seven (7)
days after delivery of the proposed statement of facts to deliver (meaning to have sent via certified
mail to CECBEMS’ office) a dispute or concurrence of the proposed statement of facts in writing
sent certified mail. The hearing panel shall then have up to seven (7) days to revise the proposed
statement of facts as deemed necessary or to leave the decision as is. The hearing panel shall
provide its final Finding of Facts in writing sent certified mail to the Activity Sponsor and to the
CECBEMS Board of Directors.
5. The Activity Sponsor may submit a response to the final Findings of Fact for consideration by the
Board of Directors. Such findings must be submitted to the Board within five (5) days of the
Activity Sponsor’s date of receipt of the final Findings of Fact. Mitigating factors may also be
submitted to the Board of Directors. Before the Board of Directors shall convene, the Board of
Directors shall inquire whether or not a response will be submitted by the activity sponsor.
6.
No more than ten (10) days after the delivery of the final Findings of Fact, the Board shall then
convene by phone or in person to make a determination on the matter. The Board shall determine
if (1) CECBEMS has followed its required policies leading to a Board decision; (2) if the violation
warrants a disciplinary action; (3) if there has been adequate resolution to the alleged violation;
and (4) whether any mitigating factors should be considered. The Board may terminate the
meeting at any time if, in the judgment of the Board, the alleged violation does not warrant a
meeting or if adequate resolution has been reached; otherwise the Board may impose a penalty. A
majority of the seated members of the Board shall be necessary to impose any penalty. Such
penalty shall be consistent with the Findings of Fact. Written notice of the penalty shall be
provided to the entity within three (3) days of the date of the decision of the Board.
7. There shall be no internal appeal from the decision of the Board of Directors.
8. An Activity Sponsor shall comply with the terms of the penalty within fourteen (14) days of the
notice of the penalty, and no penalty shall become effective until the passage of the fourteenth day.
WAIVERS AND JURISDICTION
Activity Sponsors hereby waive any right to seek or obtain attorney fees, costs, or other awards upon
successfully obtaining an order or award from a court regarding the penalty imposed by CECBEMS. This
waiver shall not apply to a finding that CECBEMS intentionally violated the due process rights of the
Activity Sponsor .
CECBEMS has consented to jurisdiction in federal court in Texas. Any proceeding brought pursuant to this
policy in a court of any jurisdiction shall be venued in Texas.
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CEH Hour Assignment Guidance
Note: CECBEMS uses a 60-minute clock hour to determine CEH, not a 50- or 55-minute,
“Carnegie” or other “hour” calculation.
Approved April 2, 2005
Purpose:
To provide guidance for CECBEMS reviewers in the determination of hour assignments for
DL accreditation applications.
Background:
The Continuing Education Coordinating Board for EMS (CECBEMS) is a continuing
education (CE) accrediting body that services educational institutions, not-for-profit
educational organizations and for- profit companies that provide emergency medical services
CE. The CECBEMS Board of Directors is comprised of one appointee and one alternate
from each of eight sponsoring organizations including NAEMT, NAEMSP, NASEMSD,
ACEP, NAEMSE, NCEMSTC, NREMT and ACOEP. The sponsoring organizations are also
charged with appointing, from within their membership, educators that serve CECBEMS as
volunteer accreditation application reviewers. The reviewers selected are physicians, nurses,
paramedics and Emergency Medical Technicians (EMTs) that have demonstrated expertise in
EMS operations and educational practice.
CECBEMS recognizes that Distributed Learning (DL) is an instructional model that allows
instructor, students, and content to be located in different, non-centralized locations so that
instruction and learning occur independent of time and place. The distributed learning model
can be used in combination with traditional classroom-based EMS continuing education,
operate independently as a traditional distance learning course, or used by educators to
operate a virtual classroom through television, satellite, telephone, or Internet technology.
While a variety of distribution methods are available to the EMS educator, CECBEMS is
particularly aware that the Internet-based World Wide Web (WWW) by its very nature is an
efficient method to distribute educational resources and information rapidly. We expect that
as technology improves, and access to high speed connections to the Internet increase, more
and more EMS personnel will be in a position to benefit from education delivered on-line.
Further, the volunteer EMS community comprises greater than 90% of all EMS providers.
These providers are often hindered from seeking CE hours by extended travel time from rural
areas wherein attractive CME programs may be hours away. The ease and convenience of
completing required CME from the comfort of one’s home or station house computer makes
DL based CME programs very attractive.
The rapid growth of EMS practice-related DL offerings has required CECBEMS to establish
a specific review procedure for DL applications and a DL policy to help guide applicants in
accreditation requirements. Further, just as DL applicants have had to adapt, the nontraditional/DL offerings have proven difficult for some reviewers to accept. Unlike the
traditional classroom setting, DL presentations are not governed by an instructor. The
presentation rate or content breadth cannot be immediately adjusted based on concurrent
student feedback. Nor can the student have direct contact with the presenter that allows for
adaptation of the presentation to meet the student’s needs. In the DL format, the rate of
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presentation/absorption and subsequent comprehension of the presented material is
completely dependant on the reading comprehension skill-level of the student/reader. (1,2)
Reviewers of DL accreditation applications are required to identify several requirements such
as timeliness of references, well-defined objectives, course pre-requisites and retrospective
feedback mechanisms. Reviewers are also asked to recommend the number of CE hours
deemed appropriate for each presentation based on applicant request, length of presentation
and the time required for the reviewer to complete his/her assessment. This particular phase
of the review process may be considered overly subjective as it is based on the reading speed
and comprehension skill level of the reviewer and not of the average student/reader. The
accomplishments and acknowledgements of individuals who are selected by CECBEMS’
sponsoring organizations to become reviewers, may also indicate well developed reading and
comprehension skills that may not be representative of typical EMS providers.
A review of current literature describes the average adult reading speed at 150-250 words per
minute.(1,2,3,4,5,6,7,8,9,10)
Rationale:
Applicants request Continuing Education Hour (CEH) credit assignments that consistently differ
from what CECBEMS reviewers are willing to assign. (Note: CECBEMS uses a 60-minute clock
hour to determine CEH, not a 50- or 55-minute, “Carnegie” or other “hour” calculation.)
The lack of a standard CEH hour policy creates subjectivity causing confusion and dissension that
undermines the accreditation process. Therefore, an objective CEH hour assignment guidance is
necessary.
By providing this document, the CECBEMS Board of Directors hopes to provide its reviewers
with objective guidelines toward the assignment of CEH hours for DL applications. Further, we
expect to reduce or eliminate a common complaint among applicants, increase consistency
between reviewers and standardize the application review process.
CEH determination:
Each presentation is comprised of a finite number of written words that are “consumed” by the
reader in a finite amount of time.( On average, adults read between 150-250 words-perminute.1,2,4,8,9,10 Thus, a one hour presentation will consist of roughly 10,000 words with
appropriate charts, graphs and case presentations that support the written objectives. Current
literature suggests that student interest and comprehension decrease dramatically after the first
hour of any CEH session. Therefore, any applicant requesting more that one hour’s worth of
CEH will be required to provide justification for such by matching course objectives with
additional content. Further, applications that request two or more hours should be broken up into
hour-long presentations as “volumes” of the subject matter presented, i.e. advanced airway-1,
advanced airway-2 etc. The examples outlined below will be used to assist you in determining
appropriate CEH designations for each application.
Discussion:
We know that DL presentations have a varying degree of difficulty. A lesson on how to apply an
arm splint is typically not as challenging as a presentation on 12 lead EKG interpretation.
Therefore, it is necessary that we apply some uniform means of increasing CEH determinations
based “degree of difficulty” of the presented material. CECBEMS reviewers are asked to
increase CEH hour assignments by 0.5 hours above the initial hour if the presented material can
reasonably be considered complex and the objectives are supported by content.
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Lastly DL presentations should include a post-test that complies with the CECBEMS itemwriting policy. Please add an additional 10 minutes for every 10 questions in the post-test.
Example 1:
A DL application contains a BLS presentation review of basic airway techniques including
measuring and insertion of NPA and OPA and bag valve ventilation. The material is limited to
simple terms and no new techniques are discussed. The applicant supplies a presentation length
of 10,000 words.
10,000 words / 200 words per minute = 50 minutes
10 question post test that meets CECBEMS item writing standards= 10 minutes
Total CEH assignment for 10,000 word presentation = 60 minutes
Example 2:
An applicant submits a 16,000-word program on the Recognition and Treatment of Chest
Trauma. The presentation is very detailed and includes illustrated x-rays, diagrams, CT scans and
arterio-grams that depict chest anatomy and clinical representations of various trauma related
chest abnormalities. Included in the discussion are detailed treatment guidelines and a
comprehensive chart that aids in the diagnosis of various trauma-related complications.
16,000 words / 200 words per minute= 96 minutes
CECBEMS reviewer assignment based on degree of difficulty = 30 minutes
20 question post test that complies with CECBEMS item writing standards = 20 minutes
Total CEH assignment for detailed 16,000 word presentation = 146 minutes
For this program we can comfortably assign 2.5 hours (150 minutes) of CEH time.
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Please refer to the following chart for CEH hour assignments:
CECBEMS CEH Hour Determination
Chart
Length of Presentation Minutes Assigned Post-test
10,000 words
50
10
11,000 words
55
10
12,000 words
60
10
13,000 words
65
10
14,000 words
70
10
15,000 words
75
10
16,000 words
80
10
17,000 words
85
10
18,000 words
90
10
19,000 words
95
10
20,000 words
100
10
21,000 words
105
10
22,000 words
110
10
23,000 words
115
10
24,000 words
120
10
25,000 words
125
10
26,000 words
130
10
27,000 words
135
10
28,000 words
140
10
International Accreditation
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Total Hours Added Degree of Diff. Total Hours Post Test Total with 20 Q p-t and DOD
60
1
30
1.5
20
1.83
65
1.08
30
1.58
20
1.91
70
1.16
30
1.66
20
1.99
75
1.25
30
1.75
20
2.08
80
1.3
30
1.83
20
2.16
85
1.4
30
1.91
20
2.24
90
1.5
30
2
20
2.33
95
1.58
30
2.08
20
2.41
100
1.6
30
2.16
20
2.49
105
1.75
30
2.25
20
2.58
110
1.83
30
2.33
20
2.66
115
1.91
30
2.41
20
2.74
120
2
30
2.5
20
2.83
125
2.08
30
2.58
20
2.91
130
2.16
30
2.66
20
2.99
135
2.25
30
2.75
20
3.08
140
2.33
30
2.83
20
3.16
145
2.41
30
2.91
20
3.24
150
2.5
30
3
20
3.33
Page 28
References:
1. Bailey, R.W. (1996). Human Performance Engineering: Designing High Quality Professional
User Interfaces for Computer Products, Applications and Systems, Prentice-Hall: Upper Saddle
River, NJ.
2. Bailey, R.W. and Bailey, L.M. (1999), Reading speeds using RSVP, User Interface Update –
February 1999.
3. Karat, C.M., Halverson, C., Horn, D. and Karat, J. (1999), Patterns of entry and correction in
large vocabulary continuous speech recognition systems, CHI 99 Conference Proceedings, 568575.
4. Lewis, J.R. (1999), Effect of error correction strategy on speech dictation throughput,
Proceedings of the Human Factors and Ergonomics Society - 1999, 457-461.
5. Omoigui, N., He, L., Gupta A., Grudin, J. and Sanocki, E. (1999), Time-compression: Systems
concerns, usage, and benefits, CHI 99 Conference Proceedings, 136-143.
6. Williams, J. R. (1998). Guidelines for the use of multimedia in instruction, Proceedings of the
Human Factors and Ergonomics Society 42nd Annual Meeting, 1447-1451.
7. Ziefle, M. (1998), Effects of display resolution on visual performance, Human Factors, 40(4),
555-568
8. Gresswell, B (1998). An Evaluation of the Advanced Reading Course. Unpublished
dissertation for the Master of Science degree in Educational Psychology, University of
NewcastleTyne,UnitedKingdomwww.anglefire.com/nb/improvedreading/science,
accessed
6/24/03.
9. http://www. Stepware.com, accessed 6/24/03
10. http://www.the-reading-edge.com, accessed 6/24/04.
International Accreditation
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TITLE OF POLICY: Distributed Learning
Policy Administrator:
Reference:
Effective Date: 1/01
Index Cross-References:
Policy File Number:
Date of Last Review/Update: 4/2007
Introduction
CECBEMS recognizes that Distributed Learning (DL) is an instructional model that allows instructor,
students, and content to be located in different, non-centralized locations so that instruction and learning
occur independent of time and place. The distributed learning model can be used in combination with
traditional classroom-based EMS continuing education, operate independently as a traditional distance
learning course, or educators may choose to operate a virtual classroom through television, satellite,
telephone, or Internet technology.
While a variety of distribution methods are available to the EMS educator, CECBEMS is particularly aware
that the Internet-based World Wide Web (WWW) by its very nature is an efficient method to rapidly
distribute educational resources and information. We expect that as technology improves, and access to
high speed connections to the Internet increase, more and more EMS personnel will be in a position to
benefit from education delivered on-line.
In order to support the growth in development, acceptance, and quality of EMS continuing education using
distributed learning (DL) methods, the following policies are applicable to the CECBEMS review and
accreditation process for eligible* organizations and individual courses that incorporate distributed learning
methods.
*Eligible organizations are defined as an educational institution; a national, state, regional or local
agency or association; a non-profit corporation; a hospital; a for-profit corporation, any
combination of the above, or other appropriate CE provider.
.
· CECBEMS will emphasize and promote organizational accreditation rather than course-by-course review
of CE programs that use distributed learning methods.
· Organizational accreditation will be based on the applicant organization's self- assessments of their
infrastructure and process for distributed learning course production, student support and quality
management. The self-assessments will follow a schedule provided by CECBEMS and will require
submission of sample curricula.
· Organization accreditation may include a site visit by a CECBEMS team qualified to assess compliance
with distributed learning structure, process, and outcome requirements.
· Each type of distributed learning methodology involves the use of different structural and process
methods that will be reviewed separately on self-assessment and during site visits. Therefore, organizations
will be accredited to offer distributed learning continuing education in one or more of the following
strategies: print, Internet, videotape, CD-ROM/DVD, satellite, and television.
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· Unaccredited organizations will submit all courses for CECBEMS review prior to delivery. CECBEMS
will provide forms for submission that will focus on the organizations infrastructure and process for
distributed learning course production, student support and quality management. The entire course must
also be presented for review prior to delivery. A key requirement for review will be the specification of the
target audience level of training. The use of out of level content in courses must be clearly justified.
CECBEMS will provide a template/form for presentation of the curriculum for a course that requires
applicants to identify each learning objective and the following supporting information:

The prerequisites required to understand the material related to a specific objective.

How learners can address and receive timely answers to questions regarding course content.
Course sponsors must provide a mechanism for instructor (or instructor proxy) and learner
to interact (synchronously or asynchronously) regardless of what type of distributed
learning methodology is being used, for a period of no less than 30 days after the learning
has taken place.

The instructional content related to each learning objective.

Learning strategies and learning activity the designer is using to facilitate meeting each
learning objective.

Assessment measures for each learning objective (i.e., Test questions for each learning
objective should be presented.) Test questions that simply request learner recall of the
content by means of a rote memory response shall be limited to no more than 50 % of all
test questions.

References used to support instructional content used for each learning objective.

Description of the rationale for establishment of any specific cut-off score for passing the
assessment tool.

The number of hours and/or minutes it takes for the average person to finish the lesson.
This number must be based on actual test usage of the lesson or course.
· Accredited organizations do not submit courses for CECBEMS review prior to delivery. However, the
learning objectives, instructional content, assessment tools and quality improvement strategy must be
documented and made available in the format described above prior to the delivery of a course.
· Failure by an accredited organization to submit this information may result in the suspension or
revocation of the organization's certification. From time to time, CECBEMS will audit course offerings that
carry approved continuing education hours and may require an individual course to be modified or
discontinued based on that review.
· If applicable, organizations must assure that the computer network and Internet access equipment needed
to insure advertised accessibility are maintained and supported properly.
· Organizations must assure that test results, scores and other evaluation materials that are electronically
collected and or stored are adequately protected with appropriate backup and security from unauthorized
access.
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Continuing Education Coordinating Board for EMS:
Item Writing Standards
Approved April 2, 2005
Background:
The Continuing Education Coordinating Board for Emergency Medical Services
(CECBEMS) is a non-profit organization headquartered in Dallas Texas.
CECBEMS reviews and accredits EMS related continuing education (CE)
programs. CECBEMS was chartered in 1992 by the National Association of
EMTs, the American College of Emergency Physicians, the National Registry of
EMTs, the National Association of State EMS Directors, the National Council of
State EMS Training Coordinators and the National Association of EMS
Physicians. The National Association of EMS Educators became a sponsoring
organization in 1998 as did the American College Osteopathic Emergency
Physicians in 2002.
Governance:
The CECBEMS board of directors consists of eight voting members and their
alternates. The eight voting members constitute the board of directors with all
powers and authority necessary to control and direct the affairs of the corporation.
One voting member and one alternate are appointed by each of the following
sponsoring organizations:





National Association of Emergency Medical Technicians
American College of Emergency Physicians
National Association of EMS Physicians
National Registry of EMTs
National Association of State Emergency Medical Services
Directors
 National Council of State Emergency Medical Services Training
Coordinators
 National Association of EMS Educators
 American College of Osteopathic Emergency Physicians
Statement of Purpose:
The purpose of CECBEMS is to develop and implement policies to standardize the
review and approval of EMS continuing education activities. Standardization of the
continuing education process for EMS personnel should lead toward system-wide
improvement in the quality of the educational offerings available to EMS providers.
Multiple-choice tests are widely viewed as the most effective and objective means of
assessment. Item development is the central component of creating an effective test, but
test developers often do not have the background in item development.1
The
CECBEMS’ Board of Directors recognizes that there is a broad spectrum of item (test
question) writing abilities amongst EMS based CE providers. Although many currently
available EMS CE offerings provide excellent quantifiable post-tests, many do not.
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This inequity exists for many reasons, and ultimately creates a lack of standardization of
EMS continuing education activities and creates overall uncertainty about the validity
and reliability of CE knowledge assessments. The CECBEMS Board of Directors offers a
compilation of accepted item writing standards. The Board intends to hold applications
for CECBEMS accreditation to these standards. CECBEMS holds the right and
responsibility to reject applications for continuing education accreditation that do not
meet the guidelines outlined herein. Post-tests that are deemed unacceptable must be
revised and resubmitted until all standards are met.
CECBEMS fully recognizes that this document does not and cannot replace or supplant
formal preparation in educational design. CECBEMS and its sponsoring organizations
strongly suggest that CE providers should seek out instructor coordinator or educational
design training from their State EMS Office or local educational institution.
CECBEMS item writing standards:
All multiple-choice items consist of two basic parts, the stem and the responses. The
stem is the question that seeks a correct answer. Each stem should address only one
problem or content area. The responses are suggested answers that complete the question
asked in the stem. Only one of the responses can be the correct answer and the others are
considered the distractors. 2,3,4,5

The stem should be clear and verbally uncomplicated. It should provide enough
information for the reader to anticipate the answer before reading the responses.

Construct the stem to be either an incomplete statement or a direct question.

Avoid repetition of words in items. Include in the stem all words that would have
to be repeated in each of the responses.

Avoid negatively stated items. Negatives in the stem usually require that the
answer be a false statement. Because students are likely searching for true
statements, this may introduce an unwanted bias. 7

Make all incorrect responses plausible and attractive. Avoid using humor and
superfluous wording as they indicate incorrect responses and fail to test the
student’s knowledge of the subject matter.

Responses should be uniform in length and devoid of unnecessary technical
wording. Avoid making the correct response longer and more technical than the
distracters.

The writer should balance the placement of correct responses throughout the
exam.

“All of the Above” and “None of the Above” type answers never truly indicate if
the student knows the correct answer. None of the above answers indicate only
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that the students recognize wrong answers.4 Questions that include ”All or None
of the Above” response items will not be accepted.

“True or false” questions do not test the students understanding of a concept or
mastery of subject matter. “True or False” questions will not be accepted.

Keep each exam item independent so as not to reveal the answer to another item
in the wording of an item.

In a multiple-choice item the correct response must clearly stand out as the one
that experts in the field would recognize as the best answer.

Distracters should represent unsafe practices or commonly held misconceptions
and should be plausible.

Items should be written to assess knowledge of meaningful facts and concepts,
not trivial information. 4

Each item should be specific enough to pose only one question or problem and
each distracter must be related to that question.
Test Validity:
 Test questions must be directly related to the objectives outlined at the beginning
of the presentation. 2,4,5,6,7,8,9

CECBEMS requires a minimum of three post-test items per stated objective.

Overall, greater than half of all the post-test items must require higher order
thinking where respondents will need to apply information that they were
provided in the presentation material. The remainder of the items should be recall
of information from the lectures, discussions and text. 3
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References:
1. Vacc NA, Loesch LC, Lubik RE, Writing Multiple-Choice Test Items.
Assessment: Issues and Challenges for the Millennium. CG 031 161.
2. Guidelines for Preparing Multiple-Choice Items (Exam Questions)
http://www.ihmm.org/forms/ItemProcessingSheetForm.pdf. Accessed 2/09/05.
3. Instructions for Preparing Test Items. www.boisestate.edu/iassess/instructions.
Accessed 2/11/05.
4. Professional Examination Service, Inc. A Guide to Preparing Multiple-Choice
Items. 1994 New York State Certified Instructor Coordinator Training Manual.
5. Cohen AS, Wollack JA. Handbook on Test Development: Helpful Tips for
Creating Reliable and Valid Classroom Tests. Testing and Evaluation Services,
University of Wisconsin-Madison.
6. Bothell TW. 14 Rules For Writing Multiple-Choice Questions. Brigham Young
University, 2001 Annual University Conference.
7. Kehoe J. Writing Multiple-Choice Test Items.
Office of Measurement and
Research Services, Virginia Polytechnic Institute and State University,
Blacksburg. October 1995.
8. Frary RB. More Multiple-Choice Item Writing Do’s and Don’ts. Practical
Assessment, Research & Evaluation, 4(11) 1995.
www.PAREonline.net.
Accessed 2/14/05.
9. Kehoe, J. Writing Multiple-Choice Test Items. Practical Assessment, Research &
Evaluation, 4(9) 1995. www. PAREonline.net accessed 2/14/05.
International Accreditation
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Definitions of CEH Categories
CECBEMS awards credit for each session or portion of the activity based on the
course content. You must indicate on the application the category(ies) and number of
credit hours requested.
Basic: Topics which address skill and knowledge objectives included in the patient care
practice of basic prehospital care personnel as described in the current U.S. D.O.T.
National Standard Curriculum for EMT Basic and current literature. CECBEMS strongly
suggests that current literature be reviewed and cited in all materials.
Advanced: Topics, which address skill and knowledge objectives included in the patient,
care practice of advanced EMT or EMT-Paramedic personnel and beyond the scope of
basic prehospital care personnel as described in the current U.S. D.O.T. National
Standard Curriculum for EMT-Intermediate and Paramedic and current literature.
CECBEMS strongly suggests that current literature be reviewed and cited in all materials.
Operational: Topics, which are relevant to the operational activities of EMS personnel,
such as emergency vehicle operations, dispatch communications, rescue, etc. non-patient
care activities as described in the current U.S. D.O.T. National Standard curriculum for
EMT-Basic, Intermediate and Paramedic and current literature. CECBEMS strongly
suggests that current literature be reviewed and cited in all materials.
Educator: Topics oriented to the EMS educator (e.g., instructional methodologies and
techniques, evaluation principles and techniques, etc.), and not directly related to the
provision of emergency patient care.
Management: Topics directed to the manager/supervisor, related to the administration of
emergency medical services, and not directly related to the provision of emergency
patient care. (fiscal, personnel and vehicle management issues.)
First Responder: Topics that address the care of the patient in the first minutes of an
emergency and before the arrival of BLS or ALS unit as described in the current DOT
curriculum and current literature. CECBEMS strongly suggests that current literature be
reviewed and cited in all materials.
DOT Refresher: CECBEMS has also pre-approved the following standardized courses.
Credit for these courses is tracked under the specific course title rather than the above
categories.
DOT Refresher EMT-Basic
DOT Refresher EMT-Intermediate
DOT Refresher EMT-Paramedic
International Accreditation
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Style Sheet for Activities Applying for CECBEMS Accreditation
Units of Measure: Provide units of measure in common reference values,
followed by Systeme International (SI) units in parentheses. See
http://physics.nist.gov/Pubs/SP330/sp330.pdf for SI units.
Drugs: Use generic names and, if necessary, list brand names (including the
manufacturer's name, city, and state) in parentheses. Please include the
International Nonproprietary Name (INN) as well. See
http://whqlibdoc.who.int/hq/1997/WHO_PHARM_S_NOM_1570.pdf
References: Number references (including references to unpublished
information) consecutively in the order of their appearance in the manuscript.
Type a list of references in their order of mention in the text, not alphabetically, at
the end of the manuscript. Abbreviate journal names according to Index Medicus.
Indicate abstracts by "abstract" in parentheses. List t the first three authors,
followed by "et al" if there are more than three. Accuracy of citations is the
author's responsibility. Examples of correct referencing forms are as follows:
Journal Article: Raftery KA, Smith-Coggins R, Chen AHM. Gender-associated
differences in emergency department pain management. Ann Emerg Med.
1995;26:414-421.
Book: Huddy J. Emergency Department Design: A Practical Guide to Planning
for the Future. Dallas, TX: American College of Emergency Physicians; 2002.
Book Chapter: Mengert TJ, Eisenberg MS. Prehospital and emergency medicine
thrombolytic therapy. In: Tintinalli JE, Ruiz E, Krome RL, eds. Emergency
Medicine: A Comprehensive Study Guide. 4th ed. New York NY: McGraw-Hill;
1996:337-343.
Courses, lectures (unpublished): Sokolove PE. Needlesticks and high-risk
exposure. Course lecture presented at: American College of Emergency
Physicians, Scientific Assembly, October 12, 1998; San Diego, CA.
International Accreditation
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Internet: Gore L. ACEP hails House passage of the HEALTH Act [press release].
American College of Emergency Physicians Web site. Available at:
http://www.acep.org/1,32181,0.html. Accessed March 14, 2003.
Personal Communication: Avoid reference to personal communications, but
when necessary, include the person's name, his or her title, month, and year. A
letter granting permission to publish from the person providing the information
must be included at the time of submission.
Tables: Number tables consecutively. Refer to each table consecutively in the
text. Each table must be on a separate page after the references.
Figures: Figures (charts, graphs, photographs, etc.) and legends should be selfexplanatory and able to stand alone; the data presented in a figure should not be
duplicated in the text. Refer to each figure consecutively in the text.
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