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Making Paramedicine a Profession

Time to build our paramedic profession infrastructure

It appears that our physician colleagues accomplished more than paramedics since 1968, establishing Emergency Medicine as a specialty in 1979 and Emergency Medical Services as a subspecialty in 2010. (How EMS physicians became recognized and rewarded)

The development of the National EMS Educational Standards in 2009 is a more significant development. (EMS Future is HERE)

Emergency Medicine built upon an existing graduate medical education structure

The significant physician accomplishments were built upon a well-established graduate medical education infrastructure.

A September 2006 article in the New England Journal of Medicine describes the foundation of medical education:

Almost a century ago, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, undertook an assessment of medical education in North America, visiting all 155 medical schools then in operation in the United States and Canada. His 1910 report, addressed primarily to the public, helped change the face of American medical education.

American Medical Education 100 Years after the Flexner Report

Two physician members of the National Emergency Medical Services Advisory Committee referenced the Flexner report when discussing update options to the 2009 National EMS Educational Standards in an all-day roundable on March 28, 2012 (agenda).

All professions with significant academic preparation go through this type of review process.

I used the results from evaluation of the Masters in Business Administration program to discuss the state of EMS Education in 2009.

The Ford Foundation and Carnegie Corporation criticized business graduate education in 1959 as filled with:

  • Weak Students
  • Inappropriately trained faculty members
  • Unintellectual curriculum
  • Poor research

What Direction for EMS Education?

From "sticky side down" first aid mechanic to health care professional

The 2009 Educational Standards vaults paramedicine out of the vocational training arena. It will have the same impact as the Flexner report had on physician education and the Ford/Carnegie reports had on Masters in Business Administration programs.

But we have signficant gaps to fill to satisfy the medical professional model.

Need appropriately trained faculty members

I will never forget talking to a community college assistant dean about the Educational Standards. An experienced paramedic with years as a state-credentialed paramedic instructor, she shared that she recently got her associate degree. The associate degree was from the same paramedic program she was running. Not sure she could complete a bachelor degree.

Most community college leaders are required to have master's degree, often they have a Ph.D. or Ed.D. terminal degree.

I have no doubt she is a dedicated, passionate and effective paramedic instructor … but she needs better academic credentials.

The biggest push back to CoAEMSP accreditation of paramedic programs was the requirement that the program director have a bachelor degree. (2008 fact sheet)

In the academic world, those with terminal doctorial degrees "create knowledge" and impact professional/graduate educational programs.

Will you step up?

Mike "FossilMedic" Ward

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Comments - Add Yours

  • Art Hsieh

    Great research Mike. As we keep stepping forward, we know more about what we didn’t know. 5th graders can’t be teaching 4th graders; yet that culture set is rigidly adhered to in EMS education.

    • http://www.firegeezer.com/ Mike “FossilMedic” Ward

       Hi Art!

      Thanks for the response.

      Mike

  • Jesse

    I agree with the recommendation to improve the educational background of our entry level and advanced instructors. 

    Sometimes in the quest to raise the bar for education, we have to be careful not to lose track of supporting the small community providers for whom EMT is “advanced education. 

    Many of those small community ambuance services cannot now pay competing, i.e. big city municipal wages and serve as training grounds for the metropolitan areas.  The call volume and the medical transport business are not paying the bills as they have in the past.  

    Rural Pennsylvania comes to mind in this regard.   

  • http://bit.ly/gwalter gwalter

    I agree – until we take responsibility for our own professional standards, we will continue to be stuck in the rut of “ambulance drivers” everywhere. I worked with some of those old ambulance drivers – they taught me much, but times have changed and it is time to move forward!