Art Hsieh on EMS Education

"10 Minutes With" is a bimonthly column that presents brief interviews with leaders involved in many facets of emergency medical services. Suggestions for topics can be sent to the author at rbarishan sky@onebox.com.

EMS, by its nature, is in a constant state of flux. To meet the demands of this ever-changing field, EMS educational initiatives must be constantly revisited and modified. Topics that have evolved in relation to this ongoing effort include addressing the learning needs of a diversified student base, CME/CEU-based recertification programs, EMS educational benchmarking and the use of nontraditional teaching techniques.

This month’s column focuses on the current state of EMS education from the viewpoint of Art Hsieh, MS, NREMT-P, of San Francisco, CA. Hsieh is the immediate past president of the National Association of EMS Educators (NAEMSE). His previous posts include professor of Emergency Medicine at George Washington University and training captain for the San Francisco Fire Department’s EMS section. Hsieh has served as an expert contributor on many position papers and authored multiple articles on prehospital education.

What are some recent initiatives in EMS education?

The biggest initiative occurring right now is the EMS Education Agenda for the Future. Representing the first major step in the implementation of the [National Highway Traffic Safety Administration’s] EMS Agenda for the Future, the Education Agenda is a systems approach to development of the educational system for EMS providers nationwide.

The Education Agenda is divided into five major phases, beginning with "Core Content," currently in its draft format. It describes the general body of knowledge that is EMS, and includes all technical skills encompassed in that domain. The development of the agenda is currently in its second phase, "Scope of Practice," which looks at the domain and aggregates the knowledge into different levels of practitioner. Phase three, "Education Standards," scheduled to begin toward the end of this year, will develop the educational process to train these practitioners. Phase four will address the development of the concept of national accreditation for training programs; phase five will create uniformity of practice through national provider certification. Put all together, these components represent an organized, rational approach to the current EMS educational system in the United States.

The second important EMS education project is NAEMSE’s State of EMS Education Research Project, or SEERP. SEERP is the first nationwide effort to collect information about the "typical" EMS instructor in the United States. The information being collected and analyzed will be beneficial in development of the education standards. It will also provide states with factual information about their current instructor corps. Finally, the data will provide the basis to begin looking at best practices in EMS education that lead to better-prepared EMS practitioners.

Do you see nontraditional delivery methods (e.g., the Internet, video learning, etc.) having significant impact on EMS education?

There are wonderful opportunities for augmented learning through advances in technology. EMS education programs that use learning management systems bring additional information literally to the student’s fingertips. Other programs are experimenting with distributed learning methods to overcome traditional barriers. Rural areas, for example, are engaging students across long distances with video and audio feeds that allow two-way interactions between instructors and students.

We are also on the threshold of creating more realistic and affordable manikins to simulate real patients, as well as learning environments that more closely mimic real-world situations. Recently, the medical community has been strongly advocating the use of simulation to minimize novice mistakes on real patients.

NHTSA has called for EMS to play a larger role in preventive medicine, such as immunization administration and child safety courses for the public. Is this a good direction for EMS to move in?

It has been repeatedly shown that the adage "an ounce of prevention is worth a pound of cure" holds true. Although EMS has traditionally been a reactive profession, there are many systems that have easily and effectively adapted proactive prevention roles into their daily operations.

Is this a good move for EMS? That depends. Is the move in response to a real or potential problem that affects the local community? Does the additional role impact the primary role of EMS in that community positively? Is the training provided to the EMS provider appropriate and sufficient? Are the results evaluated for value and effect? Is the community aware that it can seek help about this problem through its EMS system? I think the more of these questions that can be answered yes, the more likely the answer to your question is yes.

What responsibility do EMS educators have to lifelong learning?

It’s perhaps one of the primary responsibilities of EMS educators. Medicine is, by its nature, an evolving body of knowledge and practice. Words of wisdom we take for granted today may be proven completely wrong in the future. Healthcare providers who remain mired in the past are at risk of becoming obsolete; EMS personnel are not immune to that. It is critical for educators to help providers value lifelong learning and apply it to their craft.

The author would like to thank Amanda Cotter, MS, NREMT-P, for her valuable assistance and insight on this subject matter.