The High-Tech Future of Continuing Education

With more than 30 years as a paramedic and an extensive background in EMS education, Jay Scott brings an abundance of experience to his new position as executive director of the Continuing Education Coordinating Board for EMS. He also brings familiarity, having chaired CECBEMS’ board of directors.

Scott, BS, NREMT-P, took office in November. It’s a good fit at a dynamic time for continuing education, with advancing technology rapidly changing the face of how personnel get their hours. On the occasion of the release of the CECBEMS Best Practices Model Document for CE providers (published here), EMS World spoke to Scott about the evolution of EMS continuing education and his goals for the organization.

How did your extensive background in EMS and education help prepare you for your role as executive director of CECBEMS?

Well, I’ve always been passionate about the provision of EMS care, and even more passionate about making sure EMS providers get what they need. That includes getting credit for the time they spend being trained. It’s one thing to spend evenings, weekends and holidays away from your family for work, but it’s something else to ask people to spend time away from their family members and friends to go do continuing education. So it’s imperative for me that people get credit for the time they spend in training. And that training should exceptionally well done—well prepared, credible, relevant and exactly what EMS providers need.

What is the role of CECBEMS in helping to achieve that and advance the EMS profession?

When we formed back in 1992 under the guidance of Janet Head, who was then the president of NAEMT, her overriding goal was that we standardize continuing education so that every CE opportunity is a high-quality opportunity. We didn’t want any more of, “Let’s meet at the firehouse Friday night and talk about things that have been out of protocol for 10 years.” We know EMS is a very dynamic profession and things change every day, and we have to stay on top of that.

If the continuing education programs aren’t up to snuff—if they don’t stay ahead of the constant changes and this current evolution we’re going through—then we’re not going to prepare a very good EMS provider. If we want to have the best EMS system anywhere, we have to make sure the educational piece stays in pace.

With the rapid changes in areas like technology, how should CE providers approach that? What should they be doing to prepare and move into the future? 

One of the reasons the board of directors prepared the best practices model document was that we’ve seen a dramatic change in the technical ability of continuing education providers. Those changes have been absolutely amazing. We’ve seen a shift away from the traditional approaches, like reading a magazine article and getting credit for it or reading an online presentation that’s written-word-only, then taking a short post-test. People are gravitating more toward the higher-end stuff: the narrative videos, the cell phone applications. Those are the things people want to see—it has to be interactive and flashy, but also relevant and current.

Those are the trends now, and it’s fascinating to watch. Back when I started, our first monitor was the Lifepak 5, and there weren’t a whole lot of functions. It defibrillated, it read an EKG, and we could hook it up to a monitor and transmit an EKG, and that was pretty much it. But as technological changes happen, continuing education programs have to keep up with the times.

When CE providers prepare to seek accreditation for their programs, are there areas they commonly overlook or that frequently delay the process? What trips people up?

I think the things people tend to underestimate when they prepare their applications are 1) the participation of a system-wide or service-level medical director who’s active, involved and has EMS experience, and 2) that there’s an active program committee. We actually like to see some description of how the medical director interacts with the program committee and how the workings of that committee help set their educational agenda.

The needs assessment is built into that as well. Folks may not to do a good, careful, detailed needs assessment, and instead just say, “Well, let’s just do the same stuff next year we did last year.” That’s not what EMS providers want. They want new; they want to see things that are pertinent to their everyday practice, things that are coming six months from now. “What are the big changes? What do I have to prepare for?”

So doing a valid needs assessment, having an active program committee and medical director, and, for us, seeing the documentation of how those pieces interact and develop an educational agenda, and how that’s presented to the EMS providers, and then the way they get a chance to evaluate that—those are the things that are most often missing. The description of how all those pieces fit together should provide for EMS providers a valid, relevant continuing education agenda.

What goes into a good needs assessment? What sort of things should a provider look at?

There are many ways to do it; I don’t think there’s any one gold standard. However, personally I think a needs assessment really ought to be based on call volume and quality improvement initiatives. If an EMS provider has done really well with their management of STEMI and STEMI’s a large part of their call volume, do we really need to focus on STEMI? Maybe we should focus more on the things that provider sees less of. For instance, I haven’t done a live delivery in probably eight years, so maybe in my continuing education program it would be appropriate to spend some time practicing and studying up on live deliveries, in case I have to face that in the field.

A real needs assessment looks at the system as a whole, based on call volume and call trends, but also what the individual is doing. How has the individual responded to their particular calls, and how should their service match up the educational agenda for that individual? The time has passed where we just say, “This month we’re going to cover traction splinting.” That’s not good enough. We should be covering what the individual needs to see, based on what they haven’t done recently.

What was the purpose of putting together the best practices document?

As we’ve seen this dramatic shift in the technological abilities of continuing education providers, we thought in order to really improve the applications for accreditation, and ultimately the provision of continuing education, we should detail some of the best practices we’ve seen. These are areas where some CE providers really stand out above the rest.

You outline some of these new technologies in the paper; what’s new and exciting?

Some of them are really amazing. There’s one provider who has a three-dimensional platform using a smartphone where you can practice skills on your phone at any time. You can be sitting in your ambulance at 3 in the afternoon and practice pleural needle decompression. And it’s really not that expensive.

You also mention new training for reviewers to go along with that. What will that entail?

Where we have reviewers who haven’t necessarily seen all these recent technological changes, we’ll need to get them up to speed. We’ve also seen a couple of unfortunate instances where some continuing education providers have used educational products from other CE providers. That doesn’t happen often, but there have been three cases in the last 12 months.

For our reviewers to be able to recognize works that aren’t original, that maybe need to be flagged, that’s a big push for us. We’ve written a document to help them recognize things that aren’t original early in the application process. We’re training them to look through the whole reference list, to be sure they go back and do a Google scholar search to make sure the references match up with the content, the objectives match the content and references, and so on.

It’s really kind of putting all the puzzle pieces together. So when we look at a particular offering, we’re looking at the objectives, we’re looking at the needs assessment that led to that set of objectives, we’re looking at how the program committee put that list of objectives together based on the needs assessment and the input of the medical director, and we’re looking at the content to see that it’s all relevant and matches the needs assessment and the objectives. And then we’re looking at how it’s referenced—that people are using peer-reviewed journals and current textbooks and textbook chapters from well-known authors written within the last couple of years.

That’s a lot different from looking at an offering on, say, management of chest trauma and seeing the author cited a sole textbook that was the Brady paramedic manual from 1990. EMS has evolved a lot since 1990!

You and the chair of CECBEMS’ board, Dr. Juan March, are speaking at EMS World Expo. What will you be addressing?

I’ll be doing a lecture about CECBEMS, the accreditation process, how it came about, what we look for and how it all improves the educational activity. Dr. March will talk specifically about the best practices document.

A Backup Records Resource

Your deadline for completing your CE is imminent, and you’ve misplaced your records—time to panic?

Maybe not, if CECBEMS has your info. The organization now holds more than six million CE records in a database that provides easy access and reference. CE providers submit them as users complete their accredited programs.

“We do it as a means of maintaining those records,” says Scott, “but also to be sure, if somebody can’t find their completion certificate or needs to recertify and just can’t pull all their stuff together, there’s a means for them to call and say, ‘Hey, I lost a record, can you help me out?’

“We can sort the database by name, state of licensure and recertification number, then we can pull all the things that are important to CECBEMS. We require all accredited providers to report course completions just for that purpose of making sure the EMS provider doesn’t ever get lost in the shuffle.”

Those records will also soon be shared with state EMS offices and the National Registry. For more, see www.cecbems.org.

 EMS World Expo is Sept. 15–19 in Las Vegas. Jay Scott and Juan March both speak on Sept. 18. For more, visit https://emsworldexpo.com/.