The effects of EMS Education Standards in the EMS classroom.

The effects of EMS Education Standards in the EMS classroom

Define Educational Standard

Review the journey

Identify the components of the EMS Education Standards

Discuss the transition from NSC to SBE

Discuss ways to implement the Education Standards in the EMS Classroom

Level of quality or achievement

A measure

Definition body of knowledge

Defines competencies

1996 EMS Agenda for the Future

2000 EMS Education Agenda for the Future: A Systems Approach

Five integrated elements National EMS Core ContentNational EMS Scope of PracticeNational EMS Education StandardsNational EMS CertificationNational EMS Program Accreditation

Additionally: Gap Analysis Education Guidelines

Replace DOT National Standard Curricula

Meet practice guidelines within the Scope of Practice

Contain concepts of the EMS Core Content

Define entry level Competencies Clinical behaviors Judgments

Recognition of EMS as a healthcare profession !

DOT National Standard CurriculumAll levels of EMS Provider Prescribed content curriculumLesson plansClassroom activitiesHourly recommendationsFinal assessment measures

First Responder:National StandardCurriculum

United States Department of TransportationNational Highway Traffic Safety Administration

United States Department of Health and Human Services Maternal and Child Health Bureau

Complexity of Prehospital Emergency care Patient Criticality Complexity of management options

Complexity of Prehospital Emergency care Education Depth Breadth

Student learning measured by “competencies”

Shift from instructor – teaching to student –learning

Traditional lesson planning What content will I teach? How will I teach it? What materials will I need? What assignment will I give the students? What activities will I do in class? What homework will I assign? How will I test whether or not they learned it? How will I grade it? What is the next unit?

Developed by the SBE Design Team, Northern Colorado BOCES, through a Partnership Goals 2000 Grant

Standards –based education approach

What is the content standard [competency]?

How will students show what they know and can do?

What essential learning or components do students need?

What teaching strategies work best ?


Standards –based education approach (cont’d)

Are students developing knowledge and skills aligned to the standard?

What are the outcome measures?

What should be refined, revised, or retaught ?

Is change needed?


Whereby learning is achieved through a process

Comprised of four components

Standard/Competency (yellow)

Required knowledge (blue)

Clinical behaviors/judgments (green)

Educational infrastructure (white)

Table 2: Format of National EMS Education Standards

EMR EMT AEMT Paramedic

Content Area

Competency

Competency

Competency

Competency

Elaboration of knowledge

Additionalknowledgerelated to thecompetency




Clinicalbehaviors andjudgments




EducationalInfrastructure





Special PatientPopulations

Recognizes and manages lifethreats based on simpleassessment findings for apatient with special needswhile awaiting additionalemergency response.

Applies a fundamentalknowledge of growth,development, and aging andassessment findings to providebasic emergency care andtransportation for a patientwith special needs.

Applies a fundamentalknowledge of growth,development, and aging andassessment findings to providebasic and selected advancedemergency care andtransportation for a patientwith special needs.

Integrates assessment findingswith principles ofpathophysiology andknowledge of psychosocialneeds to formulate a fieldimpression and implement acomprehensivetreatment/disposition plan forpatients with special needs..


Obstetrics Simple depth, simple breadthRecognition and management of• Normal delivery• Vaginal bleeding in the pregnant patient

EMR Material Plus:Fundamental depth,foundational breadth• Anatomy and physiology ofnormal pregnancy• Pathophysiology ofcomplications of pregnancy• Assessment of the pregnant patient• Management ofo Normal deliveryo Abnormal delivery•Nuchal cord• Prolapsed cord• Breech deliveryo Third trimester bleeding• Placenta previa• Abruptio placentao Spontaneousabortion/miscarriageo Ectopic pregnancyo Preeclampsia, Eclampsia

Same as Previous Level

AEMT Material Plus:Complex depth, comprehensivebreadth• Anatomy and physiology ofpregnancy• Pathophysiology ofcomplications of pregnancy• Assessment of the pregnantpatientPsychosocial impact,presentations, prognosis, andmanagement of• Normal delivery• Abnormal delivery• Nuchal cord• Prolapsed cord• Breech• Spontaneousabortion/miscarriage• Ectopic pregnancy• Eclampsia• Antepartum hemorrhage• Pregnancy inducedHypertension

Cont’d……

EMR

Perform a simple assessment toidentify life threats (vaginal Bleeding), identifyinjuries requiring immobilization and conditionsrequiring treatment within thescope of practice of the EMR:including foreign substance inthe eyes and nerve agentPoisoning

• Assisted normal delivery• Bleeding control

Initiates simple interventionsbased on assessment findings (Braxton Hicks)

Assessment

Psychomotor Skills

Decision Making

Educational Infrastructure

EMR/EMT

Educational Facilities: •Facility approved by sponsoring agency•ADA compliant facility•Sufficient space for class size•Controlled environment

Course length •Course length is based on competency, not hours•Course length is estimated to take approximately 48-60 didactic and laboratory clock hours

Program Evaluation•Provide evaluation of program instructional effectiveness•Provide evaluation of organizational and administrative effectiveness of program

Student Space•Provide space sufficient or students to attend classroom sessions, take notes and participate in kinematic learning and practice activities

Student Assessment•Perform knowledge, skill and professional behavior evaluations based on educational standards and program objectives•Provide several methods of assessing achievement•Provides assessment that measures, as a minimum, entry level competency in all domains

Field Experience (EMT):•The student must participate in and document patient contacts in a field experience approved by the medical director and program director

Instructional Resources•Provide basic instructional support material•Provide audio, visual, and kinematic aids to support and supplement didactic instructions

Hospital Experience (EMT):•Students should observe emergency department operations for a period of time sufficient to gain an appreciation for the continuum of care. •Students must perform ten patient assessments. These can be performed in an emergency department, ambulance, clinic, nursing home, doctor’s office, etc., or on standardized patients if clinical settings are not available

Stages in the Backward Design Process

1. Identify Desired Results

2. Determine acceptable evidence

3. Plan learning experiences and instruction

Step One: Identify the standard

Step Two Identify the assessment method and scoring

criteria

Step ThreeDevelop the lesson plan and delivery

method

Class: Content area (Standard) – Competencies: Prerequisite Knowledge – Elaboration

Required Knowledge - Elaboration (lesson plan)

Clinical Behaviors & Judgments

Instructional Strategies (student- centered) Educational Infrastructure

Assessment Measures Benchmarks

Class: Cardiovascular Emergencies

Standards/Content area – Competencies: Prerequisite Knowledge – Elaboration

Recognizes and manages life threats based on assessment findings of a patient with a medical emergency while awaiting additional emergency response.

Uses assessment information to recognize shock, respiratory failure or arrest, and cardiac arrest based on assessment findings and manages the emergency while awaiting additional emergency response

Scene Size upPrimary Assessment History takingSecondary AssessmentReassessmentAirway Management Vital SignsPathophysiology of Shock & Respiratory compromiseCPR/AEDTherapeutic Communication techniquesDocumentation

Required knowledge -Elaboration – (Lesson Plan)


Simple depth and simple breadth Anatomy, signs, symptoms and management

•Chest pain (deeper discussion on CP & Heart attack)•Cardiac arrest

Perform a patient assessment and provide prehospital emergency care for patient complaints:Cardiac arrest, chest pain Manual CPRAEDDecision making

Instructional Planner

Cardiovascular – Cont’dInstructional Strategies (student- centered)

Educational Infrastructure

Classroom lectureHomework assignmentsScenario discussionRole playingSkills lab for CPR, AED, V/S

SponsorshipProgrammatic ApprovalFacultyMedical Director OversightHospital/Clinical ExperienceField ExperienceCourse lengthCourse DesignStudent AssessmentProgram Evaluation

Assessment Measures

Benchmarks

Informal checks for understanding during lectureObservation of student engagement with directed dialogueFormative QuizzesFinal Summative ExamFinal Practical skills testing - CPR/AED scenario

Students able to answer informal questioning Students awake, eye contact, note taking, asking questionsIdentified content questions - 80% accuracyIdentified content questions – 80% accuracyDemonstrates ability to manage Chest pain – Cardiac Arrest patient scenario meeting all competencies

Instructional Planner (Cont’d)

EMR EMT AEMT ParamedicAssessment Use scene

information and simple patient assessment to identify and manage immediate life threats and injuries within the scope of practice of the EMR

Applies scene information and patient assessment findings (scene size up, primary and secondary assessment, patient history, and reassessment) to guide emergency management

Same as previous level

Integrate scene and patient assessment findings with knowledge of epidemiology and pathophysiology to form a field impression. This includes developing a list of differential diagnosis through clinical reasoning to modify the assessment and formulate a treatment plan

Class: Assessment (EMR)

Standards/Content area – Competencies: Prerequisite Knowledge – Elaboration

Use scene information and simple patient assessment to identify and manage immediate life threats and injuries within the scope of practice of the EMR

Scene Size upHistory takingTherapeutic Communication techniquesDocumentation

Elaboration - Required Knowledge(Lesson Plan)


Primary Assessment: simple depth, simple breadthPrimary assessment for all patient situationsLevel of consciousnessABCsIdentify life threatsAssessment of vital functionsBegin interventions as needed to preserve life

Secondary Assessment: Simple depth, simple breadthPerforming a rapid full body scanFocused assessment of painAssessment of Vital signs

Perform simple Assessment to identify life threatsBasic Airway ManeuversAssessmentManual BP

Instructional Planner


Classroom lectureHomework assignmentsScenario discussionRole playingSkills lab : patient assessment, BP, airway management


Assessment Measures

Benchmarks

Informal checks for understanding during lectureObservation of student engagement with directed dialogueFormative QuizzesFinal Summative ExamFinal Practical skills testing - Assessment, Vital Signs

Students able to answer informal questioning Students awake, eye contact, note taking, asking questionsIdentified content questions - 80% accuracyIdentified content questions – 80% accuracyDemonstrates ability to do a patient assessment

Instructional Planner (Cont’d)

Class: OB (EMR)

Content area (Standard)– Competencies: Prerequisite Knowledge – Elaboration

Recognizes and manages life threats based on simple assessment findings for a patient with special needs while awaiting additionalemergency response.

AssessmentAirway ManagementVital SignsManagement of Shock (hemorrhagic)CommunicationScene Management

Required Knowledge – Elaboration (lesson plan) Clinical Behaviors & Judgments

ObstetricsSimple depth, simple breadthRecognition and management of• Normal delivery• Vaginal bleeding in the pregnant patient

AssessmentPerform a simple assessment to identify life threats, identify injuries requiring immobilization and conditions requiring treatment within the scope of the EMR (Vaginal Bleeding )

Psychomotor Skills• Assisted normal delivery• Bleeding control

Decision MakingInitiates simple interventions based on assessment findings (Braxton Hicks)


Interactive Classroom lectureHomework assignmentsScenario discussionRole playingSkills lab for labor assessment and delivery


Assessment Measures Benchmarks

Informal checks for understanding during lectureObservation of student engagement with directed dialogueFormative QuizzesFinal Summative ExamFinal Practical skills testing - laboring patient w/excessive bleeding through to delivery

Students able to answer informal questioning Students awake, eye contact, note taking, asking questionsIdentified content questions - 80% accuracyIdentified content questions – 80% accuracyMeets criteria on skill sheet for scenario

1. Objectives

2. Elaboration/outline

3. Behavior/psychomotor skills

4. Class activities

5. Student outcome measures

6. Revisions

1. Objectives: At the completion of this module the student will: Identify pertinent anatomy to the obstetric patient Discuss physiological changes that occur with pregnancy Discuss assessment of the pregnant patient Discuss Stages of labor Discuss true versus false labor

Braxton Hicks Discuss Vaginal bleeding Discuss management of excessive vaginal bleeding

2. Elaboration/outline Anatomy & Physiology Physiological changes Stages of labor Patient assessment Assessment of Labor Vaginal bleeding Delivery process Patient Management

Mother Newborn

3. Behavior/Psychomotor SkillsPatient assessment

Laboring patient Post delivery New born Vaginal Bleeding

Airway management Vital signs

4. Class Activities Interactive lecture Scenario based discussion Lab practice w/ delivery manikin

5. Student outcome assessment measures Quizzes/exam questions Class discussion participation Practical exam

Laboring mom w/ excessive vaginal bleeding Laboring mom with normal delivery

6. Revision

Evaluate yourself and askDo my students understand what I expect

them to know?

Does the content and teaching methods I am using match and work with the stated objectives and standard?

Do my quizzes, exams, psychomotor skill evaluations, clinical assessment tools provide a means to measure the objectives and standard?

If you answered yes to all – you are good to go

If you answered no to any of those questions something needs to be fixed. EitherFix, add or deleteChange the content or methodsModify the evaluation tools

Start with the standard Identify measurable learning outcomes Approach from “students’ perspective” Develop approach to lesson/class Measure outcomes Adapt change as needed

It is a process It will take time Keep sight of the goal Take the time Start where you plan to end Think like an assessor Remember the student-centered

approach

Terry DeVito860-906-5153 [email protected]

Capital Community College 950 Main St. Hartford, CT 06103

Drake, S., Burns,R. (2004). Meeting Standards Through integrated Curriculum. Alexandria, VA.: ASCD Publications.

Marzano, R.(1996) Eight Questions about Implementing Standards-Based Education. Retrieved: 2/22/2009 from: http://pareonline.net/getvn.asp?v=5&n=6

NAEMSE (2006) Foundations of Education. Mosby, St. Louis, MO.

NHTSA (2002) National Guidelines for Educating EMS Instructors.

Schmoker,M., Marzano, R.(1999) the Promise of the Standards Movement. Retrieved 6/4/2010, from http://mikesschmoker.com/promise.html

Sasson, D. (2008) Working with Education Standards. Retrieved 6/4/2010, from: http:/lesson-plan-help.suite101.com/article.cfm/working_with_educational_standards

United Sates Department of Transportation, National Highway Traffic Safety Administration & United States Department of Health Resources & Services Administration, Maternal & Child Health Bureau (1996) Emergency Medical Services Agenda for the Future

United Sates Department of Transportation, National Highway Traffic Safety Administration & United States Department of Health Resources & Services Administration, Maternal & Child Health Bureau (2000) Emergency Medical Services Education Agenda for the Future

Schultz,D. (2005). Standards in the Classroom. Retrieved 6/4/2010. From: http://www.astm.org/SNEWS/JULY_2005/schultz_jul05.html

Wiggins, G., McTighe, J. (1998). Understanding by Design. Upper Saddle River, NJ.: Prentice Hall Publishing.

What are Academic Standards: http://www.thirteen.org/edonline/concept2class/standards/index.html

National EMS Scope of Practice Model: http://nasemso.org/Projects/ScopeOfPractice/FINALEMSSept2006_PMS314.pdf.pdf.pdf

EMS Education Agenda for the Future http://www.nasemso.org/Projects/EMSEducation/documents/FinalEducationAgenda.pdf

2009 EMS Ed standards Gap Analysis Template http://www.naemse.org/data/content/positionpapers/2009%20NASEMSO%20Gap

%20Analysis%20Template.pdf

National EMS Core Content http://www.nhtsa.gov/people/injury/ems/EMSCoreContent/images/EMSCoreContent.pdf

National EMS Education standards http://www.ems.gov/pdf/811077a.pdf

Link to Instructor Guidelines http://www.ems.gov/education/nationalstandardandncs.html

The effects of EMS Education Standards in the EMS classroom.

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