What the New EMS Education Standards Will Mean for EMS

In this interview, Paul Rosenberger, EdD, a co-chair of the effort to revise and update the National EMS Education Standards, describes the role of the Standards and what they mean for EMS educators, leaders and students

The EMS community came together in 2009 to create the original National EMS Education Standards. These Standards were a major step toward realizing the vision described in the 1996 EMS Agenda for the Future and, four years later, outlined in the EMS Education Agenda for the Future: A Systems Approach. Today, with the support of the National Highway Traffic Safety Administration and the Health Resources and Services Administration, Maternal and Child Health Bureau’s EMS for Children program, a dedicated group of EMS education experts have been working to update the 2009 Standards while engaging with stakeholders across EMS and healthcare and the public to receive input. This Standards revision builds on a quarter-century of advancing EMS education systems nationwide, including the new National EMS Scope of Practice Model and EMS Agenda 2050. The updated Standards will be released in 2021.

Project co-chair Paul Rosenberger, BS, MPA, EdD, NRP, began his career in EMS more than 30 years ago and has spent the last two decades educating future and current EMS clinicians. He is currently the associate director of the EMS Education program at UT Southwestern in Dallas. In this interview, he discusses how the Standards are being revised, what they mean for the profession, and what he’s learned during the process.

Q: Why revise the Education Standards now?

Because the original Standards are over a decade old, they require an update to ensure that the education of new EMS clinicians is in line with the recently released 2019 National EMS Scope of Practice Model, which reflects current evidence-based medicine, best practices, and advances in technology in prehospital care. The Standards help educators, certifying bodies, and regulators ensure that EMS clinicians at all levels receive an education that prepares them to perform at their level of certification. It’s important to note that the national EMS community has largely adopted a system described in the National EMS Scope of Practice Model that includes four steps: education, certification, licensure and credentialing. This project does not involve the credentialing domain. Rather, the aim is to develop standards that help create a well-educated EMS clinician who can enter the workforce and later become credentialed by an EMS organization and medical director.

Q: How are education standards different from credentialing?

Education standards are learning goals, a common set of expectations, or a description of desired knowledge that individuals should possess at certain points in their educational careers. They have some attributes in common with the credentialing process, such as defined subject areas, learning progression and educational goals, but they don’t describe any teaching practice or assessment/evaluation method. Credentialing comes later, after an EMS clinician is educated, certified, and licensed to perform EMS roles.

Q: Are the education standards a curriculum?

No. The Standards provide guidance on minimum competency levels; an education curriculum is a detailed plan for day-to-day instruction and assessment. EMS educators and local communities select or create curricula based on regional needs, accreditation standards, and state and local policies and regulations. Curricula and other aspects of specific education programs and courses need to be resolved at the local level and based on local situations, students’ needs and available resources. With so many variables to consider, a single, one-size-fits-all curriculum couldn’t possibly serve the needs of all communities.

Q: Who have you worked with to provide input on this project?

The project team has been fortunate to receive input from several sources. Numerous individuals and EMS stakeholder groups have given comments, suggestions, and recommendations. We’re reviewing and evaluating every comment received to ensure we produce a rich and complete document. The team itself is also a group of educators who come from all over the country and have a diverse range of experiences, both in clinical and educational settings.

Q: What kinds of updates can we expect to see?

The revised Standards will define the competencies, clinical behaviors, and judgments that entry-level EMS personnel must have in order to meet practice guidelines defined in the updated National EMS Scope of Practice Model. Changes will reflect changes made to the scope model, as well as other developments in evidence-based practices and the role of EMS clinicians in their communities.

Q: Is there anything the revised Standards will not include?

They won’t include requirements for official specialty certification education, such as critical care, community paramedicine, flight paramedic, or tactical EMS—they are focused only on educational requirements for entry-level EMS clinicians at the EMR, EMT, AEMT and paramedic levels. Likewise, continuing education requirements will not be addressed. Because the larger EMS community lacks clear consensus for a formal degree requirement, the Standards will not address this issue, and EMS nomenclature is not a part of the scope of this project.

Q: What about the Instructional Guidelines?

The 2009 Instructional Guidelines (IGs) were not considered part of the original Standards—they were companion documents. They provided guidance to instructors, regulators, and publishers regarding the specific content that should be included in courses to address each area of the Standards. The original IGs were not meant to be all-inclusive; they don’t comprise a curriculum and were not intended to be adopted by states. Their purpose was to provide a resource, beyond the Standards, to an educational program’s director when developing curricula. But the IGs were also prescriptive and difficult to keep up-to-date, and we heard from many educators that while they were very useful a decade ago, EMS education had evolved beyond the need for such detailed IGs. So instead of creating separate IGs, we’ve taken some of the concepts from the IGs and folded them into the Standards, while still keeping them high-level and allowing for flexibility.

Q: What has surprised you as you have worked through this project?

The interest in the project has been surprising. I never expected so many people and organizations to pay attention to the revision process! Early on, I believed that we would be making small adjustments to the existing 2009 Standards. After all, this document has been in place for 11 years and was built upon the visions and work of the writers of the EMS Agenda for the Future and the EMS Education Agenda for the Future: A Systems Approach. But the interest has been a welcome surprise because the team has been able to produce a better document.

Learn more about the revision of the National EMS Education Standards by visiting the project page on EMS.gov.