Recently, there’s been a fair amount of discussion about continuing education in EMS. Having to maintain licenses in two very different professions gives me some unique perspective. (At least I think so…)
For EMS providers in Texas, there are several ways to maintain ones certification. Retesting is an option. There’s also an option for a refresher course, although I rarely see them offered. Texas also allows for renewal through continuing education hours or by maintaining one’s National Registry, which presents its own options for continuing education hours or retesting.
To add to this, for either Texas or National Registry, the continuing education hours have to be spread out over certain content areas. At the most abstract level, this makes sense because most EMS providers rarely get to choose the patients, illnesses, or injuries they encounter.
Now, on top of these requirements, which are overall rational and, for the most part, are practical to maintain (We’ll leave out NR’s arbitrary limits on online CE hours), some EMS systems maintain their own additional requirements for continuing education. The most onerous I’ve seen require providers to maintain certain “card courses” and to complete a minimum number of hours of CE each year, regardless of what recertification option the individual EMS provider chooses. These hours are verified on a yearly basis by the submission of the respective CE certificates. This same system requires all of its providers to maintain a CPR card and a PHTLS (That’s “PreHospital Trauma Life Support” for the non-EMS readers) card. Paramedics are also required to maintain a pediatrics card course card and an ACLS card. To their credit, though, this EMS system also has some relatively advanced protocols.
The State Bar of Texas provides the following guidance regarding “minimum continuing legal education:”
Every active State Bar of Texas member must complete a minimum of 15 hours of accredited CLE during each MCLE compliance year.
- 12 of these hours must be in accredited CLE classes
- 3 of these hours must be in legal ethics/legal professional responsibility
- 3 of these hours, including 1 hour of legal ethics, could be in self study.
That’s it. No description of what the courses have to include or address, although the State Bar does have an approval process for CLE classes. No mandates, aside from ethics, as to what attorneys need to study up on, although most attorneys either take classes on topics relevant to their practice or their personal interests. And in my twelve plus years of practicing law, I’ve never seen an employer mandate certain classes for attorneys or mandate a certain number of hours. (Of course, if the employer is paying for the course, they will only pay for courses that they think are appropriate.)
So, when you look at it solely from the continuing education standpoint, ask yourself, which of these two careers is a profession? And more importantly from the EMS side, does your EMS system really trust you, protocols aside, if they have to tell you exactly what courses they expect of you and how many hours you need each year and want to see the certificates each year? Granted, there are probably specific people who’ve caused such policies to be enacted, but to me, being a professional means more than being trusted with cool drugs or interventions. It means you’re trusted and expected to be responsible for your own professional development. If you can’t be responsible for your own development in your profession, how can your employer trust you? More importantly, should an employer want employees who need that much direction on how to maintain their certification?
That’s a professional debate worth having. Let the debate begin.
I am not sure that lifting con-ed regulations is possible for EMS providers under the current educational scheme. I don’t know about law school but part of medical school is learning a bit about the different medical specialties and spending time in each. Along with understanding of the knowledge of the respective specialties, you are also introduced to basic principles as well as where to look for answers and help when you need it. Currently, many EMS providers either don’t have broad enough clinical exposure and often even when they do, the time they spend there is wasted. For somebody who was already forced to learn the scientific principles common to all of medicine and then forced to learn clinical basics, permitting that person to further develop their professional interest or specialty, whether emergency medicine or otherwise, is very different from somebody trained only in basics of a very narrow field like EMS. Con-ed simply cannot make up for lack of initial education. In most cases it requires nothing more than showing up. It certainly isn’t going to verify competency in things like physiology or patho. One day I hope US EMS education catches up to the rest of the world and they can be self policing of their own professional development, but it is not there today. How many providers would go to the ICU or neonatology, peds outpatient, etc? I think only a marginal amount unless they are forced.
The weakest link, to me, in EMS education is our initial requirements. We spend a lot of time teaching people to do ‘stuff’, much of it things they will never, or rarely do, much more rooted in dogma and myth. In some cases, a lot of agencies find that they have to re-train and re-educate providers in modern expectations and up-to-date medicine and techniques.
We have to address THAT, which means, like I have heard many times, raising the initial expectations for EMS initial education.
But, I believe too many people have a vested interest in keeping the status quo.
Wes, I would like to point out that continuing education requiremwnts have very little to do with medicine and have far more to do with insurance regulations and maintaining proficency as expressed with the cards. Not a perfect system, but a uniform one.
i have never seen a shred that suggested that EMS CEU requirements have anything to do with insurance. Those requirements are set by state EMS boards, which are made up of (a) mostly people with MD, RN, etc. after their names, who (b) don’t think much of EMS folks and believe that we must be under their thumb.
There is also nothing to do with proficiency. The whole xLS “card” thing is a big scam to make money for a variety of associations – re-package general medical education stuff in to a “course” and then require the course, with attendant payment for books and certificates. NOTHING to do with proficiency!
Don’t know where to begin on this. The differences are big. I agree with the 9E1 comment. We need more education. But a nagging question in my mind, is an attorney required to do anything from route memory? Or do they have weeks/months to study up for it?