Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-27T21:49:07.839Z Has data issue: false hasContentIssue false
  • English
  • Français

An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014)

Published online by Cambridge University Press:  11 December 2015

Ingrid A. Brooks Open the ORCID record for Ingrid A. Brooks [Opens in a new window] ,
Michael R. Sayre Open the ORCID record for Michael R. Sayre [Opens in a new window] ,
Caroline Spencer Open the ORCID record for Caroline Spencer [Opens in a new window]  and
Frank L. Archer
Ingrid A. Brooks*
Affiliation:
School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
Michael R. Sayre
Affiliation:
Division of Emergency Medicine, University of Washington, Seattle, WashingtonUSA
Caroline Spencer
Affiliation:
Disaster Resilience Initiative, Monash Injury Research Institute, Monash University, Clayton, Victoria, Australia
Frank L. Archer
Affiliation:
Disaster Resilience Initiative, Monash Injury Research Institute, Monash University, Clayton, Victoria, Australia
*
Correspondence: Ingrid Brooks School of Nursing and Midwifery Faculty of Medicine, Nursing and Health Sciences Monash University Building 10 Clayton Campus Wellington Road Clayton VIC 3800 Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

The Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US.

Method

As US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach.

Results

Seventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession.

Conclusion

Documents produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.

BrooksIA, SayreMR, SpencerC, ArcherFL. An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014). Prehosp Disaster Med. 2016;31(1):90–97.

Keywords

Emergency Medical ServicesEmergency Medical Technicians/educationUnited States
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 31 , Supplement 1 , February 2016 , pp. 90 - 97
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Braun, V, Clarke, V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77-101.CrossRefGoogle Scholar
2. Committee on Trauma and Committee on Shock, National Academy of Sciences, National Research Council. Accidental Death and Disability: the Neglected Disease of Modern Society. Washington, DC USA: The National Academies Press; September 1966.Google Scholar
3. Shah, MN. The formation of the Emergency Medical Services system. Am J Public Health . 2006;96(3):414-423.CrossRefGoogle ScholarPubMed
4. The history of EMS at NHTSA. Emergency Medical Services Web site. http://www.ems.gov/history.htm. Accessed October 31, 2014.Google Scholar
5. Committee on Trauma American College of Surgeons. Standards for emergency ambulance services. Bull Am Coll Surg. 1967;52(May-June):131-132.Google Scholar
6. National Highway Safety Bureau. Basic Training Program for Emergency Medical Technician - Ambulance: Concepts and Recommendations. Washington, DC USA: National Highway Safety Bureau; October 1969.Google Scholar
7. National Highway Traffic Safety Administration. Emergency Medical Services Education Agenda for the Future: a Systems Approach. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 2000; National Highway Traffic Safety Administration Web site. http://www.nhtsa.gov/people/injury/ems/edagenda/final/index.html. Accessed August 10, 2014.Google Scholar
8. History of the NREMT. National Registry for Emergency Medical Technicians Web site. http://www.nremt.org/nremt/about/nremt_history.asp. Accessed October 20, 2014.Google Scholar
9. National Highway Traffic Safety Administration. National EMS Education Standards. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; January 2009; Emergency Medical Services Web site. http://ems.gov/EducationStandards.htm. Accessed August 10, 2014.Google Scholar
10. Bledsoe, BE, Sanders, MJ. Guest commentary. A tribute to Nancy Caroline, MD and emergency care in the streets. JEMS. 2002;27(6):127-129.Google Scholar
11. National Highway Traffic Safety Administration. Emergency Medical Technician - Intermediate National Standard Curriculum: Instructor’s Lesson Plan, 3rd ed. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; August 1986; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed August 10, 2014.Google Scholar
12. National Highway Traffic Safety Administration. Emergency Medical Technician - Paramedic National Standard Curriculum: Instructor’s Lesson Plan, 3rd ed.. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 1985; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed August 10, 2014.Google Scholar
13. National Highway Traffic Safety Administration. Emergency Medical Technician - Ambulance National Standard Curriculum: Instructor’s Lesson Plan, 3rd ed. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; March 1984; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed August 10, 2014.Google Scholar
14. Dawson, DE, Brown, WE Jr, Chew, JL, et al. National EMS education and practice blueprint. September 1993.Google Scholar
15. National Highway Traffic Safety Administration. EMT-Basic National Standard Curriculum. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 1994; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 1, 2014.Google Scholar
16. National Highway Traffic Safety Administration. First Responder National Standard Curriculum. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration, United States Department of Health and Human Services Maternal and Child Health Bureau; 1995; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 1, 2014.Google Scholar
17. National Highway Traffic Safety Administration. Emergency Medical Services Agenda for the Future. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration, US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau; August 1996; National Highway Traffic Safety Administration Web site. http://www.nhtsa.gov/people/injury/ems/agenda/emsman.html. Accessed July 20, 2014.Google Scholar
18. National Highway Traffic Safety Administration. EMT-Paramedic National Standard Curriculum. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 1998; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 1, 2014.Google Scholar
19. National Highway Traffic Safety Administration. Emergency Medical Technician - Intermediate National Standard Curriculum. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 1998; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 1, 2014.Google Scholar
20. National Highway Traffic Safety Administration. Emergency Medical Services Agenda for the Future Implementation Guide. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; 1998; National Highway Traffic Safety Administration Web site. http://www.nhtsa.gov/people/injury/ems/agenda/execsum.html. Accessed July 20, 2014.Google Scholar
21. National Highway Traffic Safety Administration. National EMS Research Agenda. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration, Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau; December 2001; Emergency Medical Services Web site. http://www.ems.gov/research.htm. Accessed September 1, 2014.Google Scholar
22. National Highway Traffic Safety Administration. National EMS Core Content. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; July 2005; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 20, 2014.Google Scholar
23. National Highway Traffic Safety Administration. National EMS Scope of Practice Model. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; September 2006; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 21, 2014.Google Scholar
24. Institute of Medicine of the National Academies. Future of Emergency Care: Emergency Medical Services at the Crossroads. 2007. Institute of Medicine Web site. http://www.iom.edu/Reports/2006/Emergency-Medical-Services-At-the-Crossroads.aspx. Accessed November 1, 2014.Google Scholar
25. National Highway Traffic Safety Administration. National EMS Education Standards: Emergency Medical Responder Instructional Guidelines. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; January 2009; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 21, 2014.Google Scholar
26. National Highway Traffic Safety Administration. National EMS Education Standards: Emergency Medical Technician Instructional Guidelines. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; January 2009; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 21, 2014.Google Scholar
27. National Highway Traffic Safety Administration. National EMS Education Standards: Advanced Emergency Medical Technician Instructional Guidelines. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; January 2009; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 21, 2014.Google Scholar
28. National Highway Traffic Safety Administration. National EMS Education Standards: Paramedic Instructional Guidelines. Washington, DC USA: US Department of Transportation, National Highway Traffic Safety Administration; January 2009; Emergency Medical Services Web site. http://www.ems.gov/EducationStandards.htm. Accessed September 21, 2014.Google Scholar
29. National Registry for Emergency Medical Technicians. Paramedic Accreditation Implementation Policy. 2011. National Registry for Emergency Medical Technicians Web site. http://www.nremt.org/nremt/about/para_accred_implementation_policy.asp. Accessed November 1, 2014.Google Scholar
30. National Association of State EMS Officials. Resolution 2010-04 National EMS Certification and Program Accreditation. October 15, 2010; National Association of State EMS Officials Web site. http://www.nasemso.org/documents/Resolution2010-04NationalCertificationandProgramAccreditation20101013.pdf. Accessed November 1, 2014.Google Scholar
31. National Emergency Services Advisory Council. Draft revisions to the National EMS Education Agenda for the Future: a Systems Approach. Washington, DC USA: National Emergency Services Advisory Council; 2014; Emergency Medical Services Web site. http://ems.gov/nemsac/DraftRevisionsEducationAgenda-PublicComment-Aug2014.pdf. Accessed January 6, 2015.Google Scholar
32. The United States Department of Transportation: A Brief History. National Transport Library Web site. http://ntl.bts.gov/historian/history.htm. Accessed March 1, 2014.Google Scholar
33. 1981 Omnibus Budget Reconciliation Act. Slaying the dragon of debt: fiscal politics and policy from the 1970s to the present, 2011. University of California, Berkley Bancroft Library Web site. http://bancroft.berkeley.edu/ROHO/projects/debt/1981reconciliationact.html. Accessed March 1, 2015.Google Scholar
34. Markenson, D, Foltin, GL. The new emergency medical technician-paramedic and emergency medical technician-intermediate curricula: history, changes, and controversies. Clin Pediatr Emerg Med. 1999;1(1):54-69.CrossRefGoogle Scholar
35. Rockwood, CA Jr., Mann, CM, Farrington, JD, et al. History of emergency medical services in the United States. J Trauma. 1976;16(4):299-308.CrossRefGoogle ScholarPubMed
36. Position statements. Role of the state EMS medical director. Prehosp Emerg Care. 2010;14(3):402.CrossRefGoogle Scholar
37. Cunningham, CA, Wesley, K, Peterson, TD, et al. The role of state medical direction in the comprehensive Emergency Medical Services system: a resource document. Prehosp Emerg Care. 2010;14(3):404-411.CrossRefGoogle ScholarPubMed
38. American College of Emergency Physicians. Medical direction of Emergency Medical Services PREP. American College of Emergency Physicians Web site. http://www.acep.org/Clinical---Practice-Management/Medical-Direction-of-Emergency-Medical-Services-PREP/. Accessed December 14, 2014.Google Scholar
39. Commission on Accreditation of Allied Health Education Programs. Standards and guidelines for the accreditation of educational programs in the Emergency Medical Services professions, 2005. Commission on Accreditation of Allied Health Education Programs Web site. http://www.caahep.org/Content.aspx?ID=30. Accessed November 1, 2014.Google Scholar
40. Margolis, GS. Emergency medical services education: past, present, and future. N C Med J. 2007;68(4):249-252.Google ScholarPubMed
41. About CECBEMS. Continuing Education Coordinating Board for Emergency Medical Services Web site. http://cecbems.org/About.aspx. Accessed January 4, 2015.Google Scholar
42. Ruple, JA, Frazer, GH, Hsieh, AB, et al. Education and practice. The state of EMS education research project: characteristics of EMS educators. Prehosp Emerg Care. 2005;9(2):203-212.CrossRefGoogle ScholarPubMed
43. Ruple, JA, Frazer, GH, W. B. Commonalities of the EMS education workforce. (2004) in the United States. Prehosp Emerg Care. 2006;10(2):229-238.CrossRefGoogle ScholarPubMed
44. Studnek, J, Fernandez, A, Margolis, G, et al. Physician medical oversight in Emergency Medical Services: where are we? Prehosp Emerg Care. 2009;13(1):53-58.CrossRefGoogle ScholarPubMed
45. National Association of State EMS Officials (NASEMSO). EMS educational agenda: a system approach. A report to the National EMS Advisory Council (NEMSAC) on statewide implementation of the educational agenda. Falls Church, Virginia USA: NASEMO; April 23, 2015. NASEMO Web site. https://www.nasemso.org/emseducationimplementationplanning/documents/Implementing-EMS-Education-Agenda-Report-to-NEMSAC-23Apr2014-FINAL.pdf. Accessed January 15, 2015.Google Scholar
46. NREMT Fast facts. nremt.org. National Registry for Emergency Medical Technicians Web site. http://www.nremt.org/nremt/about/NREMT_Fast_Facts.asp. Accessed January 2, 2015.Google Scholar
47. National Registry of Emergency Medical Technicians. Reaching Higher, Achieving More. 2013 Annual Report. Columbus, Ohio USA: National Registry of Emergency Medical Technicians; 2013; NREMT Web site. https://www.nremt.org/nremt/about/annual_reports.asp. Accessed January 10, 2015.Google Scholar
48. CAAHEP accredited program search. Commission on Accreditation of Allied Health Education Programs Web site. http://www.caahep.org/Find-An-Accredited-Program/. Accessed January 4, 2015.Google Scholar
Supplementary material: File

Brooks supplementary material

Tables 1-14

Download Brooks supplementary material(File)
File 39.7 KB