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A question posed frequently is “How did the scope of practice get developed?” The Kansas Board of EMS (BEMS) was aware of the need within Kansas to look at and move forward with a new scope of practice. This need to move forward was the result of the release of the National EMS Scope of Practice document that outlined a new suggested national practice scope.
Early in 2008, BEMS assembled a workgroup to review the National Model and consider what Kansas should do with the scope of practice issue. The workgroup included representatives from BEMS, the six EMS Regions, EMS and Fire professional organizations, Community and Technical Colleges, and eight members-at-large. Over the course of six months, the work group considered what direction to recommend — adopting the new National Model or modifying it to meet Kansas state needs. In doing this work the group used a “blue sky” approach that essentially stated that what was in the past and what is in the present had nothing to do with where we felt the scope should go. All options were on the table from what the different levels would be, how they would labeled, and what they would be able to do.
The result is the EMS Attendant Skills Sets Recommendations from Kansas EMS Systems Approach to the Future (KEMSSAF). In August of 2008, BEMS approved these recommendations and directed the Board of EMS staff to move forward with developing a curriculum to bridge existing certified attendants to the new levels – thus the project we are currently working to complete!
Three of the four focus group sessions are finished and we have numerous themes that run between the sessions. I’ll hold on themes for now, to give the folks who attend the North Central focus group a chance to weigh in without external input. However, one of the theme that I feared would materialize simply hasn’t.
In the first focus session held in Wichita, I had a chance to sit in as Kathleen led the group through the first parts of the focus group session. One of the words that I heard several times from attendees was the word “easy.” I’ll confess that when I heard that word surface so early in the process I shuddered at what we had gotten ourselves into.
Yet, despite that fact that the “easy” word surfaced early, it didn’t survive the process. Three focus groups into the four planned, “easy” isn’t on the list of concerns. Successful. Meaningful. Accountable. Engaging. Well taught. Realistic. All of these words rise to the surface. I now suspect that when we use the word “easy”, what we really mean is successful. In all ways. For all people involved.
And that gives me a great deal of hope.
If you haven’t held back to back meetings in opposing corners of the state within 24 hours, we highly recommend it. In the past two weeks both Kathleen and I have gone from one corner of Kansas to the other to present or facilitate at meetings. We’re a bit ragged by this point.
For all of that whining, we encountered great groups of people in the focus group sessions. Both the North East that met at at Johnson County Community College and the North West group that met at Sheridan County EMS were engaged in and prolific with their ideas. Even 15 hours behind the wheel can’t dampen our enthusiasm for the information that we’ve been getting in the focus groups.
Pat, Kenneth, Dave, Bill (hidden), and David work through small group questions in preparation for the larger discussion.
A big thanks to our hosts for the focus groups (Ray Wright at Johnson County Community College and Deb Kaufman and David Stithem at Sheridan County) and to all of the participants who were able to find time to attend and participate. We go to Ellsworth on August 11th for the final focus group and will then be on the downhill run of writing the course planning documents. So far we only have four people signed up for Ellsworth so there is plenty of room. To register, click here. August 31 looms as the deadline for the needs assessment work before moving into lesson plan development.
I’ve spent the last several years teaching course design to just about anyone who will sit still to listen. And even though I’ve crisscrossed the state with this message I still find that many folks are unsure of the process. As we work through the process of developing the transition curriculum I’ll provide a few quick summaries to let you know why we are doing what we are in this process of course design.
So, where does one start? Conducting a needs assessment is generally the first step in a rather dynamic process. In the needs assessment the course designer attempts to figure out what to focus on. This seems easy at first. The scope of practice is pretty clear about what knowledge and skills are new to each level. So why run a needs assessment process?
It is not enough to understand the “what.” Do we understand what people already know in the new material? Are we aware of the constraints to learning; such as time, money, availability of instructors, and fear of change? What about the preferred methods of learning? All of these things fit into the arena of needs and are the focus of the work that we are doing with the project. Once we have answers to these questions . . . and the questions we haven’t figured to even ask, we can identify where to spend our time and energy as we start putting the courses together.
Focus groups launched on Friday with the first one being held in Wichita. 15 people participated with Kathleen in the session which generated some very productive discussion and ideas about the transition process and curricula. Our thanks to each person who took the time to show up and give two hours of their precious time for this project. This coming week will see focus groups in Overland Park on the 24th and Hoxie on the 25th. There is still room left in each of these sessions and we encourage you to attend. Ellsworth will host the last session on August 11th. This session also has room for interested persons.
L to R: Mark, Cindy, Ralph, Brandon and Rusty work through the questions in preparation for the group discussion.
While you see the on-line work of the transition project, there is work going on behind the scenes. We are very fortunate to have gifted and insightful people helping us as we work on this project.
Tuesday evening we played host to a few people in our home as we worked to outline the focus group process. All of us bring our own assumptions to any topic or project. If we don’t learn to question them or seek outside feedback, those assumptions often give us trouble in the end . By bringing in outside people who question our thinking and challenge our assumptions as we build the transition process and materials, we are better able to produce work that meets the mark. In this case, the mark was the upcoming focus groups. A big thanks to Ryan, Dave, and Darrel for giving their time and talents in helping design meaningful focus groups.
L-R: Ryan, Kathleen, Dave and Darrel in the "think tank"
If you haven’t yet signed up to attend a focus group, there is still time. Click here to go to the registration page and select the focus group that is most convenient for you. We hope to see you there.
To read further about the conversation, check out “Don’t Think Purple” . . .
Photographers often ask people to say, “Cheese.” The result is that everyone looks at the camera and smiles as they think about the silly tradition. Then, everyone says, “Cheese.” And, click goes the button, whir goes the focus, snap goes the shutter, and the image is captured.
We’re hoping that Kansas EMS providers will join us for the Curriculum Transition Focus Groups. This is our way of asking everyone to say, “Cheese,” to join others in the EMS community to focus on the curriculum needs and capture as much information as possible for the needs assessment phase of the project.
Currently there are Focus Groups scheduled for Hoxie, Ellsworth, Overland Park, and Wichita. So please join us. We’re interested in your experiences and ideas about EMS curriculum needs.
Surveys, needs assessments, gap analysis . . . its enough to make the words I type come out sounds like the “whaa, whaa . . . whaa, whaa, whaa, whaa” that comes from Charlie Brown’s teachers. Despite this, these are important. When we begin to develop a course, the first step is to understand what the needs for the course might be. In order to do this, several mechanisms are put into place.
Surveys help the us connect with three important groups: the providers who will be taking the course, the educators who will be teaching the course, and physicians who oversee emergency medical care. Surveys also present challenges for us in that the rate of return is usually limited. In our case, we will likely be below 5% in total returns from those who are targeted to take the survey.
A second mechanism that we use is the focus group. Focus groups allow us to explore information obtained from the surveys and to also hear directly from providers and educators about their concerns and ideas regarding the courses.
We will use the information from these two mechanisms to determine not only what the needs are for each transition course, but also to understand where the gap in understanding is most significant. By understanding the “gap” we can build courses that focus most on the topics that are not as well known.
So, if you’ve been wondering where this is going, stay tuned. We’ll take the information and plug it into the development process for the next step of creating a clear list of tasks and objectives.
About 10 years ago, Scott Adams put these words into the mouth of Dilbert and captured the sentiments of most everyone. If change is good and necessary to growth and life, why do we human beings regularly resist it?
There are many directions this post could take from looking at how our brains react to the stress of change, the impact of change and transformation on organizations, or the three key elements of successfully navigating change. But, I’d like to answer the first question with a second, “Do we know what should change and what should remain constant?”
I would argue that our core values and principles should remain constant. In my observation, EMS providers, whether service director or attendant, are committed to exceptional patient care and to supporting their communities through delivering 365/7/24 care. As a community member, I hope that this commitment remains constant and is passed from generation to generation in the State of Kansas.
So what should adapt and change? Our day-to-day practices adapt and change . . . sometimes by decade and sometimes by the hour. When I was growing up, the local funeral home director provided transportation to the hospital in a vehicle that doubled as an ambulance and a hearse. This vehicle was the only one in town where a person could be loaded up in the back and rushed to the hospital with a whirling light atop. In fact, my mother was was taken to the hospital in the hearse/ambulance following a vehicle accident. In the late 1970′s, the town purchased an ambulance, staffed by trained volunteers. Then, in the mid-1990′s a full-time, 365/7/24, paramedic service appeared on the scene . . . big and significant changes.
Now in 2009, I’m observing the scope of practice for Kansas EMS changing and adapting to the circumstances across the state, to current research, and to better align with the national scope of practice. While I am involved in the curriculum development process, at some level, I will remain an outsider who sincerely hopes that in the midst of growth and transition of day-to-day practices, the core values and principles of Kansas EMS will remain constant, strong, and evident.
I’ve been receiving some feedback that leads me to believe that some clarification is in order. Several emails have landed in our inbox discussing the development of the scope of practice and what people believe to be in error with the scope document. Additional emails have voiced concerns about how the Board of EMS responded to their concerns about the scope document.
Time out!
We are not developing the scope of practice. The scope of practice has already been developed. Throughout 2008 a team of people from across Kansas met in Salina to discuss and debate the scope for each level of attendant provider in Kansas. The scope document that is posted on this website is a result of that group’s efforts. The Kansas Board of EMS approved the recommendation and pushed it forward for legislative action. It currently sits with the legislature for final action in the 2010 session.
Friesen Group is the contractor hired by the State of Kansas to develop and distribute to educators (both ICs and TOs) the curriculum that moves first responders to Emergency Medical Responder, EMT-Basics to EMT, and EMT-Intermediates to Advanced EMT. We have no role in further defining the scope. Our efforts to survey attendants and educators across the state, as well as to run focus groups, are for the sole purpose of designing the best education curricula possible to help people make this transition.
So, why engage in the survey or in a focus group? The answer is simple. If you wish to play a part in defining the final product that will be rolled out in 2011 you will want to be a constructive part of the process early on. Now is the time to give input into the course development process.
We value and appreciate your time and input.
