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If you are a Service Director or transition coordinator, you need to be talking with your Medical Director about the Kansas EMS transition. For Medical Directors, Bill 262 states that all providers must deliver EMS care under medical director supervision and protocol. This includes not only EMS agencies, but all providers of EMS services in the community including first responders, fire-based responders, and private industry responders.
The transition should include a review of the local scope of practice and required skills. Updated local protocols for each level will need to be put into place before providers are certified to begin practicing at the new levels.
If a currently Kansas certified First Responder, EMT-Basic, EMT-Defibrillator, or EMT-Intermediate does not complete the transition within the alloted time, that provider will no longer be a certified EMS provider in Kansas.
We have been working on the final curriculum update. This includes corrections in the Instructor Manual, Student Manual, and Media. It also includes updates for the AHA 2010 Standards.
If you are a Transition Coordinator, you will receive an e-mail when all of the new material is posted to the private coordinator workspace.
Several have asked about a timeframe for this update. We are working steadily toward a release on or before December 24. We appreciate your patience as we review and correct almost 2,000 pages.
In short, yes. The leeway that coordinators and instructors have is that some students will enter class having already mastered some of the content. An example is the use of a blood glucometer. In this case, the information in the lesson plan must be presented. However, the instructor would be able to make this more of a discussion rather than a lecture because of students’ pre-existing knowledge.
Regarding assessment: For the practical skills, they still need to show competency, but this can be often be achieved with less lab practice time for those individuals who are already using the skill. The students will still be expected to pass the module Post-Test with a 75% or higher score.
Assessment of successful completion of the transition bridge curricula, as approved by the Kansas Board of EMS, is a 75% or greater score on the module Post-Tests as included in the curricula and two successful demonstrations of skill competency as detailed on the Skill Check Sheets in the curricula. The assessment of competency is done using test and check sheet tools provided.
Each course has a lesson plan, formulary, media, task analysis for each skill in the course, skill check sheets, lab support materials, pre-tests, and post-tests. The skill check sheets are used to determine competency in each skill. Competency is to be shown two times with no critical errors by each student – at separate times. From the course designer standpoint, these should be done on different days. In other words, competency shows should not be done back to back. The idea is that by having the competency shows at separate times, there is a higher possibility that the student will retain the information and skill. The check sheets must be signed by the student and instructor.
As noted previously, the Post-Tests and signed Skill Check Sheets must be retained for five (5) years.
When the Friesen Group developed the courses, we did so with time lengths specified by the Kansas Board of EMS. The estimated time frames as of December 3, 2010 are:
- First Responder to Emergency Medical Responder will be approximately 16 hours in length.
- EMT-Basic to EMT will be approximately 28 hours in length.
- EMT-Intermediate to Advanced EMT will be approximately 116 hours in length.
- EMT-Defibrillator to Advanced EMT requires completion of an EMT-Intermediate Course before the bridge course is taken and will be approximately 200 – 250 hour total between the two courses.
Did you notice the word “approximately” in each line? I use that word intentionally because the curricula, as approved by the Kansas Board of EMS, are competency based. This means that as an instructor you have some estimate of the time it should take to teach each lesson, but in the end it depends upon the ability of the student to show competency. So, it could take less or more time, depending upon the student, the student to instructor ratios, and other variables in the classroom.
As of this writing, the final AEMT scope remains in question. We will continue to post updates as further information is made available.
Teaching an approved transition course does not require attendance at one of the train-the-trainer courses. It does require that you be certified at or above the level you are teaching or be a subject matter expert. This gets a little tricky in the transition.
Let’s start with existing providers. One would think that because he or she is a certified EMT, they can teach the EMT transition course. This is not true. The new EMT scope has information that an existing EMT does not know. Therefore, to teach the course as an EMT, one needs to have successfully completed the course first and have gained a deeper understanding of the material than is in the lesson plan.
So, the next question is likely, “I am an EMT. How am I supposed to get the course when I am the one who does all of the teaching in my community?” This is a fair question and is the reason that the Board of EMS has said that subject matter experts can also teach the material. For example, a local respiratory therapist might teach the airway module or a physician assistant (PA) teach the pharmacology module. A short definition of a subject matter expert:
- The person is certified at or above the level they are teaching, or
- The person possesses a non-EMS licensure or certification in the area of the topic.
Course coordinators will want to be able to defend their choice of the person as a subject matter expert, and, whoever teaches, the person needs to know the information in great depth – ”past the lesson plan.”
This subject matter expert option should open enough doors to qualified instructors to enable communities to push forward with transition courses. The course coordinator can take the bridge at the same time as the rest of the people in the agency.
The transition bridge courses must be coordinated by a certified Instructor Coordinator (IC) or Training Officer (TO) who has attended one of the Kansas Board of EMS recognized Train-the-Trainer (TtT) courses. Coordinators must have attended day one of the TtT to coordinate EMR and EMT transition courses and day two of the TtT to coordinate the AEMT transition course.
Coordination of a transition bridge course includes single program provider application for the course, oversight of instruction, and management and maintenance of all paperwork. The paperwork includes originals of rosters, signed individual skill check sheets, and completed Post Tests. The coordinator is responsible for issuing a certificate for actual course hours, which may be used for recertification. The coordinator will also issue a certificate for each successfully completed bridge course module. According to the Board of EMS staff, all of the paperwork must be retained for 5 years and be accessible and available for inspection audits.
If you were unable to attend the fall coordinator training courses, please check out a new Coordinator Train-the-Trainer Opportunity.
First some history. When the transition process began, it was the intention of the Kansas Board of EMS that providers would be able to transition downward in the levels. For example, by taking the EMT bridge transition, an EMT-I could become an EMT. This was put into a diagram in the 2008 FAQ document.
However, when 262 was passed and signed, the language required the following transition pattern for the levels:
| First Responder | → | Emergency Medical Responder (EMR) |
| EMT-B | → | Emergency Medical Technician (EMT) |
| EMT-D → EMT-I | → | Advanced Emergency Medical Technician (AEMT) |
| EMT-I or EMT-I/D | → | Advanced Emergency Medical Technician (AEMT) |
| MICT | → | Paramedic |
The “→” represents a required transition bridge course of instruction. The EMT-D must take an EMT-I initial course of instruction, followed by the AEMT transition course. MICT providers change their name only and will not take a transition course.
So the question is, “Can providers still transition to a lower level?”
Yes, at this writing (12/9/2010), providers can transition to a lower level by following the steps below:
At the individual’s renewal date:
- Submit a letter to the Board staff requesting to transition to a lower level.
- Submit the certificates indicating successful completion of the transition bridge courses for the requested level.
- Submit the required, standard number of recertification hours.
A number of you have asked about the Draft of the AEMT Formulary that was reviewed at the December BEMS meeting. It has been posted on the Board website and is also available here.
