CoAEMSP Interpretations of the CAAHEP Standards

CoAEMSP Interpretations of the CAAHEP Standards

Presenters Deb Cason, Board of Directors, CoAEMSP Chair, Site Visit & Visitors Subcommittee Joe Mistovich, Board of Directors, CoAEMSP Chair, Interpretations Subcommittee

Objective Discuss the interpretations of each section of the CAAHEP Standards & Guidelines.

Programs: By the Numbers as of August 5 476 CAAHEP accredited Paramedic programs 214 CoAEMSP Letter of Review programs

Standards and Guidelines coaemsp.org/standards.htm S & G with Interpretations document Regular font: STANDARDS must do Italics font: GUIDELINES suggestion Right column: Interpretations

Standard I: Sponsorship

I. Sponsorship A. Sponsoring Institution B. Consortium Sponsor C. Responsibilities of Sponsor

I. Sponsorship Note: The CoAEMSP office (George and Bill) will evaluate this Standard BEFORE a site visit is scheduled

Note to Programs Lack of clear compliance with Sponsorship standard is a DEAL BREAKER

I.A.1. Sponsorship 1. Post-secondary academic institution Accredited by institutional accrediting agency (recognized by USDE) Authorized to provide post secondary program or to approve college credit (minimum of certificate)

I.A.2. Sponsorship 2. A foreign post-secondary academic institution acceptable to CAAHEP

I.A.3. Sponsorship 3. Hospital, clinic or medical center accredited (accreditor recognized by DHHS) Affiliated with an accredited post-secondary ed institution, or equivalent OR affiliated with accredited graduate medical education program

I.A.4. Sponsorship 4. A branch of the US Armed Forces or other governmental educational or medical service Affiliated with an accredited post secondary educational institution OR affiliated with a national organization authorized to approve college credit

Key Issue: Academic Credit MUST have a method to award ACADEMIC CREDIT Articulation Agreement An agreement between program & an educational institution to award college credit MOU, Transfer agreement, etc. okay

Key Issue: Maintaining Records MUST maintain records permanently, insure program quality, insure fair practices

Key Issue: Fire Academy or EMS Training Agency Fire Academy or EMS training agency Must be an agency of federal, state, city or county government Must be authorized by the State to provide initial education programs Must have an articulation agreement with educational institution that can provide college credit OR must be recognized by the state as a post secondary educational institution

I.B. Consortium Sponsorship 1. A consortium sponsor is an entity consisting of two or more members that exist for the purpose of a paramedic program. One member must be a sponsoring agency that meets the requirements just discussed (Standard I.A.)

I.B. Consortium Sponsorship 2. Responsibilities of each member must be documented as a formal agreement.

Key Issues: Consortium Consortium members establish governance that runs educational program Governance, roles of each member, and lines of authority must be clearly defined.

A paramedic program is sponsored by the local hospital. The hospital is JCAOH accredited. Does this adequately meet the Sponsorship standard?

A paramedic program is sponsored by a college continuing education department and does not offer college credit. Does this adequately meet the Sponsorship standard?

A Paramedic program is sponsored by Utopia Fire Department in their training academy. Does this adequately meet the Sponsorship standard?

Standard II: Program Goals

Standard II. Program Goals A. Program Goals & Outcomes B. Appropriateness of Goals & Learning Domains C. Minimum Expectations

II. Program Goals & Outcomes Must be a written statement of program s goals and learning domains Must be responsive to communities of interest students/grads hospital reps public employers faculty police and fire sponsor admin government officials

Key Issues: Goals All program goals must be measurable All program goals must be evaluated annually All program goals must be reviewed by Advisory Committee annually

II.B. Appropriateness of Goals Program must regularly assess goals Advisory committee must review and revise and monitor needs and expectations

Key Issue: Advisory Committee Advisory Committee Must meet at least annually (minutes necessary) Must review Program Outcomes (annual report) Minimum competency requirements (include team leads) Resource assessment Action plan

Communities of Interest Advisory Committee must include Hospital rep Students/grads Physicians Faculty/sponsor admin Employers Police & fire Key govt official Public

Key Issue: Advisory Committee Advisory committee must include: Police & Fire if role in community Key gov t official can be Elected official Appointed public official Individual involved in emergency mgmt Other public official (State EMS rep) Public member not in EMS or employed by sponsor or other named representative (consumer)

II.C. Minimum Expectations The program goal is to: Prepare competent entry-level Paramedics in the cognitive, psychomotor and affective learning domains.

Note to Program Directors If the program truly subscribes to and embraces this goal, you would think it would be in the program/course syllabus and told to students and enforced, (i.e., if all are not achieved, the student would not graduate).

The Deb & George s Most Excellent Paramedic program has an advisory committee comprised of program faculty, program director, dean, 2 current students and 2 program graduates. They meet every 6 months. Does this meet the standard for Goals?

A Paramedic program is sponsored by a college continuing education department and does not offer college credit. Does this adequately meet the Sponsorship standard?

Standard III: Resources

III. Resources A. Type & Amount B. Personnel 1. Program Director 2. Medical Director 3. Faculty C. Curriculum D. Resource Assessment

III. Resources sufficient to ensure achievement of goals & outcomes. Clerical/Support Staff Curriculum Finances Class/Lab Facilities Ancillary Student Facilities Faculty Hospital/Clinical/Field Affiliations Equipment/Supplies Computers Instructional reference materials Faculty/Staff Continuing Ed

Key Issues: Resources No set number of anything Annual resource assessment matrix with analysis and updated action plans. (use survey from self study documents on website) Space classroom and lab can be the same provided space adequate for required activities

Key Issues No requirement for full-time secretary (guideline) Is anything falling through the cracks? Solutions are to be determined by the Program

Question from Site Visitors On an average, how many hours do you and your instructors spend a week doing tasks an administrative assistant can do? Your average number hours a week working?

Hospital/Clinical/Field Affiliations Standards say..access to adequate numbers of patients, proportionally distributed by illness, injury, gender, age, and common problems

Key Issues Must ensure exposure to and participation with and/or assessment and management of: Adult, Pediatrics, Geriatric Trauma & Medical Emergencies Airway management to include endotracheal intubation Obstetrics delivery & neonatal care

Key Issues Tracking system must exist, it doesn t matter how tracked Pediatric age subgroups must include Newborn Infant Toddler Preschool School-age Adolescent

Key Issues Program must set and require minimum numbers of patient contacts Minimums must be reviewed & approved by the medical director and endorsed by advisory committee (& documented). Tracking must demonstrate that each student meets minimums Periodic evaluation that minimums are adequate

Key Issue: Patient types vs. Location PATIENT types and access are important, location for patients are not Psych patients may be found in ED, critical patients may be found in ED, pediatrics maybe be found in ED OR NOT!

Key Issues Clinical objectives must exist & state the rotation intent and outcome required Live patient encounters must occur; simulations can be integrated to help achieve competency (not for field)

Key Issues: Airway Management Successful in combo of live intubations, high fidelity simulations (highly recommended), low fidelity simulations, cadaver labs, etc. in all age brackets Should have exposure to diverse environments Hospital units (OR, ED, ICU) Out of hospital settings (ambulance, field, home) Labs (floor, varied noise levels, varied lighting conditions)

Key Issues: Airway Management Recommendation: 50 minimum of airway attempts across all ages and all methods PPCP will work toward this

Key Issues Clinical and field internship sites should be evaluated by the program (includes student evaluations). Tracking should help ascertain that minimum requirements for competency are being met.

Site Visitors will check Most recently graduated class do they all have required minimums? If not, this is a citation but if it s being done on current class it can be reported in progress report.

Key Issues Preceptor orientation must occur for hospital personnel Preceptor training must occur for field Content should include: Purposes of student rotation/internship Evaluation tool use/grading criteria Program contact information Competent team lead definition

Key Issues Options for preceptor training methods: Written documents Formal course Power point presentations Video On line On site train the trainers Others what works for your system

Key Issues Documentation must exist that each field preceptor receives training Preceptors must be evaluated and provided feedback

Key Issues Program director must have Bachelor s degree from institution with USDE agency accreditation Any major acceptable

Key Issues: Medical Director Must document fulfillment of each responsibility Medical oversight is primary role Must interact with students Does not have to lecture or labs etc Terminal competency sign off must occur for each graduate Must review exams, curriculum, quality of instruction, student progress

Site Visitors Questions to Students Do you know who your medical director is? What does he/she do? When do you see him/her?

Key Issues: Curriculum Sequencing Didactic/Theory Lab practice Clinical/hospital experience (can include field experience) Field internship-goal is team leader Certainly integration is okay!

Key Issues: Curriculum Required curriculum content should be documented through: Course syllabi Lesson plans Instructional materials Text

from Definitions (in Policy book on CoAEMSP.org) Syllabus a document that describes a body of instruction (course). It must include learning goals, course objectives, and competencies required for graduation but often includes course description, days/times class meets, required text and other references, attendance policy, evaluation methods, grading, ADA, and a content outline.

Key Issues Field internship must allow for progression to team leader. A minimum number of team leads must be required. Team leads must reflect depth and breadth of paramedic profession (ALS calls). Internship must occur after completion of most didactic and clinical.

Standard IV: Student Evaluation

IV.A. Student Evaluation must be conducted on a recurrent basis and with sufficient frequency to provide both the students and program faculty with valid and timely indications of the students progress toward an achievement of the competencies in the curriculum.

Key Issues There must be a summative comprehensive final evaluation. *It must be a capstone event that occurs AFTER completion of ALL course components. *It must include cognitive, psychomotor and affective domains.

Key Issue Didactic evaluation Must include formative and summative evaluations Must be progression in the level of questions Must be reviewed for validity and medical accuracy (document medical involvement)

Key Issues Validity must be demonstrated on major exams Method of demonstration may vary Depends on # of students Reviewed by item analysis Difficulty index Discrimination index

Key Issues Psychomotor exams must demonstrate movement to entry level competence Program must designate minimum # of repetitions of skills Numbers of skill repetitions must have input from Advisory Committee and Medical Director

Key Issues Program must teach, monitor and evaluate affective domain Affective components should be continuously evaluated (in all components: classroom, lab, clinical & field) A comprehensive affective evaluation must occur on each student

Key Issues Inappropriate behaviors must be counseled and documented Inappropriate behaviors must have cont eval and successfully remediated or academic action taken (e.g. probation, failure)

Key Issues: Terminal Competency Document competency achievement in each domain for each student Joint responsibility of Program Director & Medical Director Signed by medical director and program director

Key Issue: Documentation of Student Evaluation Must be maintained in sufficient detail to verify learning progress & achievements. Master copy of all exams/evaluations (written, psychomotor and affective) Record of student performance on all written & psychomotor exams and affective evaluations Evaluations should be reviewed with students in a timely fashion and documented

Key Issues: Student Counseling academic advice and guidance at least once per academic session Adequately timed that student can respond to counseling Policy needed on when counseling will occur Documentation should include at least Date of counseling Reason for counseling Signature of faculty Student s response Student s signature

Key issue Field Internship Must keep master copy of field evaluation instruments Must maintain record of student internship performance Should show progression to role of team leader Successful team leads

IV.B. Outcomes & Outcomes Assessment Standards say Program must periodically assess its effectiveness in achieving its stated goals and learning domains. The results must be reflected in the review and timely revision of the program. Outcomes assessment include: exit point completion, grad satisfaction, employer satisfaction, job placement, state/national registration.

Programs Seeking Initial Accreditation Not required to have outcomes data but must have a plan as to how they will collect and analyze data.

Accredited Programs Must submit the CAAHEP Annual Report by December 31 st - ANNUALLY.

Standard V: Fair Practices

V.A. Fair Practices: Publications & Disclosure Standards say Announcements, catalogs, publications, and advertising must accurately reflect the program offered. The following must be made known accreditation status,admission policies/practices, technical standards, policies on advanced placement, transfer of credits

Note on Advanced Placement Do you have any students who end up on the list to test NREMT and have not gone through all your traditional paramedic program? We will be asking about this what is your policy on how this is done Ex: Nurse to Paramedic policies or P aramedic from a nonaccredited program to go through yours

Note to Program Directors Include exact statement about accreditation status from Policies (see next slide). Letter of Review (LoR) statement can be used EXACTLY off of the CAAHEP website.

CAAHEP Statement The [name of program] is accredited by the Commission on Accreditation of Allied Health Education Programs (www.caahep.org) upon the recommendation of the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP). Commission on Accreditation of Allied Health Education Programs 1361 Park Street Clearwater, FL 33756 727-210-2350 www.caahep.org

Key Issues Must be current affiliation agreements Must define responsibilities of program/institution Must define what students can do and responsibilities of preceptor Must have periodic review to ensure needs met

NEW Standards

Key Changes to 2015 Standards Associate Medical Director Assistant Medical Director Lead Instructor More Explicit: Preceptor Training (Program Director Responsibilities) Patient Minimums (Medical Director Responsibilities)

2015 CAAHEP Standards for the EMS Professions will go into effect for ALL programs on January 1, 2016.

Thank You! Questions? www.coaemsp.org Joe Mistovich jjmistovich@ysu.edu Deb Cason debra.cason@utsouthwestern.edu George W Hatch, Jr george@coaemsp.org