# NREMT slashes required CE hours!



## Summit (Dec 7, 2016)

National Continued Competency Model replaces the current method in 2019
https://www.nremt.org/rwd/public/document/nccp

EMT: 45% decrease in CEs

40 hours instead of 72 hours every two years...

Instead of 24 hours of specified content by NREMT and 48 hours of elective, there will be 20 hours of super duper specific content by NREMT, 10 hours of state specified content, and 10 hours elective.

PARAMEDIC: 17% decrease in CEs

60 hours instead of 40 hours every two years...

Instead of 48 hours of specified content by NREMT,  and 24 hours of elective, there will be 30 hours of super duper specific content by NREMT, 15 hours of state specified content, and 15 hours elective.

The content requirements are getting so specific that it will be very challenging for anyone to recert by CEs without taking a pricey and difficult to schedule formal refresher class. That may be NREMT's goal... because it will drive people to the recertify by exam option, a lucrative result for NREMT.

Reducing CE requirements doesn't seem like a good idea for our already under-educated profession.


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## Handsome Robb (Dec 7, 2016)

And yet another move in the wrong direction. 


Sent from my iPhone using Tapatalk


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## VentMonkey (Dec 7, 2016)




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## VentMonkey (Dec 7, 2016)

In all seriousness though, definitely sounds awful conspicuous. A shame, really.


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## EpiEMS (Dec 7, 2016)

Summit said:


> National Continued Competency Model replaces the current method in 2019
> https://www.nremt.org/rwd/public/document/nccp
> 
> EMT: 45% decrease in CEs
> ...





Summit said:


> The content requirements are getting so specific that it will be very challenging for anyone to recert by CEs without taking a pricey and difficult to schedule formal refresher class. That may be NREMT's goal... because it will drive people to the recertify by exam option, a lucrative result for NREMT.
> 
> Reducing CE requirements doesn't seem like a good idea for our already under-educated profession.



On one hand, I like the idea - it means no repeating ad nauseam the same curriculum that I learned X years ago, and it's not so incredibly burdensome because it (partially) maps to many of the standardized merit badge courses offered in so many places. Plus, it is nice that they tried to align to the certification framework that physician boards (ABMS boards, I believe?) are using.

On the other, it is not optimal to reduce the number of hours of CE required...especially considering the (1) relatively low barrier to entry in terms of time and (2) relative paucity of baseline knowledge imbued in initial EMS certification educational programs.

I'll say this - they really did a nice thing by adding specific national content. But reducing hours overall is a big mistake.


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## akflightmedic (Dec 7, 2016)

I am almost of the mindset of simply requiring a board re certification like specialty docs and PAs go through...I mean if you cannot pass an entry level exam say every 5 years, well then it is time to go inactive. That would certainly thin the herd, weed out wannabes or incompetents and drive up our asking price eventually...


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## Summit (Dec 7, 2016)

Most people leave the field before 5 years.


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## EpiEMS (Dec 7, 2016)

akflightmedic said:


> That would certainly thin the herd, weed out wannabes or incompetents and drive up our asking price eventually...



I like this argument for sure - but it could also lead to practitioners who are abandoning national registry in favor of just maintaining a state license, thus undermining the idea of a national standard for practitioners, no?



Summit said:


> Most people leave the field before 5 years.



I haven't been able to find any data on this - but I'd believe it. Are you aware of any substantiation for this stat?


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## OnceAnEMT (Dec 7, 2016)

At least for EMT, I see this as an overall decrease in hour requirement but an increase in true CE value. As a college student all I have to do is state 1 or 2 courses that I took and it knocked out my 48 elective hours. I don't remember the exact requirements, but it really didn't take much of anything to do these hours, and the spectrum was broad. I did the 24 via a refresher course. With the new system, I'll probably do the 20 national hours via a refresher course again, the 10 electives through college credit again, but will (hopefully) have to do something EMS-specific that Texas DSHS deems appropriate. So there is potential for 30 hours of truly EMS-specific material, as opposed to the old 24. But we'll see what the states do.

Side note - I've never seen those Training Officer resources before, very interesting. Does anyone know if changelogs for these documents exist?


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## Carlos Danger (Dec 7, 2016)

I don't see it as a bad thing. There needs to be a CE requirement, but refreshing your entire initial education every two years was always a dumb idea. 

The focus should be on continuing education, rather than constantly repeating education. Quality not quantity.


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## VentMonkey (Dec 7, 2016)

Honestly, I don't think this field will ever evolve into a profession. Just take a look at some of the recent threads, and posters.

The true epitome of what it means to try and take two steps forward, only so others can set you 15 steps back. It doesn't much matter to me how many hours I do, or don't need to keep my NRP, or what content is or isn't required; clearly it matters not.

Can you be a professional in the field? Yes. Can this field turn into a profession? Welp, clearly the obvious has been stated even without this opinionated rant.


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## Summit (Dec 7, 2016)

Remi said:


> I don't see it as a bad thing. There needs to be a CE requirement, but refreshing your entire initial education every two years was always a dumb idea.
> 
> The focus should be on continuing education, rather than constantly repeating education. Quality not quantity.


The high ce hour requirements was the only justification for the low initial hours.  I don't see them bumping up initial certification.


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## VentMonkey (Dec 7, 2016)

Summit said:


> The high ce hour requirements was the only justification for the low initial hours.  I don't see them bumping up initial certification.


Ironically, I was just talking with one of our local EMT course instructor about how they're upping the course requirement to 200 hours, further expanded the A&P portion of the course itself. Could this have some relevance?


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## EpiEMS (Dec 7, 2016)

VentMonkey said:


> Ironically, I was just talking with one of our local EMT course instructor about how they're upping the course requirement to 200 hours, further expanded the A&P portion of the course itself. Could this have some relevance?



I haven't seen any info on upping the requirements or expanding A&P - I love the idea. Any sources you could provide?


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## VentMonkey (Dec 7, 2016)

EpiEMS said:


> I haven't seen any info on upping the requirements or expanding A&P - I love the idea. Any sources you could provide?


Sorry Ep, I don't have any cold hard facts. I wouldn't quote me on it, I'm not an instructor, but the instructor who gave me this info is one of the local JC EMT instructors and our former training coordinator, so I gave him the benefit of the doubt.

If anyone can substantiate this, by all means feel free. I do believe @STXmedic is an EMS instructor, perhaps he can enlighten us?


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## Alan L Serve (Dec 8, 2016)

akflightmedic said:


> I am almost of the mindset of simply requiring a board re certification like specialty docs and PAs go through...I



I've just read that the AAPA has taken the formal position that the recertification exam is unnecessary and there exists no studies to support any benefit in retesting after initial certification.



> AAPA opposes re-testing because there is no evidence that it improves patient outcomes or safety.
> http://news-center.aapa.org/recert/


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## Summit (Dec 8, 2016)

VentMonkey said:


> Ironically, I was just talking with one of our local EMT course instructor about how they're upping the course requirement to 200 hours, further expanded the A&P portion of the course itself. Could this have some relevance?


That would be a decision by the JC. There is no new hours requirement from NREMT much less DOT.


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## Carlos Danger (Dec 8, 2016)

Increasing and academic-izing the basic science (A&P, pharm, research) portion of initial EMS training is probably the best thing that could happen to EMS education.

As for CE, it should involve reviewing important basic foundational knowledge, but mostly in the context of updating knowledge to cover new developments in the field.

The NREMT template of basically repeating an abbreviated version of your initial education (often without covering anything new) every two years has always irked me.


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## DrParasite (Dec 8, 2016)

akflightmedic said:


> I am almost of the mindset of simply requiring a board re certification like specialty docs and PAs go through...I mean if you cannot pass an entry level exam say every 5 years, well then it is time to go inactive. That would certainly thin the herd, weed out wannabes or incompetents and drive up our asking price eventually...


that is how NYS used to be back in 2000s.... not sure if they have changed it since I was up there....

As for the original topic, I'm all for it.  I know many people who get their original certification through NREMT, but let it lapse because the continuing education requirements were so high, and they had to be done every 2 years.  Since most employers don't care about NREMT, and only wanted employees to maintain their state certifications, it wasn't a big deal.  I am in favor of increasing the initial hours, because my college is routinely maxed out on the number of hours we can teach in our basic EMT class.  

 I am all for reducing the hours, especially for those people who are active providers.  Having to rehash your entire initial education every two years always seemed like a waste of time for me.  Now if you were covering new material, or new topics, that's a different story.


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## EpiEMS (Dec 8, 2016)

Remi said:


> Increasing and academic-izing the basic science (A&P, pharm, research) portion of initial EMS training is probably the best thing that could happen to EMS education.



I totally agree, but I'm not sure how willing people are to change from EMT (~200 hours) as the entry-to-practice level...



DrParasite said:


> that is how NYS used to be back in 2000s.... not sure if they have changed it since I was up there....



NYS lets you do a 36 hour refresher every three years to recert, if you want to,. It's not a terrible option - take a pre-test and a skills test, then skip the classes you don't "need" to retake based on knowledge/ability, then take the state cognitive exam. Pretty easy.


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## DrParasite (Dec 8, 2016)

EpiEMS said:


> NYS lets you do a 36 hour refresher every three years to recert, if you want to,. It's not a terrible option - take a pre-test and a skills test, then skip the classes you don't "need" to retake based on knowledge/ability, then take the state cognitive exam. Pretty easy.


back in 2002ish, I remember being some discussion about changing from the pre test and skills test you discussed, and going to a strictly continuing education refresher, and once you complete all the con ed, you get a new card, without needing to reset.  After seeing what happens in Jersey, I was very much against it.

I'm actually 100% in favor of everyone needing to pass the original entry level written exam (updated to the current standards, of course) and practical (provided by a neutral party, IE, not your agency or coworkers) as a condition of maintaining your credential.  If you can't pass the entry level exam, you have no business holding that certification, regardless of whether this is you have been doing the job for 2 years or 20.


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## EpiEMS (Dec 8, 2016)

DrParasite said:


> back in 2002ish, I remember being some discussion about changing from the pre test and skills test you discussed, and going to a strictly continuing education refresher, and once you complete all the con ed, you get a new card, without needing to reset.  After seeing what happens in Jersey, I was very much against it.



Seems nutty to me. Jersey does that? You can just get your original card, take your CE and recert?



DrParasite said:


> I'm actually 100% in favor of everyone needing to pass the original entry level written exam (updated to the current standards, of course) and practical (provided by a neutral party, IE, not your agency or coworkers) as a condition of maintaining your credential.  If you can't pass the entry level exam, you have no business holding that certification, regardless of whether this is you have been doing the job for 2 years or 20.



I like the idea, I'm just not sure it would take hold, politically, if you will. Especially because so many folks maintain EMS certification as a collateral duty.


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## STXmedic (Dec 8, 2016)

VentMonkey said:


> If anyone can substantiate this, by all means feel free. I do believe @STXmedic is an EMS instructor, perhaps he can enlighten us?


Neither I, nor our program director have heard of anything. Just asked him after reading this.


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## Summit (Dec 8, 2016)

@many folks:

*The current NREMT 24 hour refresher for basic reinforcement just doesn't rise to the repeated claim I see in this thread of "repeating initial certification.*" The whole thing that was SUPPOSED to happen was spend 24 hours making sure EMTs get the basic "don't hurt your patients" and hopefully spend 48 hours on something like an A&P course, or IV and EKG classes.

A lot of people were able to take a 45-50 hour WEMT upgrade that integrated refresher content!

You could usually fill in the 24 hours of core "refresher" content through other means too, because they weren't so specific like the NCCP model.

Now we have NCCP 20 hours of VERY VERY VERY SPECIFIC "don't kill your patient" content. 10 hours of state/local "protocol review/skills training." And 10 hours of whatever elective, certainly no enticement for EMTs (or AEMTs or Medics) to take college classes for CE.



EpiEMS said:


> I totally agree, but I'm not sure how willing people are to change from EMT (~200 hours) as the entry-to-practice level...


You can do an NREMT course in 150 hours INCLUDING clinicals and testing.

Why is anyone surprised that reinforcement is needed every two years?


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## NysEms2117 (Dec 8, 2016)

I remember back a few years ago, my friend said that he applied for reciprocity(NY->NJ), and NJ gave him their card, and he just re-applied for reciprocity every time and didn't have to take any tests, or classes. he "got away" with it 2 times.


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## DrParasite (Dec 8, 2016)

EpiEMS said:


> Seems nutty to me. Jersey does that? You can just get your original card, take your CE and recert?


I should probably clarify that.... Because NJ does it, NC does it, NR does it, and I'm sure there are plenty of other states that do too..  Yes, you need to retest, but it's with a local instructor, so if the instructor knows you, they are more willing to help you out.  After all, no one wants to be known as the instructor who fails people for not meeting the standards, then people will stop hiring that instructor to do the classes.  You do need to pass a practical exams (at least on paper, and at least in theory), but outside of NY, I wasn't aware of any state that required you to take the proctored state entry level exam to maintain your credential once you expired.

I'm convinced that is also how many fire department based EMS providers maintain their credentials, because they know the elevators, and no one wants to fail their coworker and cost them their job, despite being mediocre providers at best (but that's an entirely different topic).

and @NysEms2117, reciprocity is different... in NY, they will grant you a card once, with the same expiration as your current card... after that, you need to recert through their process (jammed up a buddy of mine who was granted reciprocity when his NJ cert was expiring that month, which was the same date of expiration they gave for his NY card; lesson learned, when possible, apply for reciprocity after you have a new card).  But oddly enough, you can be an EMT in NJ using a PA or NY card, no reciprocity is needed (but again, that's an entirely different topic).  

Kinda weird that NJ let him do it multiple times, but I guess the thinking is, if you can pass the requirements for one state, you should be good enough for the other.


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## NysEms2117 (Dec 8, 2016)

DrParasite said:


> and @NysEms2117, reciprocity is different...


Only reason i even mentioned it is since he skipped the CEU's and Re-cert tests all in all. I avoid all NREMT things so I am moot here


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## EpiEMS (Dec 8, 2016)

Summit said:


> You can do an NREMT course in 150 hours INCLUDING clinicals and testing.
> 
> Why is anyone surprised that reinforcement is needed every two years?



No disagreement. That being said, if you're an active practitioner, one should hope you're seeing the common stuff - and probably could use a refresher on the less frequent/more serious complaints?



DrParasite said:


> After all, no one wants to be known as the instructor who fails people for not meeting the standards, then people will stop hiring that instructor to do the classes.



Herein lies a *major *flaw in the testing/"educational" system for EMS. 



DrParasite said:


> I'm convinced that is also how many fire department based EMS providers maintain their credentials, because they know the elevators, and no one wants to fail their coworker and cost them their job, despite being mediocre providers at best (but that's an entirely different topic).



Thiiiis. Though when I took an NYS recert class, the exam was proctored by independent-seeming folks (same sort of demographics as folks that proctor the SAT).


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## DrParasite (Dec 8, 2016)

NysEms2117 said:


> Only reason i even mentioned it is since he skipped the CEU's and Re-cert tests all in all. I avoid all NREMT things so I am moot here


sure, but I am assuming he completed all the requirements to re-certify in NYS, correct?  IE, he either did all the NYS con ed and/or passed the tests again, correct?  and if he did, wouldn't you assume it was redundant for him to do it all over again for NJ?  

it's not like he did absolutely nothing to get a new card, he did need to follow the steps for NY


EpiEMS said:


> Though when I took an NYS recert class, the exam was proctored by independent-seeming folks (same sort of demographics as folks that proctor the SAT).


Mine too (and NC is the same way).  you finish you class, than you schedule your state test at the regional testing site, so there is no question that proctor doesn't know you, and was able to help you with the exam.  it's a completely objective testing process.

Although I think that paying a little extra for getting your results immediately after the exam was well worth it.


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## EpiEMS (Dec 8, 2016)

DrParasite said:


> Although I think that paying a little extra for getting your results immediately after the exam was well worth it.



One of the many reasons why I like the NREMT approach - Kaplan or whomever runs the cognitive testing, and they're pretty good about both exam security and turning around results.


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## Summit (Apr 4, 2017)

New bump because many of us are now looking at NCCP in two years.


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## PassionMedic (May 16, 2017)

EpiEMS said:


> I like this argument for sure - but it could also lead to practitioners who are abandoning national registry in favor of just maintaining a state license, thus undermining the idea of a national standard for practitioners, no?
> 
> 
> 
> I haven't been able to find any data on this - but I'd believe it. Are you aware of any substantiation for this stat?



I can try to find the graduate thesis I read that cited the same information. It uses 5 years as the bench mark of longevity in EMS because of high burnout rates. 


Sent from my iPhone using Tapatalk


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## Summit (Dec 14, 2017)

New bump because it is downright painful to write a training curriculum to match NCCP


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## VentMonkey (Dec 14, 2017)

This doesn’t make me feel particularly thrilled about my next go round of NRP CE’s. What’s worse is that a lot of CCP/ FP-C CE’s don’t carry over.


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## Summit (Dec 14, 2017)

VentMonkey said:


> This doesn’t make me feel particularly thrilled about my next go round of NRP CE’s. What’s worse is that a lot of CCP/ FP-C CE’s don’t carry over.


You mean your training about managing ventilated patients doesn't fit into the NCCP required 60 minutes about Human Trafficking? Maybe you can make it cover the 2 hours of NCCP required Special Populations training since in theory your vent patients might have tracheotomies and central lines.

(This is what I mean by the pain of finding ways to cram training into fulfilling NCCP)


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## TransportJockey (Dec 14, 2017)

This is why I'm just going to recert by exam


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## Summit (Dec 14, 2017)

TransportJockey said:


> This is why I'm just going to recert by exam


The NREMT is laughing all the way to the bank


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## TransportJockey (Dec 14, 2017)

Summit said:


> The NREMT is laughing all the way to the bank


All my recert hours for fpc were from last certification. I'm not going to pay several hundred for the ce hours to satisfy their requirements. I figure 150 too pass the dead simple test and I'm good


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## ViolynEMT (Jan 4, 2019)

I'm confused as to what is required now with the new rules. I'm signed up for a refresher that counts as 24 hours. That is enough to satisfy state requirements. The director at the school says that I will need another 16 hours of CE, but the NREMT says that only 20 hours is required by them for EMT, 30 for medic. That tells me that the refresher should be all I need......


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