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To Degree or Not to Degree. That is The Question.

Discussion in 'ALS Discussion' started by MedicMcGoo, Jan 7, 2019.

  1. MedicMcGoo

    MedicMcGoo Forum Ride Along

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  2. DesertMedic66

    DesertMedic66 Forum Troll

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    A fire association not wanting EMS/paramedics to get degrees but also pushing for firefighters to have degrees in order to promote? Color me shocked.

    Seems like you would want the people who deal with 80-90% of the fire departments call volume (if they are a medical responder) to have a degree just like the vast majority of all healthcare...
     
    CCCSD likes this.
  3. DrParasite

    DrParasite The fire extinguisher is not just for show

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    You have issues with supervisors needing to have degrees? damn, I've worked with so many good ole boy EMS supervisors in my career, who barely have a HS diploma. it's stupid not to mandate degrees for supervisors and management.

    Some highlights from the article:

    Moreover, these 71% of the 86 current and former medics all felt their education was in adequate, yet how many went back to school to earn degrees in EMS?

    69% had some type of associates (likely in underwater basket weaving), but if it's not in EMS, than it's not beneficial to EMS. If I have a bachelors in civil engineering, how does that help me as a paramedic? unless your degree is in EMS, it doesn't count.

    So the author admits there is not current evidence, but then states that doesn't mean there is no evidence? There is no current evidence that I can walk on water, but that doesn't mean there is no evidence?

    And yes, there is a downside. increased cost to the student, increased time in class for the student when they aren't making money. and increased student debt if they are taking out loans. if they are currently employed, that's more time when they are not able to work because they are in class.

    Should all paramedics need to earn AAS in EMS in order to keep their certifications? if it's beneficial to the patients, absolutely, once they get their paramedic cert and some experience, a degree can only help. To do flight, community paramedicine or CCT, AAS should be the minimum, as well as several years of experience (at which the degree builds on). Should all supervisors have bachelors degrees, and all managers have Masters level education? absolutely.

    But for entry level ambulance work, when the certification has been sufficient for how many decades? There is no evidence that it is needed, or that it benefits anyone other than the college system. And as the author says, just because there is no evidence that it will hurt the profession, doesn't mean there is no evidence, but there are several downsides.
     
  4. DesertMedic66

    DesertMedic66 Forum Troll

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    I have zero issues with management having degrees and IMPO it should be mandatory.

    Its not just as simple as “as long as your degree isn’t in EMS, then it doesn’t matter”. Degrees all require general education classes such as English, reading comprehension, mathematics, sciences, etc. It’s a far reach to say those classes don’t benefit healthcare providers.

    The argument of “the certification has been sufficient for how many decades” IMO is not a valid reason. That sounds very similar to “but we have always done it this way” which is a horrible way to do anything healthcare related. Do we really know it is sufficient? How do we know this? Can we look at other countries who mandate a degree and look at their statistics, patient outcomes, skill set? Does our system still stand water?

    We want to be considered healthcare and clinicians however we are the only ones to not require a degree. In my area RTs need an AS, Rad Techs need an AS, RNs need a BSN, NP/PA need a masters, Etc. Really the only people who do not need a degree are CNAs and LVNs.
     
    Ensihoitaja and CCCSD like this.
  5. DrParasite

    DrParasite The fire extinguisher is not just for show

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    Actually, it does. If you look at most AAS EMS degrees, out of 60 credits, usually 15 or so are gen ed. My BS didn't have any BIO classes, no Chem classes, and if it required a LAB, I didn't take it. My math was calculus, which isn't very useful in EMS (at last not what I can recall).

    There is a reason every degree programs has different prereq classes. My BIO 101 and 102 would likely not help me as much as all the math classes needed for an engineering degree. Each degree has specific prereqs to that degree. Accepting any associates degree in lieu of an associates degree in EMS signifies that the EMS degree doesn't matter, because any AAS is acceptable.
    Sounds like you are asking for evidence that our system is lacking in education. You want hard facts that show that a degree is beneficial. Good, so do I. Show me that certificate paramedics students are failing the NR-P exam with greater frequency than degree paramedic students. Show me actual data that paramedics without degrees have a higher mortality rate than those with degrees. If our system doesn't "still stand water," show me where the leaks are actually occurring, don't just tell me "there must be a leak somewhere.... I don't see any proof of a leak, but I know it's there, so you should definitely update to a more expensive system."
    Do RNs really need a BSN? meaning, do you not know any RNs who don't have BSNs, and are still working? Know any PAs that got their PA cert through Bachelors programs?

    Do you really think healthcare thinks a certificate paramedic isn't a clinician, but once they get an associates, they will magically be viewed as a clinician, esp in a world where most "clinicians", defined as the person making the treatment plan for the patient, have masters degrees or went to medical school?

    If every current paramedic needed to get an AAS in EMS, like NYS is mandating with BSN or else their nursing license is suspended, I would support this 100%. As the recommendations are currently being made, the existing paramedics don't need this "much needed" education, but the next generation def needs it. It's massively hypocritical.
     
  6. mgr22

    mgr22 Forum Asst. Chief

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    It's hard to do research on the value of a degree. How does one measure success, or any other perceived upside of a college education? We could focus on wages, but we'd still have to make allowances for all kinds of variables. Plus, there are many small, subtle advantages that are mostly anecdotal (therefore begging the question, How can I even prove they exist?).

    I look at degrees as a form of insurance. College gave me something to fall back on in case nobody wanted to hire me just for my charm :), and helped me earn a living before starting in EMS and after getting hurt and leaving EMS. I've accepted jobs and turned down jobs I probably wouldn't have been offered without a degree -- their rules, not mine. I also know some stuff about the planet, its people and history that I wouldn't know if I hadn't taken a few classes.

    If your hypothesis is that degrees aren't worth the time and/or cost, I doubt you'll find proof to the contrary. On the other hand, maybe it's time to move along to other topics and just concede that a college degree, like other kinds of insurance, won't hurt.
     
  7. DrParasite

    DrParasite The fire extinguisher is not just for show

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    that is not my hypothesis at all. What I said was a degree requirement for a paramedic isn't worth the time and / or cost for someone who is currently able to do the exact same role with a certificate course. I fully support education, and would encourage a paramedic who took the medic to AAS in EMS bridge program after a year or two on the truck., especially if their employer was paying for it, as it would open up other EMS career paths besides what is available to an entry level paramedic.
    sure, it won't hurt (other than the time spent in class and cost for the actual piece of paper), but it won't help as much as everything thinks it will.
     
  8. mgr22

    mgr22 Forum Asst. Chief

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    DrParasite, you sound like you thought I was addressing you. I wasn't...until now. :) When you say "It won't help as much as everyone thinks it will," what does that even mean? Is "everyone" really everyone? How much do they think it will help, and does it even matter what "they" think? It's like me saying "It won't hurt," which is just as speculative and imprecise.

    My original point was that the OP's attempt at researching this topic didn't bear much fruit because the value of degrees is so hard to quantify. We're all just throwing opinions around. I think that's fine as long as none of us tries to characterize them as research or facts.
     
  9. VentMonkey

    VentMonkey calpuleque Premium Member

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    That is the question to ponder for myself...often. In the event that I was permanently unable to return to work from some gawd awful injury, then yes, a degree would serve its purpose. Can, or will it happen? I don't know.
    Full disclosure: I am not arguing my point, it's a legitimate question.

    Where does this leave folks such as myself who have all of the "experience", and no degree with no honest desire to pad their resume with an associate's? I believe if anything, this is sort of your point as well. I am seriously asking though, because I don't see it happening right now. It offers little value to my current predicament.

    I want to say that this topic is brought up almost weekly and can be discussed endlessly with varying opinions. I do agree that providers should seek higher education; basic math and English skills and the like. I also believe ultimately even an Associates in Paramedicine will afford more opportunities than not for providers new to the field.

    But for now, does this make people such as myself hypocritical for not having a degree since most paramedic degrees that I've researched have zero buy in from me curriculum-wise? I think people such as myself may benefit from college-level courses even if they're non-matriculated, but what if there's absolutely no genuine interest in any of the courses taken? Does this make said paramedic any less competent, any less intelligent, or obtuse?

    I've known college-educated individuals who would have you think otherwise, or make you think twice about its value; I believe we all have. I'm legitimately torn on this subject matter for now, and as a result remain in the "pending further college-level education" category.
     
  10. DrParasite

    DrParasite The fire extinguisher is not just for show

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    @mgr22 the value of degrees is very hard to quantify. the costs are not as difficult, nor is the time required. And by "they" I mean the groups that write position papers on these topics. We can also evaluate test scores on the NR-P exam, first time pass/fail rates, length in the field (how many years total), patient satisfaction scores, patient complaints/compliments, and many other objective things. And then people waaay smarter than me can analyze the data to see if they can identify the causes.

    That is exactly my point. If a college educated (and by that, I mean an AAS in EMS, not any generic degree) makes for a better paramedic, than every paramedic should have to get it. It's not about padding a resume, it's the belief that an AAS in EMS will make you a better paramedic, as well as the whole better recognition in healthcare. if you (referring to every experienced and smart paramedic who doesn't have a degree) are as smart as you think you are, than you should have no problem with any of the material, especially since you have already been doing the job for several years.

    my challenge to you (@VentMonkey) would be 1) if the requirement to keep your medic required you to complete a paramedic to AAS in EMS bridge program in so many years (lets say 5, since you are doing it part time), wouldn't you want to do it? and would you want a paramedic treating your loved one who wasn't dedicated enough to the field to hold him or herself up to the same standards as every newly graduated medic school? and 2) if the course work is all related to EMS (which is your FT job), other than the foundation courses which everyone needs to take to make sure they meet the basic college standards, shouldn't every course appeal to you? 3) and if you don't want to get your degree, than maybe it's best for the industry that you retire from EMS, because the standards have risen and you have chosen not to rise with them?

    JUST SO THERE IS NO CONFUSION: I am picking on @VentMonkey because I know he's an experienced CCEMTP who doesn't have a degree. I am not saying he's a bad provider, or lacks competency, or is unintelligent, or lacks dedication, or smells bad or anything like that. But he is a great example of an experienced medic who does not want to go back to school to get an AAS degree, and I'm sure there are plenty of experienced medics in the exact same position; including some who are advocating for all new medics to have AAS in EMS before they take the NR-P exam.
     
  11. mgr22

    mgr22 Forum Asst. Chief

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    VentMonkey, I don't think you're hypocritical at all. You're wondering and asking. I think lots of us would benefit by simply doing that and keeping an open mind. One bit of advice I can offer is to consider all sorts of majors -- not just those that are EMS related. For example, my degree is in engineering. I don't think my major had much to do with any EMS jobs I got, but I know having a degree did.

    I dislike most formal classes, so I can definitely relate to your mixed feelings about signing up for semesters full of them. Try finding a curricula that you think you can tolerate. You don't have to love it, but you'd have to stick with it. I've done lots of hiring in two industries, and I can tell you that the major almost always mattered less than the degree (and the person, of course).
     
  12. DrParasite

    DrParasite The fire extinguisher is not just for show

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    My degree is in information management and technology. I also double majored in History. my graduate degree will be an MBA, and I am going to try to get a Grad certificate in cyber security management too. None of that helped me get an EMS job. none of it helped me get a fire job. the only thing that matter was that I had the certs,decent interview skills, and above average networking skills. it did help me get an IT job though.

    Please explain how your degree helped you get the job more than having your paramedic certificate. Other than maybe filling out a checkbox for HR for "has bachelors degree."
    While the major might not have mattered. the coursework likely did. If your degree is is in engineering, and mine is in underwater basket-weaving, and we are both new grads applying to work in an engineering firm, who would you think has the upper hand?

    One of colleagues on the college ambulance squad was also an information management and technology major. But he was also pre-med. While all of my non-core classes went to history, he took a full load of bio and chem and all the other premed stuff. So yes, while our majors might have been the same, our coursework was much different, and I can assure you that if we both applied to medical school, he was waaaay more prepared for their curriculum.
     
  13. StCEMT

    StCEMT Forum Deputy Chief

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    An associates gives a damn good amount of course work to tailor to this field though. Having a degree that has a writing course, A&P 1/2, pharmacology, etc. gives a much better foundation than going in with essentially nothing.

    My medic program was a year long. It was a very good program, but that is a lot of information to try to compress into a year and have a high level of comprehension of it all.

    There will always be a learning curve when starting out with this job, but we can still raise the standard of where they start. I know some newish medics that I dont trust and it is a mix of either just newness and trying to climb that learning curve, or being cocky and not knowing their ability is not on par with their confidence.
     
  14. Tigger

    Tigger Dodges Pucks Community Leader

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    My BA certainly helped me get my new (fire) job. The hiring committee circled back to it several times when speaking about critical thinking and communication. I didn't bring it up, but they were pleased to see it. It helped me get my last (3rd service job too), I was a new grad and was actually asked to bring my thesis with me on my first day so the boss and community paramedic coordinator could read it just to see what sort of thoughts I had on community college. Maybe I'm just lucky?

    Some people are great writers, I wasn't until I went to college and studied...Political Science of all things. I brought over a million dollars in grant revenue in the last few years using those skills. Certainly doesn't hurt my ability to write reports either. I wasn't much for public speaking in high school, college helped me out there too. Such a skill is part of many, many aspects of EMS and made me a better educator. There are many other ways to learn these skills besides my silly liberal arts degree and I respect that wholeheartedly. I think those with long EMS careers and less formal education probably have no problem learning these things as they go along. I can't imagine forcing current paramedics to go back to school for an AAS, it doesn't seem feasible and the return on it is probably not that great.

    Where it does benefit is with giving new folks a better foundation to learn on. We need to give paramedics a more well rounded education to help them excel in their roles. The amount of time we spend teaching pharm math and report writing at the medic program I'm an adjunct at is significant. We want our grads to be good when they get out of school, and part of that is knowing those two things. Yet it can take weeks to effectively teach it, which is probably made worse by many of the paramedic instructors not having much ability to really teach these non-technical subjects. I would like to think that a semester of math and semester of english comp would go along away to leaving more time for paramedic specific education.

    It's also far from impractical timewise, at least in Colorado. For most programs, two semesters of AP is required, with a 100 level bio class prereq. To receive the AAS, you need to add a math, one to two english courses, and a computer science course. It's a relatively small investment that many of our local medics already do, and I can't imagine we're much different than the rest of the world.

    We probably can't measure M&M outcomes between AAS and certificate paramedics. I don't think that invalidates the degree argument. There are countless benefits that are perhaps less tangible.

    And as much as I hate to say it, it's important to get a seat at the adult's table. Healthcare will use our lack of degree requirements against us forever, fair or not.
     
  15. mgr22

    mgr22 Forum Asst. Chief

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    DrParasite, you should re-read my post. I didn't say my degree helped me get an EMS job more than my paramedic certificate did. I said my degree helped me get an EMS job. You ask how I know? Mostly by the job description that listed a college degree as a prerequisite. Oh, and then there was the interviewer -- my eventual employer -- who said something like, "We're looking for someone with a degree."
     
  16. mgr22

    mgr22 Forum Asst. Chief

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    Yes, you're right about some majors carrying more weight than others. However, getting a degree in something -- even basket-weaving -- would be better than not getting a degree at all, in my opinion. Earning a degree is evidence of achievement and scholarship, two attractive qualities that not all non-degreed job candidates can promote as easily.
     
  17. TXmed

    TXmed Forum Captain

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    Just throwing my 2 cents in. I obtained my paramedic certification THEN went on to get my associates in EMS and should graduate with my BS in may.

    Working towards my degree has made me a better clinician and caregiver. Formal science classes taught me things that I either never knew or took me years to learn. Classes in statistics, psychology, English, and speech have made me a better professional. My classes surrounding culture, healthcare, administration, and project planning have helped me see a bigger picture.

    I never would have known the value of my degree, if i never have pursued it.

    Pre-hospital healthcare delivery needs to be a career choice. Not a certification you get with a fire department.
     
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  18. DrParasite

    DrParasite The fire extinguisher is not just for show

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    So any generic degree? The content wasn't important, as long as they can fill out the checkbox for "has a degree"? I've seen jobs that required a degree too. And seen a lot of super qualified people get passed over because they had 20 years of work experience, but never got their degree.

    Out of curiosity, at which point did you start working as a paramedic? after you obtained your certification or your degree?

    Your educational progression is exactly how I think it should be. complete the basics for the cert, get the job, obtain some experience, than further your education in EMS with the AAS, and then continue to get a BS. That would impress me a lot more than a new hire applying for a job with a medic certs, an AAS, and a BS, with 0 experience. I would start the cert medic and the BS medic at the exact same level.
     
  19. mgr22

    mgr22 Forum Asst. Chief

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    Well, he didn't share all his thoughts with me but...yeah...the content didn't seem important, to the extent that he didn't ask what my degree was in. I may have told him anyway.

    Not sure where you're heading with this, DrParasite. You seem to be challenging my answers to your questions about my personal experiences. What's the point?

    Regarding super-qualified, experienced people without degrees getting passed over, yes, that happens and I agree that those are sometimes bad decisions. I could tell you stories about how I've occasionally been the only person in the room who advocated for capable people without college degrees. No doubt others on this forum have done the same.

    As unfair as hiring decisions may be, they get made. Our colleagues without degrees will be better prepared if they understand that. Some of them may choose to seek degrees not because they want to learn stuff, but because they want to have more options. Not a problem for me -- that's why I got a degree.
     
  20. cruiseforever

    cruiseforever Forum Captain

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    How long have colleges been offering a degree for paramedic? I got my cert. 30 years ago and I cannot think of a college that offered a degree in EMS.
     

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