I guess the idea of discussing individual teaching traits is lost on the dilemmas of EMS education so I guess I will add some perspective.
Not because I agree with it, but because there seems to be this grand idea that simply making educational requirements more “intensive” that somehow things are going to change.
Increasing entry level requirements on a tech certification is like putting entry level requirements on a welder or medical assistant. “We’re sorry Mr. Smith, little Johnny is just not smart enough for shop class.” By the very definition an EMT is a “technician.”
technician [tɛkˈnɪʃən]
n
1. a person skilled in mechanical or industrial techniques or in a particular technical field
2. a person employed in a laboratory, technical college, or scientific establishment to do practical work
3. a person having specific artistic or mechanical skill, esp if lacking original flair or genius
Maybe that is why the fire service sees EMS as an add on skill. Lest we forget, most EMS in the US is provided by the FD. Firefighting is a vocation.
As well, a large portion of EMTs work in interfacility transport. There is no training in EMS education for such. Even the glorious National Registry is based around emergency care. You need a 2 year degree to give somebody a lift to the doctor? The certification test so easy you don’t even need a class, just a test prep book. How about ranking students who pass the test? "Sorry, you were in too low a percentile to work here."
The simple fact is Nursing, Physical therapy, etc. were not add on skills to another occupation.
Textbooks. My textbooks have lots and lots of pictures and diagrams. I even purposefully buy ones like “Illustrated review of biochemistry.” Granted it is a review book, not a primary text, but not a page goes by in Pathological Basis of Disease without a picture and that is a primary text in medicine world wide.
Blame a school? For what? In the US education is paid for. Economic means is the barrier. From Harvard to your local community college, SATs, ACTs its all a farce, show up with enough cash and you are in. Schools exist because there are people who will pay for what they offer. From “career centers” to Universities, if nobody is paying for a class, it is not offered. I am all for merit based education, but who is going to pay for it?
Job to pay ratio. I advocate to increase EMS education. But after a person takes out a loan for a 4 year degree is the industry going to start paying more than McDonalds?
http://www.mcdonalds.com/usa/work/careers/shiftmanager.html
http://www.mcdonalds.com/usa/work/careers/assistantmanager.html
http://www.mcdonalds.com/usa/work/careers/restaurantmanager.html
You can reduce the number of EMS schools, similar to Nursing or Medicine, but then who is driving Grandma to dialysis 3 days a week? At what cost to medicare?
US EMS has a culture of shifting responsibility. “It is not my fault it is the:” Lt. the FTO, the doctor. Sounds like a tech mentality to me. I could rattle off a list of (high performance) EMS agencies that don’t want critical thinking like I was reciting the alphabet in a song. Maybe a handful are or aspire to be more. They are the exception not the rule. We all know who they are because there are so few.
I’m sorry, there are many people in EMS who should be considered more than a tech. They are more capable and more dedicated than many allied or nursing "professionals". But like every other profession or vocation, they don’t get a special certification or expanded scope. They are held to the same rules and laws everyone else is, the lowest common denominator.
Even in “reputable” EMS agencies, qualifications are often labor focused. “Must have 1 year experience in 911 ops” awesome, one year out at good ole boys volunteer FD. Even in education “must have one year as an EMT working in the field.” Never saw “must have one year as a PA or one year as a nursing assistant.
It’s not that schools aren’t listening or providers are listening. The public and politicos aren’t listening. They don’t know good EMS from bad. EMS has shot its own foot with BS like response times to justify its existence. It has been legislated by a number of parties to a vocational position. From trucking companies in the dialysis derby to FDs who need $600+ dollars for a cab ride with lights to a hospital. You can find doctors who are also firemen, you cannot find firemen who are also doctors. (Change “doctor” to “medical professional” of your choice.)
Blame does not lie with the schools or with testing. If you want to find fault, start with hiring managers. “if you don’t have a degree you cannot interview.” Move on over to finance, “If you cannot pay the fee, you cannot have an ambulance.” How about the providers? “I was just following protocol when I forced the 90 year old lady onto the backboard.” Or “Our agency follows the standards of care no matter what evidence to the contrary has been presented because we cannot be the first to change so the stndard remains.”
If US EMS is ever to be a profession, an increase is education is a given. But you could increase it to a doctorate, exclude anyone you don’t subjectively feel is worthy, and certify yourself as all knowing all powerful raiser of the dead. But there is too much money and therefore special interest involved to think any educational increase will solve EMS’s problems.
Let’s not also forget if you take away “low level” jobs, you will increase unemployment. EMS especially today is a quick “retraining” to get back to work before your unemployment benefits run out. Such is the savior of a fallen economy.
