EMERGENCY MEDICAL
TECHNOLOGY PROGRAM REVIEW
The following
document presents a comprehensive review of the Emergency Medical Technology
(EMT) program at Northland Pioneer College (NPC) as of November, 2005. Because NPC programs are reviewed on a
five-year cycle, data was collected back to the 1999-2000 academic year. There does not appear to be a previous
program review of the EMT program on file.
An introductory
section, Part I, provides the reader with background information for
understanding the development and evolution of the program. Part II examines all aspects of the current
program with regard to instruction, student services, and external alliances
and support. The third part of the
report describes noteworthy accomplishments that have advanced and improved the
EMT program in the past five years.
Parts I-III were developed using information gathered from the Division
of Workforce Development, the Office of Records and Registration, the EMT Program,
and the Division of Student Services. Part IV analyzes the results of a survey
of all fire departments and
In
1996, oversight of the EMT program was moved from the department of Extended
Learning Services to the Science and Mathematics division. Under Extended Learning Services, the
department chairperson supervised the duties of the program coordinator. Under Science and Mathematics, the division
dean supervised the duties of the program coordinator. In November of 2002, EMT was again moved,
this time to the Division of Business and Industry Training, which became the
Division of Workforce Development in 2004.
Peggy Belknap, M.Ed., The Dean of Workforce Development currently
supervises Donna Farkas, FLT CEP, the EMT Program Coordinator.
Until
November of 2002, the program coordinator position for EMT was described as
half-time Fire Science (FRS) and half-time EMT.
Since 1996, four different individuals have held the position. The three coordinators who served in the years
1996-2002 had EMT backgrounds. In
November 2002, two full-time coordinator positions were created, one for FRS
and one for EMT. Donna Farkas, a
Certified Flight Paramedic with over fifteen years of experience, currently
holds the full-time EMT coordinator position. Ms. Farkas took over coordinator
duties in a part-time capacity in August of 2002, and was made full-time in
January of 2003. Her office is located on the
The
Emergency Medical Technology program has undergone significant changes with
guidance from NPC’s EMT Advisory Board (a description of the board can be found
on page 10) and the direction of Ms. Farkas.
Because of the advisory board’s involvement and input, the changes have
been industry-driven in response to employment trends. A new associate degree program has been
developed, and was approved by NPC’s Academic Standards and Curriculum
Committee (ASCC) at its 4/30/04 meeting.
The District Governing Board approved the new program on 5/18/04. Degrees and certificates will be described in
detail in Section II A, beginning on page 4.
The
most noteworthy change to the EMT curriculum is that Intermediate Emergency
Medical Technician (IEMT), although listed in the current 2003-2005 catalog, is
no longer offered by the college, and the associate degree and certificate
programs have been revised. To fully understand why these changes were
implemented, it is necessary to understand the framework of education and
certification for Emergency Medical Technicians (EMTs) and Paramedics (CEPs).
Northland’s
EMT 102, Emergency Medical Technician-Basic, prepares students to take the
National Registry EMT for EMT-Basic certification. This constitutes the skill set and
certification required of entry-level Emergency Medical Technicians and
Firefighters in
An IEMT has all the training of a paramedic
(CEP), with the exception of advanced cardiac care and large-vein skills. Prior
to the Fall semester of 2003, NPC offered EMT-Basic, IEMT and the 500-hour CEP
curriculum. In 2001, the Arizona Department of Health Services (AZDHS), which
oversees all EMT training programs in the state, no longer accepted the
500-hour CEP program, and chose to adopt the 1,000-hour CEP program instead.
In
2003, NPC dropped IEMT from its program offerings. Current NPC offerings preparing students for
national certification include EMT-Basic and the 1,000-hour CEP program. There are two reasons the college chose to
drop IEMT and to adopt the 1,000-hour CEP program. The first is that there is no path of progression for students from IEMT to CEP. If a student becomes certified as an IEMT and
wishes to upgrade his or her certification to CEP, he or she, per state mandated curricular requirements,
must start over at the beginning of the 1,000-hour CEP program, regardless of
the education, training and experience acquired as an IEMT.
The
second reason the 1,000-hour CEP program was adopted in lieu of the IEMT is
that the Certified Emergency Paramedic possesses a skill set that is far more
appropriate to meeting the critical care needs of a rural and remote service
area. Dr. Phil Johnson, Medical Director for Northland’s EMT Program, explains
thus: In metropolitan areas, the IEMT suffices, because patients can be
transported immediately to hospitals.
While IEMTs do not have critical cardiac and large-vein skills, these
skills are not required – in fact it is usually not even possible to employ
them in a metro area – because patient transport can be accomplished so
rapidly. However, if a patient in a
rural area requires intravenous medications or fluids in a large-vein and/or
critical cardiac care, these treatments must
be administered during the often-lengthy
ride to the nearest hospital, and only the CEP has the requisite skills. In an
April 3, 2003 letter to EMT Program Coordinator Donna Farkas, Dr. Johnson
refused to be the Medical Director for an EMT program that offered the IEMT on
the grounds that it “…would not serve our community needs.”
Initially,
area fire chiefs did want the college
to offer IEMT, a 500-hour program, believing it was the faster, less expensive
way to gain qualified employees. They
were, in fact, sending recruits to Cottonwood, Arizona for the 500-hour IEMT
program at a cost of $1,500 per student.
In an April 2003 meeting between various fire chiefs and EMS providers,
Dr. Johnson, and NPC Dean of Workforce Development Peggy Belknap, the chiefs
were convinced that the CEP was indeed a more appropriate program for serving the small, sparsely distributed
communities of Northeastern Arizona. Moreover, Northland’s 1,000-hour CEP
program is the least expensive in the state, costing only $2,260 per student,
whereas other state CEP programs offered by Glendale Community College, Mesa
Community College and Phoenix College range from $3,000 - $4,000.
As
of Fall, 2003, Northland Pioneer College’s Emergency Medical Technician Program
offers courses from First Responder to Certified Emergency Paramedic. The program also offers refresher, continuing
education, and customized training courses, in addition to American Heart
Association CPR and First Aid. The
program has 8 official EMT instructors who meet both AZDHS and NPC
requirements, as well as 40 EMT associate faculty and 28 CPR and First Aid
instructors. As aforementioned, the newly revised Associate of Applied Science
in EMT was approved by ASCC on 4/30/04 and by the NPC District Governing Board
on 5/18/04.
A.
Requirements for certificates and
degrees, including prerequisites
The
recently approved Associate of Applied Science degree in Emergency Medical
Technology requires eighteen general-education credits and forty-seven core
requirement credits. The core
requirements are divided into the Emergency Medical Technician (EMT)
certification and the upgrade from EMT to Certified Emergency Paramedic
(CEP). To complete the paramedic (CEP)
program, the Arizona Department of Health Services (AZDHS) mandates a minimum
of 120 clinical hours and 372 vehicular hours of training, in addition to the
core classes. To qualify for acceptance into the degree program, a student must
be certified by the AZDHS as an EMT.
The
Certificate of Applied Science in Emergency Medical Technology requires
completion of the 47 credit-hour core, in addition to ENL 101 or SPT 120, and
MAT 101.
A
degree is not compulsory for employment as an EMT or CEP in the State of
Arizona; certification by the AZDHS is all that is required. However, the NPC EMT Advisory Committee
strongly supports EMTs and CEPs earning the Certificate of Applied Science and
Associate of Applied Science, and posits that college continuing education
credits and degrees will become much more important in the future of the
industry. A survey of fire departments
and EMS agencies in the NPC service area further reinforces this stance among
EMS employers in the communities. For further explanation of the survey, please
see page 15.
In
order to enroll in EMT 102, Emergency Medical Training – Basic, students must
be at least 18 years of age, have a negative TB skin test, and proof of
immunizations. They must also possess
current health care provider CPR certification, as well as a minimum reading score
of 41 on the ASSET or 81 on the COMPASS.
In the past, area fire chiefs advised against the requirement of a
minimum reading score, believing it would discourage or prevent candidates from
taking the class, thus reducing the available pool of qualified employees. Because of the reading level of materials
used and the level of comprehension required, not only of EMT students, but
also of certified EMTs, the need for a minimum reading level is justified. Not specifying a minimum reading level in
this course and program would be tantamount to setting students up for failure.
With
input from NPC’s EMT Advisory Board, nine new courses were developed (EMT 104,
230, 231, 232, 233, 234, 235, 236, and 237) and nine courses were deleted from
the 2001-2003 catalog (EMT 102, 210, 211, 212, 220, 221, 222, 223, and
224). To compare the 2003 course
offerings with the new course offerings, see Appendices, pages ii-x.
The
United States Department of Transportation develops curriculum for EMT and CEP
programs nationwide, and The Arizona Department of Health Services (AZDHS) is
the governing agency over all Basic Life Support and Advanced Life Support
(EMT) training centers in the state, adopting and approving national
curriculum. AZDHS certifies all
instructors of courses for EMT and CEP certification. NPC must use the AZDHS approved
curriculum. Students who complete EMT
102 with a cumulative score of 80% or higher are eligible to apply to take the
National Registry EMT. To become
eligible to test for Certified Emergency Paramedic, a student must complete 47
credits (EMT 102, 230, 231, 232, 233, 234, 235, 236 and 237 and FRS 110),
passing with a cumulative score of 80% or better.[1]
In
another industry-driven change to the 2003 course offerings, EMT 101, a
one-credit CPR and First Aid class designed to certify the student in AHA CPR
(Health Care Provider Level) and First Aid, was dropped and replaced by EMT
104, a half-credit class. This change was made in order to eliminate redundancy and
ensure that course contact hours reflected credits given. The two-day, sixteen-hour EMT 101 covered
Health Care Provider CPR on day one, and First Aid, plus Heart Saver CPR on Day
Two. Therefore, day two found
participants repeating CPR instruction at
a lower level than was covered previously on day one. The difference
between Heart Saver CPR and AHA Health Care Provider CPR is that the latter
covers CPR in a more in-depth fashion, and includes the use of adjuncts such as
oxygen that basic CPR providers (laypersons) would not utilize. Because of the
redundancy, instructors were dismissing students early, and the sixteen hours
required for a one-credit class were not being met. Now EMT 104, a half-credit course developed
for nursing assistants, medical assistants, and other health care providers
covers Health Care Provider CPR and Heart Saver First Aid. A separate course for laypersons is offered
as a 199 course to cover Heart Saver CPR and Heart Saver First Aid. This is further discussed on page 6.
The
American Heart Association (AHA) oversees EMT 085, Basic First Aid, EMT 090,
designed to certify or re-certify the student in AHA Heart Saver Level CPR and
EMT 095, designed to certify or re-certify the student in Healthcare Provider
Level CPR. EMT 100, listed in the
current catalog, follows the First Responder National Standard Curriculum,
approved in 1995 by the U.S. Department of Transportation, the National Highway
Traffic and Safety Administration, the U.S. Department of Health and Human
Services, and the Maternal and Child Health Bureau. As such, it meets 1995 requirements allowing
students to become eligible for national registration as a First
Responder. Donna Farkas, reviewing this
curriculum and comparing it to other offerings throughout the state, determined
that the course content was obsolete. An
update is in the works, and while NPC does not currently offer a course for
National First Responder certification, plans are to do so as of the Fall 2006
semester. This is discussed in greater
detail in Part V-C, pages 15 - 16.[2]
Other
refresher/continuing education EMT courses are open to working professionals in
the emergency medical field. Short-term,
customized training for working professionals is also provided by request
through the Division of Workforce Development.
C.
Occupations and transfer programs for
which the program prepares students
Table
1 on page i illustrates numbers employed and hourly wages for the Bureau of
Labor Statistics Standard Occupational Classifications (SOC) of Emergency Medical Technicians and Paramedics (SOC #29-2041) and Firefighters (33-2011). For comparison, statistics are given for the
United States, Arizona, and the Flagstaff area.
(Statistics for the Phoenix Metropolitan area are not available.) The Standard Occupational Classification
(SOC) System is used by the Bureau of Labor Statistics to classify workers into
categories according to their occupational definitions. While the SOC lists Emergency Medical
Technicians and Paramedics under the same occupational code, they are indeed
disparate professions with unique skill levels and salary ranges. The occupation of Firefighter is included in
the table, because it is preferred that full-time, career firefighters in the
State of Arizona hold EMT-Basic certification for entry-level employment.
D.
Licensure/regulatory or national industry
skill standards that affect the program
The
Arizona Department of Health Services (AZDHS) is the governing agency over all
Basic Life Support and Advanced Life Support (EMT) training centers in the
state. Subsequently, the college is
bound by all the rules and regulations mandated by the AZDHS, including use of
the prescribed curriculum. Training
centers and their programs must be reviewed and re-approved by AZDHS every two
years. NPC just passed its 2005 AZDHS
audit in October (see page 15). The same form that is used for training center
renewal is also used to petition for approval of individual classes (see
Appendices, pp. X). Class approval forms must be sent to and approved by AZHDS
ten days prior to the start of the proposed class. The college is obliged by AZDHS to follow a
minimum requirement for course content and hours; hours and content may be
increased by the college, but never decreased. The NPC EMT Coordinator must be
approved by the AZDHS, and she reports to them regularly, following a required
format.[3]
In order
to qualify to take the National Registry EMT, which is the exam for EMT
licensure, students must pass EMT 102, Emergency Medical Training – Basic with
a cumulative score of at least 80%.
While AZDHS requires a cumulative score of only 75%, Northland Pioneer
College elected to raise the minimum requirement, due to the complexity and
quantity of the subject matter covered.
Students must also pass a random criminal background check conducted by
the AZDHS. Finally, their credentials must be reviewed and approved by the
Medical Director of the NPC EMT Program.[4]
AZDHS
mandates that NPC, as an approved EMT training facility, have a Medical
Director. Dr. Phil Johnson, M.D., an
Emergency Department Physician at Navapache Regional Medical Center in Show
Low, serves in this capacity. His
responsibilities include participating on the NPC EMT Advisory Council,
reviewing program curriculum, and signing off his approval for all exam
candidates to take the National Register EMT.
The college pays Dr. Johnson a small stipend for his services; it should
be noted that the EMT Program Coordinator and the Dean of Workforce Development
do not feel that the stipend is equal to the services and support rendered by
Dr. Johnson. In addition to the
responsibilities related to his position as NPC’s Medical Director, Dr. Johnson
also teaches classes as an associate faculty member.
The
American Heart Association (AHA) oversees all CPR and First Aid classes at
NPC. The EMT Program Coordinator sends
the AHA annual reports on numbers trained and certified in CPR and First Aid
(see Appendices p. xxvi). In order to
maintain its status as a certified AHA CPR and First Aid Training Facility, NPC
must train a minimum of 500 students per year in CPR, First Aid, or a
combination of the two. While CPR/First
Aid instructors are not required to be associate faculty members, they must
have the approval of the AHA. The EMT
Program Coordinator keeps records on all CPR/First Aid instructors and shares
this information with the AHA in quarterly reports. When Donna Farkas took over as full-time EMT
Program Coordinator in January of 2003, there were ten CPR/First Aid
instructors working for the college.
There are now twenty-eight.[5]
The EMT
Program Coordinator has the liberty, under the AHA, to customize CPR and First
Aid classes to meet the needs of particular businesses or industries. For example, a First Aid class requested by a
pre-school might cover first aid for injuries such as those sustained on the
playground, and information on proper handling of bodily fluids. A First Aid class requested by a power plant
might focus on injuries sustained through the handling of certain chemicals.
There is an upward trend in the need for CPR/First Aid classes, as more and
more employers are requiring employees to be certified in these areas. In addition, retailers such as Wal-Mart are
installing Automated External Defibrillators (AEDs) to provide emergency care
to employees and customers who suffer heart attacks on store premises. In order to qualify to receive AEDs,
employees must be certified in their use.
A CPR class for Wal-Mart employees would be customized to include
training and certification in use of AEDs.[6]
It is
worth noting that Navapache Regional Medical Center is also an AHA approved
CPR/First Aid Training Facility. The
relationship between the hospital and the college was competitive in the past,
but Donna Farkas has developed an excellent working relationship with NRMC,
beyond that which is needed for CPR/First Aid training. In fact, the CPR/First Aid trainer at NRMC is
certified as an associate faculty member at NPC. The EMT Program Coordinator asserts that
there is more than enough need in the college service area for both the college
and the hospital to fill their required training quotas each year.
E.
Student organizations/leadership
development organizations available for students
Northland Pioneer College currently sanctions no student
organization or leadership development organizations for students in the
Emergency Medical Technician program.
As of
the Fall 2005 semester, there are 65 declared Associate of Applied Science
degree plans on file for the EMT program.
There is only 1 declared degree plan on file for the Certificate of
Applied Science, probably because it was only recently approved by the Academic
Standards and Curriculum Committee (4/30/04) and the district governing board
(5/18/04). The chart on page xxiii of
the appendices illustrates EMT enrollment by headcount and course number from
1998-1999 through 2004. Page xxiv depicts EMS enrollment for Fall 2005. The low
annualized FTSE recorded in 2002-2003 (44.15) reflects the fact that there was
no program coordinator for that academic year. In Fall 2003, FTSE in the EMT
program was 44.66, or 2.1% of the total college FTSE of 2,122.17.[7] Fall 2004 FTSE was 44.57. It is worth noting that annualized FTSE for
1999-2002, prior to the program enjoying a full-time coordinator, averaged
71.065. FTSE for the 2004-2005 academic
year was 83.39.
The
Northern Arizona Vocational Institute of Technology (NAVIT) is a Joint
Technological Education District (JTED) formed in 1999 to assist high school
juniors and seniors in completing community college technical education
classes. NAVIT serves 11 school
districts in Navajo, Apache and Gila Counties.
Students enrolled in NAVIT can get a jump-start on the Associate of
Applied Science degree by taking community college classes beginning in the
junior year of high school. NAVIT
assists these students with tuition, books and fees, and NAVIT students take
classes at the community college from community college instructors for part of
their high school day. Because they are
high-school age, NAVIT students are not eligible for the EMT program, since
there is a minimum age requirement of 18 years.
Still, NAVIT students have enrolled in EMT 101, CPR & First Aid, as
partial requirement for the Nursing Assistant Training (NAT) program. While NAVIT enrollment constitutes a significant
portion of the enrollment in other vocational programs at the college, such as
Fire Science and Welding, it has averaged less than 5% of the headcount
enrollment in EMT since Fall 2003.[8]
G.
Number of students completing program
There have been only five students completing an Emergency
Medical Technology degree program between 1999 and 2005. In 1999 and 2002, one AAS degree was
awarded. In 12/2004, one AAS degree was
awarded, and in 5/2005, one CAS and one AAS were awarded.[9]
This is in part due to the percentage of students enrolled in short-term
training classes, such as First Aid and CPR, who are not EMT-degree
seeking. It may also be due in part to
the fact that a degree in EMT is not a requirement for employment in the State
of Arizona. For entry-level employment,
certification in EMT-Basic is the only requirement. Still, a recent survey of
fire departments in the college service area reveals that the AAS is valued,
and sometimes leads to an increase in pay for employees. Moreover, the newly
approved changes in course offerings and degree and certificate requirements
were industry-driven. Moreover, as of November, 2003, the EMT program has been
managed by a full-time coordinator, rather than a half-time coordinator as in
the past. As of Spring 2004, there were 65 degree plans on file for an AAS in
EMT and one for the CAS in EMT. The new
Associate of Applied Science and Certificate of Applied Science in EMT have
been approved, so the number of students completing an EMT certificate or degree
will certainly increase in the next year or two.
A discussion on enrollment would not be fully
developed without an examination of completion rates. Since the terminal, career related goal for
students in the EMT program is certification, either as EMTs or CEPs, pass
rates for the respective exams are extremely relevant. Since the college adopted the new CEP
curriculum under Program Coordinator Donna Farkas, there have been 31 paramedic
students enrolled in and completing the course.
Of those 31, 28 have become licensed paramedics. At 90.32%, this shatters the national average
of 64%. It is important to note,
however, that for these seminal classes, students were carefully handpicked by
their agencies, and the student groups were comprised of the cream of the crop
with regard to potential. These facts
notwithstanding, they clearly received excellent instruction, mentoring and
exam preparation from Farkas. Still,
when you start at the top, there is a significant challenge to maintain such
percentages with regard to pass rate.
For EMTs, the pass rate is a work in
progress. The initial EMT-Basic pass
rate for students under the new curriculum was 52%, which is just below the
national average of 54%. This prompted
EMT Instructor Jeri Eichler and Farkas to examine all the elements of the
course with an emphasis on textbooks, materials, instruction, and exam
preparation. They chose to adopt a new
textbook, a new workbook, and a new student study guide. They also implemented an exam pretest and a
preparatory course, which students take immediately before sitting for the
national test. The pass rate for 2004-2005, which is the first year these
changes have been in effect, has risen to 60%, six percentage points higher
than the national average, but still not satisfactory to Eichler and Farkas who
continue to examine the issue and refine solutions.
H.
Salary ranges in occupational field
Table 1
on page i gives hourly wages for the Bureau of Labor Statistics Standard
Occupational Classifications (SOC) of Emergency
Medical Technicians and Paramedics
(SOC #29-2041) and Firefighters (33-2011). For comparison, statistics are given for the
United States, Arizona, and the Flagstaff area.
(Statistics for the Phoenix Metropolitan area are not available.) It should
be noted that Emergency Medical Technicians and Paramedics are combined under
the same SOC number, but EMTs make less per hour than CEPs. EMT-Basic is an entry-level position in the
field of Emergency Medical Technology. CEP requires more training and a higher
skill level; commensurately, the salary for a CEP is higher than that of an
EMT. Firefighter salaries are given,
because full-time, career Firefighters in the State of Arizona must be
certified not only in Firefighter I and II, but also in EMT-Basic.
I.
Program cost per FTSE
The
chart on page xxv illustrates the amounts budgeted and spent on the Emergency
Medical Technology program since 2002-2003, and includes an estimate of the
cost per FTSE based on the following: Amount Spent / Annualized FTSE. Estimates of cost per FTSE do not predate
2002, because prior to that year the program was managed jointly with Fire
Science, and the funds could not be disaggregated. The formula, Amount Spent / Annualized FTSE
uses the amount drawn for the program from the college’s general fund. It does not include monies received from
grant programs, nor does it reflect revenues generated by course fees, even
though these figures reduce the cost per FTSE.
All students completing the proposed AAS degree in Emergency Medical Technology are required to complete eighteen credits of general education courses. All students completing the proposed Certificate of Applied Science are required to take six general education credits, which include three credits of math and three credits of English or Speech.
Services to special populations are the responsibility of
the Coordinator of Disability Resources and Access (DRA), under the Division of
Student Services. The DRA Coordinator ensures equitable access for any NPC
student who self-identifies as having a disability by providing classroom
accommodations and various support services under the guidelines of the
Americans with Disabilities Act (ADA).
These include, but are not limited to the following: assisting with
registration; coordinating services with other local, state, and federal
agencies and programs; and assisting the Vice President for Administrative
Services with monitoring of facilities to make sure they meet ADA access
guidelines. In addition, the DRA
Coordinator provides training to faculty and staff on issues related to the ADA
and oversees ADA issues that may arise with regard to staff and faculty.
In Spring of 2005, the EMT department discussed recruitment
of women and minorities. This heightened
awareness of the need for recruitment strategies, and the team plans to develop
and implement focused recruitment efforts in 2006.
The
list on page xxvii illustrates all equipment on inventory for the Emergency
Medical Technology program.
This
group consists of the following persons:
·
Dr.
Phil Johnson, MD – Emergency Department Physician at Navapache Regional Medical
Center and NPC Medical Director
·
Jeff
Farkas, FLT CEP – NPC adjunct faculty for the EMT program
·
Deanne
Niven, RN, CEP - NPC adjunct faculty for the EMT program
·
Lynn
Brown-Wagner, RN, BSN - NPC adjunct faculty for the EMT program
·
Darren
McDowell, CEP – Pre-hospital Coordinator for Navapache Regional Medical Center
and NPC adjunct faculty for the EMT program
·
Donna
Farkas, FLT CEP – Program Coordinator for the NPC EMT Program
·
Peggy
Belknap, M.Ed., NPC Dean of Workforce Development
The
advisory group meets quarterly, or as needed to discuss EMS course needs, new
curriculum or changes to existing curriculum, student and instructor issues and
trends in the EMS industry. Members
assist Ms. Farkas with decisions related to the NPC EMT program by providing
input, information and alternative perspectives for her consideration.
This
is the Arizona State authorized EMS council for Northern Arizona. It consists of EMS providers, fire
departments, hospitals, and interested individuals from across Northern
Arizona. Donna Farkas is a member of
NAEMS, and attends all regular meetings as a representative of NPC. NAEMS also meets quarterly to network and
discuss EMS issues, state funding, tuition assistance, grant availability,
equipment updates and needs, and also current EMS and EMS-related courses in
Northern Arizona. As a member of this
group, Ms. Farkas is able to stay up to date on developments in the EMS field
and EMS education in and around Arizona, with an emphasis on service to rural
areas.
3. Northeastern
Arizona Fire Chiefs Association (NAFCA)
This
group consists of the fire chiefs of all departments in southern Navajo and
Apache Counties. Donna Farkas and/or
Peggy Belknap attend(s) their monthly meetings as representatives of NPC. The group was formed to promote information
sharing across the fire fighting field in the White Mountains and surrounding
communities. The group has been
instrumental in promoting the Northeastern Arizona Training Center (NATC – see
page X), and their input and feedback have influenced curricular developments
at the college. Participation with this
group enables Ms. Farkas to stay abreast of training and continuing education
needs on a local basis, so the college may plan to effectively serve those
needs for the fire fighting and EMS communities.
4. National
Association of EMS Educators (NAEMSE)
N.
Facilities and Services that Support the
Program
The
following entities provide facilities and equipment for NPC EMT program
classes:
·
Arrowhead
Mobile Health Care of Show Low
·
Heber
Fire Department
·
Holbrook
EMS
·
Lakeside
Fire Department
·
Navapache
Regional Medical Center
·
Pinetop
Fire Department
·
Puerco
Valley Fire/EMS
·
Show
Low Fire Department
·
Springerville
Fire Department
·
St.
Johns EMS
·
Taylor
EMS
·
Taylor
Fire Department
·
White
Mountain Ambulance
·
White
Mountain Apache Tribe Fire Department
·
Whiteriver
IHS Hospital
Show Low
Police Department and Pinetop/Lakeside Police Department also provide use of
their facilities for classes under the NPC EMT program. NPC EMT students are required to check off
skill sets for certification as EMTs and CEPs.
To do this, it is necessary that working CEPs precept them, and that
hospitals provide them with supervised clinical experiences. In addition to facilities and equipment, NPC
has precept and/or clinical agreements with all of the above agencies. Winslow Memorial Hospital also provides
clinicals for students in the NPC EMT program, and Action Medical, the
ambulance service in Winslow, precepts NPC students. Donna Farkas has also coordinated precept
agreements with Gilbert, Mesa, Phoenix and Sedona Fire Departments, and
Guardian Ground Division, and a clinical agreement with Flagstaff Medical
Center. The latter six entities
experience a higher call volume and patient load than is found in the rural
communities of Navajo and Apache Counties, so students are more likely to
experience a broader variety of emergency situations, exposing them to a more
comprehensive complement of skill sets for certification.
O.
Articulation and Collaboration
While
various college credits will transfer to other colleges and universities,
students seeking EMT or CEP certification must complete their EMT and CEP
programs at an AZDHS certified training facility. Once they have begun an EMT or CEP
certification program, they cannot transfer from one AZDHS certified training
facility to another.
In
the past, the EMT department has not participated in state articulation
meetings with other Arizona colleges and universities. However, as Fire Science (FRS) and EMT
departments fall under the Allied Health category, the Dean of Workforce
Development, Peggy Belknap will participate in the October 2005 meeting of the
state articulation task force for Allied Health, and will determine whether
future participation by Donna Farkas and FRS Coordinator Scott Burt is
warranted.
P.
Marketing Plan
According
to the Office of Marketing and Public Relations, there has never been a formal
marketing plan for EMT. Course offerings
appear in the college catalog and course schedules, and on the NPC web site. In
years past, there have been occasional news releases about happenings in the
program, but there is no official brochure or other printed material produced
by Marketing and Public Relations. The
Division of Workforce Development does produce flyers to advertise course
offerings; these flyers are sent to the various campuses and centers and to the
fire chiefs in the NPC service area.
One of the process objectives of the ROPE project (see page 13,
below) is the development and implementation of a marketing plan to promote
project activities. This marketing plan,
which will be a joint effort by the Dean of Workforce Development and the NPC
Director of Marketing and Public Relations, will serve to promote the EMT
program as well as the ROPE project. The
ROPE marketing plan is scheduled to be completed by November 2005.
III. Noteworthy Accomplishments and Developments
A.
Rural Outreach for Paramedical Education
(ROPE)
In the
summer of 2004, Donna Farkas conceptualized a project for bringing
hands-on critical care skills
education to rural areas to eliminate the need for EMS students and
professionals to travel to metropolitan areas to check off skills competencies required
for keeping professional certifications up to date. A proposal, based on Ms. Farkas’ “Rural
Outreach for Paramedical Education” project (ROPE) was submitted to the Health
Resources Services Administration (HRSA)
Rural Emergency Medical Services Training Equipment Assistance Program
(REMSTEP), and in September of 2004, a grant in the amount of $83,687 was
awarded to NPC to fund ROPE. Northland Pioneer College partnered with Northern
Arizona EMS (NAEMS - the State
authorized EMS council for Northern Arizona), 14 Northern Arizona fire
departments, and 12 hospitals to form Rural Outreach for Paramedical Education
(ROPE). The purpose of the ROPE partnership is to provide high-quality, accessible, and cost effective training
opportunities for certification and re-certification of Certified Emergency
Paramedics (CEPs) and continuing education for Emergency Medical Service (EMS)
providers in Northeastern Arizona, thereby eliminating the need for costly
travel to distant metropolitan areas.
This
innovative project brought a mobile
hands-on, critical care skills lab, the
centerpiece of which is a human patient simulator, to CEP students and
EMS providers across the NPC service area. Project goals are as follows: 1.) By
9/29/2007, 70% or more of the 400 Certified Emergency Paramedics in the project
service area will receive a Certificate of Completion for re-certification,
from one of the project partners, through use of the mobile skills lab. 2.) By 9/29/2005, 100% of Certified Emergency
Paramedic candidates at NPC will be able to check off 100% of their initial
training in all critical care competency areas by using the mobile skills
lab. 3.) By 9/29/2007 at least 75% of
the first-year group that were served by the project will return for their next
re-certification.
Project
sustainability is assured by ongoing evaluation activities that are regularly
reviewed by the partnership, and an innovative train-the-trainer model, through
which mobile skills lab instructors come directly from the ranks of the partnership. Course fees, tuition and user fees provide
for maintenance and repair of the mobile skills lab.
In
August of 2005, a second year of funding in the amount of $60,000 was awarded
to NPC by REMSTEP. This grant will allow
the project to be expanded to include a Disaster Medical Readiness module that
will enable the human patient simulator to be used to train medical personnel
in disaster response. Funding will also
allow an ambulance to be equipped with audio-visual equipment so students may
observe other students and instructors working on the human patient simulator
in the ambulance’s interior. By
expanding the capabilities of the mobile skills lab, the EMT program can
optimize the scope and quality of training offerings across the project service
area.
The
REMSTEP grant also allowed Donna Farkas and EMT faculty member Jeri Eichler to
travel to Washington, D.C. in August of 2005 to attend the HRSA All Programs
National Conference. There, they learned
about other grant-funded programs operated under HRSA, and shared information
about NPC’s ROPE project. Farkas and
Eichler were able to network with other colleges, as well as other HRSA
representatives to identify potential sources for future grant funding. The ROPE project was extremely well received,
and a group from Guam expressed an interest in having Farkas and the ROPE team
travel to Guam to demonstrate the project and assist in developing and
implementing a similar training model there.
The
Health Resource Services Administration anticipates that REMSTEP will be funded
at the federal level in 2006-2007. While
this funding is subject to congressional approval, if REMSTEP notifies NPC that
a third year of funding is available to further enhance ROPE, the college plans
to apply for it.
.
B.
Expansion of Associate Faculty Pool
One of
the most noteworthy accomplishments of Donna Farkas’ tenure as EMT Program Coordinator to date has been the
expansion of the associate faculty pool.
When Donna began her full-time duties in 2003, there were ten
instructors certified with the college and the Arizona Department of Health
Services to teach CPR and First Aid.
Donna actively recruited instructors from her contacts within the health
care field, and there are now twenty-eight instructors available for CPR and
First Aid.
Similarly,
there were only two associate faculty certified by AZDHS and NPC to teach EMT
courses. Due to Farkas’ recruitment
activities there are now eight, as well as forty associate faculty to teach
various program courses, and a full-time EMT faculty member, Jeri Eichler, who
joined NPC in this capacity in Fall 2004.
Ms. Eichler is herself a graduate of the NPC EMT program, and is now
responsible for instructing students in EMT 102 the EMT Basic course, which
prepares students to test for national certification as Emergency Medical
Technicians.
C.
Addition of Half-Time Administrative
Assistant
One of
the greatest administrative burdens the EMT program faces is the need to
report, on an ongoing basis, to the following accrediting agencies: The
American Heart Association (AHA), the Arizona Department of Health Services
(AZDHS), the National Highway Transportation Safety Administration / Department
of Transportation, and the National Registry of EMTs. Between program coordination, teaching
duties, and coordination of the ROPE project, Donna Farkas’ schedule is
tight. In August of 2005, Ms. Bonnie
Pastorino joined the EMT program as a half-time (20 hours per week) assistant. Her role consists largely of handling the
paperwork associated with reporting to the aforementioned agencies in order to
keep all accrediting current. Ms.
Pastorino also assists students and prospective students with questions
regarding the program, prepares meeting agendas and notes, and keeps budgetary
records for the program and its ROPE project.
Already, the 20 hours Ms. Pastorino is allotted to work each week are
maximized, and Ms. Farkas reports that her skills could easily be utilized in a
full-time capacity.
D.
2005 Arizona Department of Health
Services Audit of NPC EMT Program
In
October 2005, the NPC EMT program underwent a mandatory audit by the Arizona
Department of Health Services. These
audits are required for EMT and CEP certification programs to maintain
compliance with state and national standards.
While they are scheduled on a two-year cycle, NPC had not undergone an
audit since 2001. The program passed
that audit “with infractions”. Under
AZDHS, infractions require immediate correction in order for a program to
maintain its accreditation. Violations
will result in the immediate cancellation of a program’s accredited status. The
NPC EMT program passed its 2005 audit with no infractions.
Dean of
Workforce Development Peggy Belknap, working with EMT Program Coordinator Donna
Farkas developed a survey for completion by all area fire departments and
ambulance services. The purpose of the
survey was to learn about employment trends and salary ranges for CEPs, IEMTs,
and EMTs in the NPC service area, and to determine whether college courses and
even degrees are currently important, or will become increasingly important
with regard to these careers.
The
survey was disseminated by U.S. Mail, with a postage-paid return envelope, to
20 local fire and EMS agencies. The
survey was also sent electronically to the same agencies, and response via
e-mail was invited. This effort generated only four responses, all through the
U.S. Mail. EMS Program Assistant Bonnie Pastorino then attempted a telephone
survey, but found that the fire chiefs were often occupied elsewhere, and
unable to come to the phone. On
Thursday, October 27, Dean Peggy Belknap hand-carried the survey to a meeting
of the Northeastern Arizona Fire Chiefs Association (NAFCA). All chiefs present completed the survey,
which brought the total responses to 11 or 55%.
One more survey arrived by mail on November 1, so the final responses
totaled 12/20 or 60%.
While a
sample of the survey and a synopsis of the results may be found on pages
xxviii-xxix, three key points are worth noting here: (1) All respondents
foresee using the college as a partner to meet their training needs; (2) Eleven
(11) of the twelve respondents would consider it beneficial for their CEPs,
IEMTs and EMTs to earn the newly adopted Associate of Applied Science degree in
Emergency Medical Technology; (3) All respondents will be adding new positions
in the next five years, with an emphasis on CEPs and EMTs.
Respondents
were also asked to rate their satisfaction with the NPC EMT program on a scale
of 1 (Poor) to 5 (Excellent), two years ago and currently. Responses averaged 2.9 (Fair to Adequate) two
years ago; they now average 3.6 (Adequate to Very Good) an improvement of
24.1%. It is worth noting that only ten
respondents replied to the question regarding program satisfaction two years
ago; all respondents replied to the question regarding current program
satisfaction.
Survey
responses, when compared to the salary range charts on page i indicate that
CEPs, IEMTs and EMTs are paid slightly less than their counterparts in the
state. Still, given the regional
economy, it appears that a local career in the EMS field has the potential for
stability and for competitive salary based on the agencies’ anticipation for
future needs.
In
preparing this program review, members of the NPC EMT Advisory Board were asked
what the report should include, in addition to those areas discussed thus
far. Three industry trends, with
implications for the NPC EMT program, were discussed.
The current EMT Basic course, EMT 102 is a seven-credit
course. Donna Farkas compared the course
content and contact hours for the NPC offering to that of other community
colleges, and determined that the NPC course should be an eight-credit
course. Based on the material covered,
and the contact time required of students to accomplish all course competencies
related to both lecture and laboratory settings, the eight-credit weight is
justified. Moreover, a change in the
number of credits from seven to eight would more closely align with the
offerings of other state community colleges.
Thus, it would be more likely that credits would transfer within the
state system. As was previously
mentioned, the NPC EMT and FRS programs have just begun to explore
participation with the state’s articulation task force under the Allied Health
division, so transfer of credits may be highlighted in the upcoming year. For now, Ms. Farkas is proceeding with a
presentation to the NPC Academic Standards and Curriculum Committee to petition
for the change of credits.
B.
Change in mode of testing for national
EMT and CEP certification
At a recent meeting of the Northern Arizona EMS group
(NAEMS), Donna Farkas learned that the Arizona Department of Health Services
and the National Registry of EMTs are proposing to change their methods of
testing candidates for EMT and CEP certification. Currently, tests are administered at NPC by
proctors from the certifying entities.
The written portion of the test is performed with examinees responding
to questions by blackening the correct “bubble” on a “scantron” sheet. AZDHS and the National Registry of EMTs hope
to streamline and heighten the integrity and security of the testing process by
converting to a completely computerized testing procedure. A key problem with this is that examinees
would have to travel to Phoenix, Tucson or Flagstaff for testing. Moreover, the current rate of $20.00 for
taking the test will increase to anywhere from $75.00 to $125.00. Questions arose at the NAEMS meeting as to
how community colleges might work within this new testing model to become
testing centers, therefore alleviating the burden of travel, thus lessening the
testing expense, for examinees. The
ramifications for NPC and other community colleges remain unclear at this time,
but it will be worth future consideration as to whether NPC can test EMT and CEP
students on-site, perhaps incorporating the expense of becoming a testing
center into course fees. Juxtaposed
with this is the challenge of keeping the testing process affordable for those
EMT and CEP course completors who are seeking national certification.
C. Providing paramedical skills training to residents of rural areas, especially for Nationally Registered First Responders
Board members immediately pointed to the need for taking the
offerings of the EMT program out into the most rural parts of the NPC service
area. The need for this is based upon
some compelling statistics. Jeff Farkas,
a paramedic with the Heber-Overgaard Fire Department, reported the sobering
fact that of all firefighters killed in the line of duty each year, fully 50%
of deaths are caused by vehicular accidents that occur while en route on
emergency calls. This is especially
significant in rural areas, where most fire departments are comprised of
volunteers who cannot spare time away from regular full-time jobs for updated
training and continuing education. Jeff
suggested a Nationally Registered First Responder class, that could be taken
“on the road” and presented on-site in even the most remote communities. He explained that in rural communities of
fewer than 10,000 residents (virtually all
of the communities within the NPC service area) an individual with National
First Responder certification can drive an ambulance. Jeff recently had to
travel out of the NPC service area to obtain his own National First Responder
card. NPC used to offer a First Responder course, but the curriculum is no
longer adequate and must be updated.
Still, plans are in place to revive the course for the Fall 2006
semester.
Jeff and Donna Farkas, along with Peggy Belknap and Betsyann
Wilson who authored the REMSTEP grant, explored the possibility of taking
components of the NPC EMT program “on the road”. They surmised that it would take
approximately $160,000 in seed money to initiate such a project. This sum would purchase a large sport-utility
vehicle and enclosed cargo trailer, equipment for conducting the classes, and
pay the salary and benefits for two full-time faculty. To cover this expense the project would have
to produce approximately 133 FTSE per year.
After the initial expense of purchasing the vehicle, trailer, and equipment,
FTSE would continue to cover faculty salary packages and travel expenses. A yearly schedule consisting of First
Responder courses, EMT and CEP refresher training, and EMT Basic classes would
provide the necessary enrollment. Wilson
suggested that Jeff and Donna Farkas conduct a feasibility study to determine,
based on market research, if the potential does indeed exist for such a
project. She pointed out that, if that
is the case, grant funding for the seed money would probably be fairly easy to
secure, and the college could pick up operational expenses through returns
generated by FTSE.