Learning Outside the Box

• Cameron Bucek, BS, EMT-P
• 2009 Nov 20

Those of us seasoned EMS professionals who have spent the last few decades studying prehospital science and recertifying their ACLS, PHTLS and CPR certifications have been missing a key component of education. It's something "outside the box," an education for the asking, through the National Fire Academy (NFA). 

Since 1980, the NFA has offered its on-campus fire programs, which were specifically designed for fire department members and are considered to be among the best fire and leadership training available in the world. These programs range anywhere from six to 10 days of coursework and were primarily focused on fire department issues with some emphasis on EMS.

Because the campus is designed as an all-inclusive college-type setting -- you learn, eat, socialize and sleep on campus -- the cafeteria is a great place to network. This year, I had the opportunity to have lunch with the NFA Superintendent Dr. Denis Onieal. This lunch proved to be an invaluable meeting on changes in how the U.S. Fire Administration and the NFA participate in EMS education.

Onieal told me that when the Senate enacted the "United States Fire Administration Reauthorization Act of 2008," it amended the extent to which the NFA is involved in EMS education. Most importantly, the NFA now focuses on advanced EMS issues and combines appropriate courses that consist of EMS topics in addition to fire ones. The curriculum content now includes EMS scenarios or examples in conjunction with the standard fire examples. The NFA is also convening a national steering committee to recommend upcoming years of course development as it relates to EMS topics and combining current curriculum with EMS topics. The greatest challenge is going to be the development of a national consortium, because each state has such different variations of EMS delivery standards and regulations.

Pyramid of Learning
Most EMS agencies throughout the nation have no standardized system. But, they all have one thing in common -- people. In order to meet the needs, the majority of the curriculum will focus on program management and leadership development. The Fire and Emergency Services Higher Education (FESHE) EMS Professional Development Model shows the hierarchy of an EMT to an EMS executive (see above image). The pyramid process is a combination of education and training to provide a professional development path for transforming our people into future EMS executives. This model has provided a direct, low-cost, grass roots process. Even though the process was initiated by the National Fire Academy within the fire-based FESHE model, the intent of the EMS model was for all EMS organizations, including third service and for-profit agencies. So all EMS providers can embrace the model.

Climbing the Pyramid
I recently had a chance to attend a pilot program at the NFA titled, "Management of Emergency Medical Services." This 10-day course focused on supervisory management practices as they relate to EMS in the participant's agency or jurisdiction. The interactive format and fast pace enables participants to quickly learn to deal more effectively with day-to-day management issues. Personnel, resource management and quality improvement techniques are some of the major components. Upon completion, students are able to enhance the quality and overall effectiveness of their EMS operation through various management methods acquired during the course.

Many of the EMS management topics were current and taught by professional instructors with a wealth of experience. The lead instructor for the course I took was Bruce Evans, Division Chief of EMS from the City of North Las Vegas Fire Rescue and a JEMS editorial board member. Like many of the instructors, Evans brought to the table an abundant of knowledge and practical application. As the class members discussed the many EMS management situations their departments face -- such as staffing, pay, retention and discipline -- it became apparent these situations are something all agencies encounter at some point. We're all trying to achieve the same goal, which is to deliver the highest standard of patient care available through effective EMS personnel management.

Conclusion
Many EMS programs are already in place at the National Fire Academy to enhance your leadership characteristics, with development for others being underway since the reauthorization act. The EMS curriculum can be found on the NFA Web site. The following two new courses are being piloted over the next few months:

EMS Management of Quality Assurance: Quality assurance is an integral part of EMS managers' abilities, as is improving overall system delivery by data collection analysis and reporting technologies.

NIMS Command for EMS Simulation Training: The National Incident Management System (NIMS) simulation will utilize EMS scenarios to allow EMS personnel to function in the ICS during a variety of incident response types.

The EMS providers who choose to utilize these outside resources and educate themselves will become the industry’s innovators of the future. Remember that in these tough economic times, education is something no one can take away from you.

Cameron Bucek is a company officer and special assistant to the chief for the Villages (Fla.) Fire Rescue. He has 20 years of fire and rescue experience. He also is a fire/EMS instructor for Palm Beach Community College and an adjunct faculty member for the National Fire Academy's EMS and injury prevention courses. He has an associate's degree in EMS management and a bachelor's degree in fire science.

• FESHE Model: United States Fire Administration.
• Evans B: " Stepping Up: Professional development standards establish the difference between education & training." JEMS. 32(7):60–63, 2007.