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Striking a balance between distance and in-person training

Pandemic reality: Demand for online learning drives development of innovative EMS training platforms


EMS managers have been forced out of stagnation, EMS professionals are being called upon to contribute, governing EMS bodies are listening and adjusting, and citizens are recognizing the essential nature of our existence.

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As we gravitate toward innovations in cardiac monitors, stretchers, vehicles and communications, one of the greatest opportunities for innovation in the prehospital setting is also one of the most critical: online training.

There are two questions we need to ask when it comes to online EMS training opportunities:

  1. Where are we as an industry in the online learning evolution?
  2. Have we become rapid adopters in response to the COVID-19 pandemic or was this training platform evolving pre-pandemic as agencies adapted to a shifting educational paradigm?

The revolution of distributed learning

Distance learning is nothing new. Virtual classes began in the 1990s, with the advent and subsequent growth of the internet. In fact, a paramedic, nurse and physician who were deployed overseas and unable to attend in-person continuing education classes created Distance CME, one of the first online training websites for EMS professionals. CE Solutions is another online source that has been around since the late 1990s when there were few choices for distributed EMS continuing education. The pandemic has put these learning platforms in the spotlight at a time when in-person classrooms are restricted or closed.

For many years, EMS has dabbled in online learning. There are numerous platforms available; coincidentally, there are only a few platforms that are truly EMS-centric, such as the EMS1 Academy and Pearson. The EMS1 Academy provides online training that is accredited or approved by multiple agencies, including CAPCE, NREMT and UMBC’s CCEMTP program, which provides empirical evidence-based content.

Additionally, agencies have the ability to create their own online training programs and submit them to the EMS1 Academy’s online training library. In lieu of reinventing the wheel, agencies with access to EMS-centric platforms have been able to effectively share different ideologies and methodologies. Recently, this has helped spread the word on how different agencies are managing through the pandemic. The online learning platforms have provided a stage for agencies nationwide to share pandemic-related policies, procedures and training ideas.

Diversity and efficiency in online learning

Online learning seems to be more available in some areas of our country than others. Depending on the state you practice in, some are moving toward tier training requirements; such as 40% instructor lead and 60% distributed training.

States that follow the National Registry model allow up to one-third distributed learning on the national component, two-thirds on the local component and 100% on the individual component.

Some states, such as New York, transitioned to online state recertification programs, while other states, like Georgia, transitioned many years prior. In New York, through an approved agency, an active EMS provider can complete all required didactic hours online. The only exception is psychomotor skills stations, which are conducted in person to complete state certification.

This transition has provided many benefits to both the providers and their employers. For instance, a provider will no longer need additional time off to attend an in-person class; rather, they have the ability to access the required training remotely at any time.

Online learning in EMS has proven to be effective and cost-efficient during the COVID-19 pandemic. Our current need to physically distance allows providers and employers to continue recertification during the pandemic without concern for the current risk associated with classroom learning, classes being limited or even canceled. With the need to physically distance yet educate our providers, online learning platforms have been driven to provide resources to accomplish this.

Pandemic-related online learning opportunities are available for providers on the front lines as well as for EMS and fire department leaders. These courses range from managing personnel sick time and developing quarantine protocols to developing policies that align with what other agencies are doing to manage patients. For example, Montgomery County Hospital District EMS in Texas began using a lower-cost approach to administer albuterol via metered-dose inhaler in response to airway management safety concerns, which they shared with other agencies.

Ensuring training supports quality of care

There are some distinct drawbacks to distance learning. Classroom settings have always been a staple in EMS and healthcare training. The camaraderie in conjunction with hands-on training experience ensures quality and consistency within programs.

Without hands-on training and the ability to ask the instructor questions, students may lose the opportunity for effective networking communication with the instructor and classmates. Some skills, such as, intubations, live mega codes during CPR/ACLS courses and new medical equipment checkoffs that are especially high-acuity interventions, may only be practiced during yearly competency training.

Equally important, we cannot assume everyone has direct access to computers, smartphones, tablets and high-speed internet.

Despite the potential disparities that exist between EMS systems and agencies, one 0.2 micron virus has redirected the profession into an active quest for innovation. We must continue to ensure the quality of patient care is not affected by the loss of hands-on training. As we are faced with new restrictions to normal operating procedures, we have to consider options outside of the box.

For example, field training personnel may be deployed one crew at a time to provide the traditional hands-on approach while limiting social exposure. Podcasts may also become a popular choice, to not only release your inner James Earl Jones, but also to provide another avenue to create and deliver educational content. Initial education programs are also utilizing SIM labs and video cameras to record proficiencies due to class size limitations.

State EMS agencies are embracing ideas that are being offered from the plethora of engaged professionals to connect people with a purpose other than creating an army of dopamine thumb junkies.

We cannot deny that the pandemic has created problems for all of us; however, this constant is directly responsible for the opportunity in front of us.

EMS managers have been forced out of stagnation, EMS professionals are being called upon to contribute, governing EMS bodies are listening and adjusting, and citizens are recognizing the essential nature of our existence.

Isn’t this the what-if scenario that has been contemplated at every EMS management retreat since 1966? Victor Hugo is credited with saying, “There is only one thing stronger than all the armies of world: and that is an idea whose time has come.” Now more than ever, it is up to EMS leaders to determine what time it is and how to use the tools at hand to ensure consistent, quality EMS training and education.

Read next: EMS education in the age of social distancing

About the authors

Christie Grice, division chief – EMS, Hall County Fire Services; Josh Shore, general manager, Medshore Ambulance; Chris Cullen, operations supervisor, Greater Baldwinsville Ambulance Corps; and Angela Mabry, operations manager, Baptist Ambulance are members of the Priority Ambulance Leadership Foundation 2020 class.

The Priority Ambulance Leadership Foundation, a 501(c)3 non-profit, dedicated to supporting and developing professionals currently practicing in EMS and promising leaders outside of the industry who seek a career in the emergency medical industry. The Foundation’s annual flagship leadership program, EMS Leadership of Tomorrow, provides formal and informal training and education in all key areas of the ambulance industry and includes a mentorship program led by ambulance company owners and respected leaders in the ambulance industry. For more information, visit