Emergency Medical Services Education in Emergency Medicine Residency Programs: A National Survey

Abstract

Objectives: Emergency medical services (EMS) was recently approved as a subspecialty by the American Board of Medical Specialties, highlighting the core content of knowledge that encompasses prehospital emergency patient care. This study aimed to describe the current state of EMS education at emergency medicine (EM) residency programs in the United States. Methods:The authors distributed an online survey containing multiple-choice and free-response questions pertaining to resident EMS education to the directors of EM residency programs in the United States between July 21 and September 10, 2010.Results: Of 154 programs, 117 (75%) responded to the survey, and 108 (70%) completed the survey by answering all required questions. Of completed surveys, 82 programs (76%) reported the cumulative time devoted to EMS didactic education during the course of residency training, a median of 20 hours (range = 3 to 300 hours; interquartile range [IQR] = 12 to 36 hours). There is a designated EMS rotation in 89% of programs, with a median duration of 3 weeks (range = 1 to 9 weeks; IQR = 2 to 4 weeks). Most programs involve residents on EMS rotations strictly as in-field observers (63%), some as in-field providers (20%), and the rest with some combination of the two roles. Ground ride-along is required in 94% of programs, while air ride-along is mandatory in 4% and optional in 81% of programs. Direct medical oversight (DMO) certification is required in 41% of residency programs, but not available in 26% of program jurisdictions. Residents in 92% of programs provide DMO. In those programs, most residents (77%) provide DMO primarily while working in the emergency department (ED), 13% during dedicated EMS or medical oversight shifts, and 4% during a combination of these shifts. Disaster-preparedness was most frequently listed as the component programs would like to add to their EMS curricula. Conclusions:There is a wide range in the didactic, online, and in-field EMS educational experiences provided as part of EM training. Most residents participate in ground ride-along activities, provide DMO, and have a dedicated EMS rotation. Disaster-preparedness is the most common desired addition to existing EMS rotations.ACADEMIC EMERGENCY MEDICINE 2012; 19:174-179 ª 2012 by the Society for Academic Emergency Medicine T he recent establishment of emergency medical services (EMS) as a subspecialty by the American Board of Medical Specialties underscores the unique body of knowledge that encompasses out-ofhospital emergency care. As this care is closely tied to the management of patients in the emergency department (ED), the Accreditation Council for Graduate Medical Education (ACGME) program requirements for

Evaluation of Change in Knowledge and Attitude of Emergency Medicine Residents after Introduction of a Rotation in Emergency Medical Services and Disaster Medicine

“…In a study on American Board of Medical Specialties, highlighting the core content of knowledge that encompasses prehospital emergency patient care, Katzer et al . [ 12 ] reported disaster-preparedness as the most common desired addition to existing EMS rotation. The present study was conducted on a 1-month rotation of EM residents in EMS and disaster medicine in view of the significance of the serious involvement of EMS in matter of exigencies related with disaster situations.…”

Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States

“…Data from over a decade ago surveying US EM residencies had indicated inconsistent and inadequate training, specifically in the area of bioterrorism, which is still consistent with the data from this survey when assessing across-broader Disaster Medicine competencies 5 . The current requirement in place by the ACGME for EM residencies is both broad and vague, stating only that “residents must have experience in Emergency Medical Services (EMS), emergency preparedness, and disaster management” and “this should include participation in multi-casualty incident drills.” 2 The 2013 Model of Clinical Practice of Emergency Medicine specifically addresses “Mass casualty/Disaster management” in the matrix of physician tasks that are part of EM practice, and further defines this task as “Understand and apply the principles of disaster and mass casualty management, including preparedness, triage, mitigation, response, and recovery,” which while more specific is still a very broad guideline 6 …”

“…Recent data indicate disaster preparedness is one of the most frequently listed component Program Directors want to add to their curricula 1 . While the Accreditation Council for Graduate Medical Education (ACGME; Chicago, Illinois USA) residency program requirements for EM has some baseline recommendations for education in Disaster Medicine, there are no clear standardized requirements or guidelines for training programs on how to address the topic 2 . In a study published in 2012, a consensus document addressed the need for basic educational competencies in Disaster Medicine across all fields and produced a list of core competencies for medical personnel 3 .…”

A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency

“…Despite prior publications relating to EMS curricular design and the minimum training requirements determined by the Accreditation Council for Graduate Medical Education (ACGME) for emergency medicine residents specific for EMS, the training experiences completed by residents are variable [4-5]. Such variability leaves open the opportunity to provide our residents with a robust and well-defined curriculum that may lead to better preparation upon graduation or interest in EMS as a fellowship.…”