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Emergency Medical Services Education Agenda 2050: Request for Information Publication: Federal Register Agency: National Highway Traffic Safety Administration Byline: Nanda Narayanan Srinivasan Date: 13 October 2023 Subject: American Government 
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[Federal Register Volume 88, Number 197 (Friday, October 13, 2023)]
[Notices]
[Pages 71081-71083]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-22625]
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DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety Administration
[DOT-NHTSA-2023-0037]
Emergency Medical Services Education Agenda 2050: Request for
Information
AGENCY: National Highway Traffic Safety Administration (NHTSA), U.S.
Department of Transportation (DOT).
ACTION: Notice of Request for Information (RFI).
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SUMMARY: This notice announces a RFI. The NHTSA Office of Emergency
Medical Services (EMS) is seeking comments from all sources (public,
private, government, academic, professional, public interest groups,
and other interested parties) on the planned re-envisioning of the 2000
EMS Education Agenda for the Future: A Systems Approach. The purpose of
this document is to solicit comments on EMS Education Agenda 2050, and
request responses to specific questions provided in this document. This
is neither a request for proposals nor an invitation for bids.
DATES: It is requested that comments on this announcement be submitted
by October 31, 2023.
FOR FURTHER INFORMATION CONTACT: Clary Mole, EMS Specialist, National
Highway Traffic Safety Administration, U.S. Department of
Transportation is available by phone at (202) 868-3275 or by email at
Clary.Mole@dot.gov.
SUPPLEMENTARY INFORMATION: In 2012, the National EMS Advisory Council
(NEMSAC) convened a national roundtable meeting on the EMS Education
Agenda for the Future: A Systems Approach. In a 2014 report on these
proceedings, NEMSAC advised that stakeholders at the State and local
level had just begun to experience the full impact of the evolution
toward a national integrated system of education for EMS personnel.
While stakeholders were reticent to move forward with a new education
agenda, they did provide feedback about themes that should be
considered in the future publication. From the feedback collected at
the meeting, NEMSAC developed recommendations to be used in the
eventual re-envision of the agenda for EMS. These recommendations are
summarized below:
Educational content should retain the flexibility accorded
by the National EMS Education standards, but programs should use
nationally recognized evidence-based guidelines to drive local
curriculum development.
The National EMS Information System data, evidence-based
research, and practice analyses should be sourced in developing
evidence-based guidelines and curriculum.
Mobile Integrated Healthcare has received considerable
attention from the EMS Community. This and other alternative community-
based healthcare delivery models (of the future) should evoke an
expanded foundational knowledge and critical thinking capabilities that
will poise future EMS practitioners to be able to evolve with the
changing healthcare system or rapidly adjust to emerging healthcare
crises.
EMS educators should begin a career in academia with
expertise in adult learning, educational theory, curriculum
development, and competency evaluation but also possess experiential
knowledge in evidence-based care.
In the 10 years since NEMSAC's roundtable meeting, the national EMS
education system continued to evolve--especially during the COVID-19
pandemic. In late 2021, the Federal Interagency Committee on EMS
(FICEMS) began sponsoring listening sessions to inform a consensus-
driven, national report entitled, FICEMS: EMS and 911 COVID-19 Response
White Paper. This publication cited challenges and solutions collected
during stakeholder listening sessions for the EMS education system.
Among the challenges, EMS education stakeholders cited scarcity (in
some cases deficits) in resources for education, rigidity of curriculum
delivery modalities, the increased employer demands on students, and
inconsistent or delayed responses to the needs of the national EMS
education system as major contributors that led to the breakdown in the
EMS workforce pipeline.
Prior to the COVID-19 pandemic, NHTSA published EMS Agenda 2050: A
People-centered Vision for the Future of EMS (Agenda 2050). This
collaborative project set a vision for a people-centered EMS systems
that serves every individual in every community across the Nation.
Later this year, NHTSA and its partners will begin a new project to
develop EMS Education Agenda 2050. This project will not replace but
build upon the achievements of the 2000 EMS Education Agenda for the
Future: A Systems Approach to lead a national conversation around the
future vision for EMS Education and EMS as a profession.
I. Background
NHTSA, in partnership with Health Resources and Services
Administration,
[[Page 71082]]
published EMS Education Agenda for the Future: A Systems Approach
(Education Agenda) in 2000. This document was founded on the broad
national EMS education system concepts introduced in the EMS Agenda for
the Future (1996). The Education Agenda described a consensus vision of
an EMS education system with a high degree of structure, coordination,
and interdependence. It proposed a less prescriptive system that
offered educators flexibility in creating a student-centered learning
environment and a process for accommodating future advancements in
technology and medicine. The proposed system maximized efficiency,
consistency in instructional quality, and entry level graduate
competency by prescribing a high degree of structure, coordination, and
interdependence. To achieve this vision, the education system of the
future centered on five integrated primary components:
National EMS Core Content
National EMS Scope of Practice Model
National EMS Education Standards
National EMS Education Program Accreditation
National EMS Certification
After the Education Agenda was published, stakeholders began
implementing their respective integrated system components. Almost 25
years later, the national EMS education system has successfully evolved
into one that exemplifies both consistency and flexibility. System
interdependencies have helped to avoid duplication of effort in
curriculum and education program development, evaluating the minimum
competencies of graduates, certification and licensing processes, and
facilitation of practitioner reciprocity.
In 2020, the EMS education system interdependencies modernized by
the Education Agenda were tested. Challenges presented by the COVID-19
pandemic forced a variety of adaptations. Traditional education
programs reported a lag in students' capabilities of achieving the
programmatic competencies requirements for graduation. The lag was
attributed to a variety of causes including a focus on pandemic
response activities over training and education, employer demands on
working students, and the rigidity of in-person, classroom-based
education delivery models. After the majority of programs adjusted to
the challenges, lags in graduation were cured, and students achieved
programmatic competencies at rates similar to those pre-pandemic.
The response to the pandemic did not impact education programs
only. The impact to EMS agency daily operations was felt as well.
During the COVID pandemic, agencies experienced increases in EMS
activation and response rates which created additional stressors for
student EMS practitioners already working in a high stress job
environment but also enrolled in an EMS education program. These
stressors were a major contributor to a migration of practitioners away
from the EMS workforce. Agencies and organizational stakeholders
asserted that it could be education program graduation requirements
causing breakdown in the workforce pipeline; however, there were no
observed decreases in graduation or certification testing rates. These
observations prompt two questions: If graduation and certification
testing rates have remained unchanged, why have agencies reported
recruitment and retention issues? If graduates are not entering the EMS
workforce, where are they finding jobs?
With agencies experiencing increased demand and a deficiency in
qualified EMS practitioners to respond to it, service delivery models
had to evolve. To bridge the gap in community-based care resources,
community paramedicine and mobile integrated healthcare (CP-MIH)
service delivery models increased in prevalence, and improvised
training programs were used to close new job-specific competency gaps
among existing EMS practitioners and individuals in training.
Other themes brought to the forefront during the pandemic include
addressing healthcare disparities; the use of EMS data as a tool for
surveillance and nationwide quality of care improvements; and a greater
value to having an EMS workforce that is not only equitable, inclusive,
and accessible, but as diverse as the community it serves. These
themes, evolving service delivery models, and the subsequent evolution
of competencies needed by practitioners suggest that it is time for
NHTSA to gather our partners to begin a new conversation about the
future of EMS Education and EMS as a profession in the United States.
II. Questions Regarding EMS Education Agenda 2050
Responses to the following questions are requested to help plan the
revision of the Education Agenda. Please be as specific as possible and
as appropriate please provide references.
1. What are the most critical issues facing EMS education system
that should be addressed in the revision of the EMS Education Agenda?
Please provide specific examples.
2. What progress has been made in implementing the EMS Education
Agenda since 2000?
3. How have you used EMS Education Agenda? Please provide specific
examples.
4. As an EMS Stakeholder, how might a revised EMS Education Agenda
be most useful to you?
5. What significant changes have occurred in the EMS education
system at the national, Federal, State, and local levels since 2000?
6. What significant changes will impact the EMS education system in
the next 25 years?
7. How might the revised EMS Education Agenda contribute to
enhanced EMS for children?
8. How might the revised EMS Education Agenda support and/or
promote data-driven and evidence-based improvements in EMS education
systems and EMS practitioner practice?
9. How could the revised EMS Education Agenda enhance collaboration
among EMS systems, health care providers and facilities, public safety
answering points, public health, public safety, emergency management,
insurers, and others?
10. How could the revised EMS Education Agenda be used to promote
community sustainability and resilience?
11. How could the revised EMS Education Agenda contribute to
improved coordination for disaster response, recovery, preparedness,
and mitigation?
12. How could the revised EMS Education Agenda enhance the exchange
of evidence-based practices between national, Federal (and military),
State, and local levels?
13. How could the revised EMS Education Agenda support the seamless
and unimpeded transfer of military EMS personnel to roles as civilian
EMS providers?
14. How could the revised EMS Education Agenda support interstate
credentialing of EMS personnel?
15. How could the revised EMS Education Agenda support improved
patient outcomes in rural and frontier communities?
16. How could the revised EMS Education Agenda lead to improved EMS
systems in tribal communities?
17. How could the revised EMS Education Agenda promote a culture of
safety among EMS personnel, agencies, and organizations?
18. Are there additional EMS attributes that should be included in
the revised EMS Education Agenda? If so,
[[Page 71083]]
please provide an explanation for why these additional EMS attributes
should be included.
19. Are there EMS attributes in the 2000 EMS Education Agenda that
should be eliminated from the revised edition? If so, please provide an
explanation for why these EMS attributes should be eliminated.
20. What are your suggestions for the process that should be used
in revising the EMS Education Agenda?
21. What specific agencies/organizations/entities are essential to
involve, in a revision of the EMS Education Agenda?
22. Do you have any additional comments regarding the revision of
the EMS Education Agenda?
(Authority: 23 U.S.C. 403(b)(1)(A)(iv); 49 CFR 1.95; 501.8)
Issued in Washington, DC.
Nanda Narayanan Srinivasan,
Associate Administrator, Research and Program Development.
[FR Doc. 2023-22625 Filed 10-12-23; 8:45 am]
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