A Quality Conversation: By Dr. Robert Stanley
– By #School of EMS
In the EMS education community, phrases like "Diploma Mills" and "Butts in Seats" are thrown around often. If you follow particularly "spicy" conversations online, you’ll hear well-meaning but misguided critics claim that "nobody can teach paramedics online" or that "only degree programs can produce quality paramedics".
At SOE, we enroll hundreds of students each year who learn online, earn a vocational certificate, and go on to have highly successful careers. So, how complicated is it to define and measure quality? Let’s break it down.
I want to address the first two points head-on. Didactic portions of paramedic education can absolutely be taught online. It definitely takes a certain type of instructor – but really, that also applies to a traditional course. I can recall several instructors throughout my time in college who were so dull that I would zone out for the entire class, and walk out not even remembering the topic. Our semi-official motto is “online learning is flexible, not easy.”
I have four degrees, including a PhD, but after 20 years in this industry, I am firmly in the camp that EMS is a trade. While AS degrees are excellent requirements for promotional tracks such as officer or instructor, they are not the sole indicator of a "quality" medic. I have met paramedics from abroad with bachelor’s degrees who couldn't pass a basic ACLS mega code.
So with those out of the way, how do we measure quality? Let’s start by establishing a floor. Standard benchmarks like the NREMT exam, CAAHEP accreditation, and state licensure are just the "ticket to the party"—they represent minimum competency. But we don’t want the minimum; we want quality.
So, what other metrics can we use? Pass rates on the NREMT can be deceptive because some students are naturally better test takers. Programs can and should teach test-taking, but the limited time in school must be balanced with learning and practice across all three learning domains (cognitive, psychomotor, and affective). A program that focuses solely on students passing the test will likely find its graduates struggling in the workplace.
What about if we de-emphasize the “Academic” part of medicine and focus on skills and hands-on settings? Unfortunately, these students are likely to struggle to pass the NREMT, and the school may struggle to demonstrate that it is meeting national education standards. Unfortunately, even the best students in this situation are missing their “ticket to the party.”
So, how do we measure something like quality, which is so difficult to even define?
In truth, quality is a holistic, intricate, and sometimes difficult to measure combination of:
- Regulatory compliance
- Student volume, instructor training, and program resources
- Strong attrition rates, pass rates, and placement rates
- And most importantly, graduate feedback and employer satisfaction.
Our mission statement is to provide quality education built around the needs of the patients in the communities we serve through effective partnerships and evidence-based practices.
When a successful paramedic graduate tells their friend to come SOE, or when an employer continues to hire and employ our graduates, we consider that mission accomplished.
About the author: Dr. Robert Stanley is a third-generation paramedic and lover of EMS research. He completed his master’s in public health with a thesis on EMS injury prevention and his Doctor of Philosophy with a dissertation on online workforce education.
If you have a specific topic you would like to see covered in a future column, please contact me at rstanley@schoolofems.org.
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