Emergency Medical Responder - EMR

Course Standards

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Resource Links

• EMR Student Registration (Required)
  • Requires Course Registration Code (located in course confirmation email)
  • Requires Course Approval Number (located in course confirmation email)
• Instructor Information Form A2 (Required)
• EMR General Information
• EMR Course Standards
• EMR Course Matrix
• National EMR Education Standards

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EMR Course Components

The following standards define the minimum components necessary to conduct an Emergency Medical Responder (EMR) education course in Alabama:

Education Program Specifics

1. Any Institution desiring approval as an education program for EMR shall be an institution approved by the Alabama Community College System (ACCS), the Alabama Department of Public Health, Office of Emergency Medical Services (OEMS), and or the Alabama EMS Regional Office.
2. All EMS education programs shall utilize a program medical director who is licensed by the Medical Licensure Commission of Alabama, is a local member of the medical community, and is experienced and knowledgeable of the emergency care of the acutely ill and traumatized patients.

 

Course Approval Requirements

All courses approved by the OEMS/Regional EMS Office will have the following:

1. An EMR course will have a designated Course Coordinator. The primary instructor may serve as the Course Coordinator. Course Coordinator Responsibilities:

1. Serve as the primary contact for the OEMS and Regional EMS Office,
2. Represent the sponsoring entity and provide all administrative oversight,
3. Provide the educational resources necessary for teaching all of the EMR course objectives,
4. Ensure compliance with all administrative and educational standards listed in this document,
5. Advance scheduling and prior orientation of all other instructors and guest lecturers to the knowledge and skills objectives of the session being taught,
6. Schedule and coordinate all of the educational components,
7. Develop, maintain and ensure all course policies and procedures are followed, to include:
   1. Pass/Fail criteria
   2. Skill proficiency, and
   3. Attendance requirements.
8. Maintenance of student files documenting individual progress and eligibility for enrollment, completion and exams,
9. Complete, record, submit, and maintain all course documentation described in this document, and
10. Work with Regional EMS Office to ensure that all data necessary for registration of the course and students with NREMT is available.

 

2. EMR course will have a designated primary instructor and sufficient secondary or skill instructors approved at the level of course conducted to ensure no greater than a six to one (6:1) student to instructor ratio for psychomotor portions of the course.

Primary instructor (PI) responsibilities include:

1. Delivery of appropriate classroom and skills lessons,
2. Providing continuity of qualified and experienced instruction by providing a minimum of 50% of classroom content,
3. Providing physical oversight for 50% of all skills lessons and practice sessions,
4. Reviewing and monitoring of all secondary instructors and guest lecturers to ensure compliance with the course objectives,
5. Orient all guest lecturers, clinical preceptors and field internship preceptors to the specific course objectives,
6. Orient all students to the ADPH OEMS licensing procedures and patient care protocols,
7. Evaluation of student performance and competency during didactic education, clinical rotations and field internships, and
8. Documentation of student attendance, performance and competency.
9. Meeting the primary instructor qualifications.

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EMR Standards and Procedures

 

EMR Instructor Requirements

Internship Preceptor

1. High school diploma or General Equivalency Diploma (GED)
2. Current Alabama license at the level being supervised, or a current Alabama license as a Registered Nurse (RN)
3. Be familiar with prehospital patient care
4. Supervise students in the internship/field setting and accurately document their performance.

 

Course Instructor

1. High school diploma or General Equivalency Diploma (GED)
2. Current Alabama license as an EMT or above, or currently licensed in Alabama as a physician.
3. Certification from an EMS instructor course approved by the OEMS.
   1. Level 1 National Association of Emergency Medical Services Educators (NAEMSE)
   2. Department of Transportation (DOT) instructor course
   3. Alabama Fire College instructor course
   4. Department of Defense (DOD) instructor course
   5. AHA Core Instructor Course
4. Minimum of three (3) years of prehospital field experience as a licensed practitioner at or above the level being taught.
5. Current CPR certification.

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EMR Course Administrative Requirements

To receive EMR course approval from the OEMS, all EMR courses must be compliant with the administrative requirements described in this section. The course coordinator, primary instructor, and assistant instructor(s) share responsibility for ensuring full compliance with these requirements.

1. 1. All EMR courses require application and course approval prior to conducting the education.
   2. 1. EMR Course application packages are available from the regional EMS office.
      2. EMR Course approval process is conducted by the regional EMS office.
      3. EMR Course application packages are approved by the ADPH OEMS.
      4. EMR Course approval number is provided by the ADPH OEMS through the regional EMS office.
      5. EMR Course approval number will be referenced on all course forms, documents, and correspondence.

1. 2. The EMR Course Coordinator is responsible for submission of all EMR course approval documentation to the regional EMS agency.
   3. The EMR course approval process should begin at least five (5) weeks prior to the first day of class. This will allow enough time to submit the required documents, complete a site evaluation, receive certification, and receive final approval from ADPH. If all documentation is completed and ready for submission, a shorter approval process may be granted by OEMS.

   4. Initial EMR course application paperwork (A-Forms) must be received by the regional EMS office five (5) weeks prior to the first day of class unless a shorter time has been approved. The initial EMR course application paperwork due:

      1. Verification Flow Sheet (Part 1)- provides check list for all materials due and sets date for course. 

      2. EMR Course Application (Form A1)- provides the regional EMS office and OEMST with course, instructor, clinical and field EMS sites (if applicable), and course Medical Director demographics.

      3. EMR Course Instructor Information (Form A2)- provides instructor designation and qualifications. A separate form must be completed for each lead and secondary instructor(s), each skills practice instructor, and CPR instructor(s).
      4. EMR Course Schedule (Form A3)- provides the regional EMS office and OEMST with instructor assignments and a detailed description of how the national scope material for EMR will be covered throughout the course. The schedule should show material to be covered each class. All classroom hours and skills sessions must be listed. Instructions and an example are provided on Form A3 of this standard.
      5. EMR Course Equipment List (Form A4)- describes the minimal equipment necessary for the course will be available. The list is based on Alabama State EMS Rules and the National Scope of Practice. Any equipment, which will be obtained/borrowed/leased from any agency/person other than the sponsor, should be listed in a letter of agreement from each agency and must be attached.
      6. EMR students must receive a copy of the EMR course guidelines, attendance policy, dress code, course objectives, grading method and scale, and instructor contact information. A copy of this material should be provided in the Initial EMR course application. (Verification Flow Sheet- Part 1)
      7. At a minimum, National Registry skills sheets must be used for verifying EMR skills. A copy of these sheets, along with any other skills sheets that might be used, should be provided in the Initial EMR course application.
   5. A detailed preliminary EMR course student roster is due one week prior to the first course date. Verification Flow Sheet (Part 2)- provides check list for all of the required roster information.
      1. Roster must have EMR course sponsoring agency, course coordinator, primary instructor, course location, and course starting and ending dates listed in header. 
      2. Roster must show student first and last name, middle initial, address, and phone number.
      3. A place to write the date received by regional EMS office and the approved course number should be provided on the roster.
   6. On first course date- EMR students must receive a copy of the EMR course guidelines, attendance policy, dress code, course objectives, grading method and scale, and instructor contact information. (A copy of this material should have been provided in the Initial EMR course application.)
   7. On first course date- EMR students must receive a Student Application Packet (B-Forms). Students should be given adequate time to complete forms however all B-Forms are due at the regional EMS office within ten (10) business days of the first course date.
      1. EMR Student Registration (Form B1)- provides the regional EMS office and OEMS with student information and demographics as well as assurance that course fees, course accreditation, college credit, and EMR eligibility has been discussed. A copy of provided college information sheets should be attached to the B1 form.
      2. Confidentiality Briefing Statement (Form B2)- provides the regional EMS office and OEMS with written acknowledgment from the student that he or she understands and agrees to the confidentiality requirements for EMR students.
      3. Release of Liability (Form B3)- provides the regional EMS office and OEMS with written acknowledgment from the student that he or she understands the risks of exposure to blood and/or other potentially infectious materials and that these risks include potentially lethal viruses such as hepatitis and HIV. This form is required even if no clinical or EMS field rotations are scheduled.
   8. Changes to an approved course must meet ADPH OEMS standards and require written notification to the regional EMS office within five (5) days. Additional documentation may be required. Changes that require notification are listed below. Contact regional EMS office if other changes arise.
      1. Course Coordinator, any instructor, physician
      2. Course beginning or ending dates, classroom dates, classroom hours
   9. Instructor Requirements are defined below and are listed on the Instructor Information form A2:
      1. EMR Course Primary Instructor
         1. Alabama licensed EMSP at EMT level or above
         2. Must have an instructor certification
         3. Must have a minimum of three years field experience.
      2. EMR Course Secondary Instructor
         1. Alabama licensed EMSP at EMT level or above
         2. Must have an instructor certification
         3. Must have a minimum of three years field experience.
      3. Skills Assistant or other Instructor
         1. Alabama EMSP
         2. Nurse with pre-hospital field experience
      4. CPR Instructor (Certified at Healthcare Provider level by AHA, ASHI, American Red Cross, or equivalent.)
      5. Special Presenter or Speaker
         1. Recognized as having superior skill and/or knowledge of the presented material.
         2. Lead or secondary instructor must be in attendance during presentation or skills.
   10. Upon completion of the EMR course, the course coordinator will provide:
       1. A detailed final EMR course student roster provided to regional EMS office within ten (10) days of last course date, and at least every two weeks until all student dispositions are declared PASS or FAIL (or other final disposition):
          1. Roster must show EMR course sponsor, course coordinator, primary instructor, course location, and course starting and ending dates listed in header.
          2. All students listed on the preliminary EMR course roster must also be listed on the final EMR course roster with end of course disposition appropriately noted.
          3. The final roster must provide the following information for each student:
             1. First and last name with middle initial.
             2. Social Security Number (for National Registry)
             3. EMR Course disposition (Pass, Fail, Pending, Withdraw, Dismissed)
             4. National Registry Skills verification (Pass, Fail, Pending, Withdraw, Dismissed)
             5. A place to write the date received by regional EMS office and the approved course number should be provided on the roster.
       2. A course completion document issued to all students who successfully complete the educational program. The course completion document will include the following:
          1. Type of course (EMR),
          2. Name of the sponsoring entity,
          3. Location of EMR course
          4. The full legal name of the student,
          5. Course completion date,
          6. The ADPH OEMS EMR course approval number,
          7. Printed name and signature of the course coordinator,
          8. Printed name and signature of the primary instructor.
       3. Completed National Registry skills verification sheets.
   11. The regional EMS agency will maintain complete official course documentation in paper format for five (5) years from course completion, which includes:
       1. Original course application as submitted to the regional EMS office,
       2. Course approval issued by the ADPH OEMS
       3. Documentation of student compliance with all required prerequisites for the level of the course
       4. EMR course preliminary roster as submitted to the regional EMS office,
       5. Final EMR course schedule to include:
          1. Documentation of canceled, modified or added classes, and
          2. Dates, times, instructor and location changes.
       6. Class attendance roster for each session, to include:
          1. The dates individual classes were held,
          2. Lesson number(s),
          3. Signatures of attending students, and Instructor(s),
       7. List of any make-up session(s) to include:
          1. Session date(s),
          2. Lesson plan objectives,
          3. Verification of the accomplishment of objective(s) for each student participating, and
          4. Instructor(s) signatures.
       8. Documentation of remediation conducted for any student who, by written examination or skill evaluation, failed to demonstrate achievement of an objective during regularly scheduled class time, to include:
          1. The objective(s) being remediated,
          2. Date of session(s),
          3. An evaluation demonstrating achievement of the objective(s),
          4. Student(s) and instructor(s) signature.
       9. Individual skill evaluation(s) that document:
          1. Student performance for each specific psychomotor objective contained in the curriculum,
          2. Pass/fail criteria,
          3. Student name and Individual score, and
          4. Date administered.
       10. Examinations, quizzes or evaluations administered during the course to include:
           1. Student name,
           2. Individual score,
           3. Pass/fail criteria, and
           4. Date administered.
       11. Documentation recording the individual reasons that student(s) failed to complete the course of study.
       12. Documentation should be provided in the order it is listed in this section.
       13. If the sponsoring agency wishes to keep records, providing the regional EMS agency a paper copy of the documentation paperwork listed in this section is acceptable.

2. 1.  

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      EMR Course Quality Monitoring

       

      The regional EMS office will monitor and evaluate approved EMR courses for compliance with ADPH OEMS EMR course standards. To ensure compliance, the regional EMS office may audit any or all course records at any time.

   2. 1. Audits/evaluations may include but are not limited to the following:
         1. Sponsoring entity compliance with the educational standards,
         2. Course coordinator compliance with educational standards,
         3. Instructor performance evaluated by:
            1. Students, using an evaluation tool provided by the ADPH OEMS or regional EMS office, and/or
            2. Review of student performance on National Registry examinations or other course examinations.
         4. Course physician compliance with educational standards,
         5. Inspection of the educational facility for compliance with educational standards,
         6. Inspection of educational equipment and training aids for suitability to the curricula, and
         7. A formal audit of any or all records for compliance with the educational standards.
      2. The regional EMS office may make summaries of education program findings, including National Registry testing outcomes, available to licensed EMS services, organizations sponsoring EMS educational programs, and individuals interested in historical course performance when considering attendance.
      3. The regional EMS office is authorized to enter the training facility at reasonable times, for the purpose of assuring that the training program meets or exceeds the provisions of rule and standards.
      4. Planned Site Visits:
         1. ​​​​​​​​​​​​​​Required for:
            1. A new sponsoring entity, or a new course location, and
            2. All sponsoring entities once each year
         2. Consists of assuring compliance with standards for:
            1. Facilities, Equipment
            2. Curriculum, Processes
            3. Physician, Instructors, Course coordinator
      5. Unplanned Site Visits:
         1. ​​​​​​​​​​​​​​Due to complaints or compliance questions, and
         2. Consists of assuring compliance with standards for:
            1. Facilities, Equipment
            2. Curriculum, Processes
            3. Instructors
      6. The regional EMS office must be able to attest to course completion, skills competency, and CPR competency for National Registry acceptance. The following information is required prior to any students receiving approval for National Registry testing:
         1. ​​​​​​​​​​​​​​Copies of all required EMR course documents, paperwork, and rosters.
         2. Copies of all student National Registry Skills verification forms
            1. Each skills sheet must be timed, scored, and signed by evaluator
            2. There must be a complete set of skills sheets for each student
            3. Failures must be explained and documented on skills sheet
         3. ​​​​​​​Copies of EMR course completion certificates and CPR cards for each student.​​​​​​​​​​​​​​