EMSP Course Approval Request

Emergency Medical Technician - EMT

Course Standards

Resource Links

EMT 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)
EMT General Information
EMT Course Standards
EMT Course Matrix
EMT Verification Flow Sheet

Essential Job Functions Analysis Form

(BREMSS EMS Students or their instructor should email a copy to bcg@uab.edu)

EMT Course Components

The following standards define the minimum components necessary to conduct an Emergency Medical Technician (EMT) education course:

Education Program Specifics

Any Institution desiring approval as an education program for EMT 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.
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. 1. An EMT 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 EMT 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.

1. 1. EMT 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.
    1. 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.
    2. Secondary Instructor responsibilities include:
      1. Assisting PI with training of students in skill objectives,
      2. Assisting PI with valuation of student performance and competency,
      3. Assisting PI with documentation of student performance and competency, and
      4. Assisting the PI as directed.
      5. Meeting the secondary instructor qualifications.
  2. EMT course will have medical direction oversight.
    1. Physician must meet offline medical director criteria
    2. Physician provides medical oversight for all medical aspects of instruction
  3. Equipment
    1. Education programs will have access to all equipment and educational aids necessary to teach, demonstrate, and practice all objectives of the national EMT curricula.
  4. Facilities
    1. Classrooms used for the course are required to be conducive to learning as defined in the curriculum.
  5. Clinical Sites
    1. All clinical facilities are required to be compatible with and appropriate for the objectives of the specific curriculum. The sponsoring entity is responsible for securing and maintaining written agreements with clinical facilities.

Curriculum

1. 1. Each educational program shall use the curriculum established by the National Emergency Medical Services Education Standards and shall conform to other stipulations as set forth in the 420-2-1 rules.
  2. Each educational program shall add to its curriculum any new drugs or procedures approved by the State Board of Health, after notice is given by the OEMS to do so.
  3. Each educational program is subject to announced and unannounced visits by personnel of the OEMS and or Alabama EMS Regional Office to check adherence to lesson plans, self-study documentation, and training objectives. If the educational program is found to be out of compliance, it may be placed on probationary accreditation status for a period of time, or the OEMS/Alabama EMS Regional Office may withdraw an education program’s approval if the program is found to not be in compliance with the 420-2-1 rules, or if the program does not maintain a 70% certification examination pass rate over a three year rotating basis.
  4. Each education program shall submit all documentation pertaining to course offerings and instructors as required by the OEMS/ Regional EMS Office. Documentation shall include, but is not limited to self-study documents, instructor data sheets, intent to train forms, and any administrative updates or changes made by the education program.
  5. All Education programs must ensure each graduate completes the OEMS and Alabama EMS systems Presentation.

EMT Standards and Procedures

Didactic / Internship Credit Hours

Time frames designated herein are recognized as minimum required hours. This is no way suggests that these times may not be exceeded by an accredited education program. As new requirements in EMS education are adopted, minimum required hours may increase to ensure that students receive adequate instructional time.
1. All levels of EMS education must include current national curriculum
2. Current Alabama EMS Protocols

1. 1. The minimum time frame for an EMT course of instruction is
    1. One hundred forty (140) hours of didactic / laboratory
    2. Forty-eight (48) hours for internship

1. 1. Internship hours may be divided between emergency room and prehospital experience on an ambulance.

Skills Requirement

The instruments used to measure validity and reliability of the internship experience should be standardized documents reflection the practical skills of the curriculum and be approved by the approval agencies.
1. 1. The EMT student shall successfully perform patient assessments and management.

Internship Requirements

Licensed emergency medical provider services may enter into an agreement with EMS educational institutions to provide field internships for EMSP students.
1. 1. Licensed providers services shall ensure that all designated preceptors are informed of educational requirements for the EMSP student.
1. 1. Field internship experiences shall include supervised instruction and practice of emergency medical skills and shall be evaluated by the designated preceptor.
  2. Licensed provider services are responsible to ensure that no EMSP student exceeds his or hers current level of scope of privilege unless supervised by a designated preceptor in a designated field internship.

EMS Student Requirements and Standards

The EMT student shall:
1. Possess a high school diploma or General Equivalency Diploma (GED), or dual enrollment.
2. Meet all institutional admission requirements.
3. Maintain a current Health Care Provider CPR certification
4. Comply with the “Essential Functions” of the program or attach documentation to the program application from those essential functions of which the student is not in compliance.
5. Provide an acceptable physical examination by a licensed physician, Nurse Practitioner, or Physician Assistant to include written documentation of the practitioner’s opinion regarding he perspective student as follows:
  1. The emotional and physical ability to carry out the normal activities of the prehospital emergency care.
  2. Health history
Have up to date immunizations to include:
1. Tetanus /D within the past ten (10) years.
2. Measles, Mumps, and Rubella (MMR) vaccine (RubellaTiter of 1:8 or above sufficient in lieu of MMR)
3. Varicella
4. Two-Step TB skin test (with chest x-ray if positive)
5. Begin or have had the series of Hepatitis B vaccination, or sign a waiver regarding the series of Hepatitis B vaccinations
Possess verification on file with the educational institution of the following:
1. Professional Liability insurance
2. Current health/hospitalization/accident insurance
3. And / or waiver of liability
All education programs must inform students of the specific requirements for progression through each level of EMS education. No student will be allowed to sit for the state approved certification exam if a student attempts to circumvent the matriculation requirements set by the education program in which they are enrolled.
All EMS students must maintain current professional liability insurance while enrolled in an education program.
All students must maintain current health and hospitalization insurance and/or have a waiver on file while enrolled in a program.
All EMS students must comply with all institution and program rules, polices, and procedures.

EMT 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 the level being taught or above.
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 Instructor certification
6. Instructor certifications appropriate for the curriculum being taught, e.g. (BLS) instructor certification.
7. Complete a supervised probationary teaching experience for one entire course at the instruction level being taught
8. Be approved by the Program Director and Medical Director.

Guest Lecturer
1. High school diploma or General Equivalency Diploma (GED)
2. Expert Knowledge in the subject matter; and
3. Program Director and Medical Director approval for topic to be presented.

Medical Director
1. Licensed physician by the Medical Licensure Commission of Alabama
2. Experience and knowledge of emergency care of acutely ill and traumatized patients.
3. Review and approve adherence to the program curriculum and quality of medical instruction and supervision delivered by the faculty.
4. Routinely review student performance to assure adequate progress toward completion of the program; and
5. Knowledgeable in EMS education programs and legislative issues regarding the EMS programs and prehospital providers.

Practical Skills Preceptor
1. High school diploma or General Equivalency Diploma (GED)
2. Minimum of three (3) years of prehospital care experience as a licensed practitioner at the level being taught.
3. Current CPR certification; and
4. Program Director and Medical Director approval to assist with practical skills instruction.

Field Preceptor
1. High school diploma or General Equivalency Diploma (GED)
2. Current Alabama License at the level being supervised
3. Minimum of two (2) years of experience
4. Familiarity with prehospital patient care
5. Supervise students in the internship and field setting and accurately document their performance.

EMT Course Administrative Requirements

To receive EMT course approval from the OEMS/Regional EMS Office, all EMT 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. All EMT courses require application and course approval prior to conducting the education.
  1. EMT Course application packages are available and approved through the regional EMS office.
  2. EMT Course application packages receive approval and numbering by the regional EMS office.
  3. EMT Course approval number will be referenced on all course forms, documents, and correspondence.

1. The EMT Course Coordinator is responsible for submission of all EMT course approval documentation to the regional EMS agency.

1. The EMT 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.

1. Initial EMT course application paperwork (A-Forms) should 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 EMT course application paperwork due at T-5 weeks:
  1. Verification Flow Sheet (Part 1)- provides check list for all materials due and sets date for course.
  2. EMT Course Application (Form A1)- provides the regional EMS office and OEMST with course, instructor, clinical sites, and course Medical Director demographics.
  3. EMT 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. EMT 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 EMT will be covered throughout the course. The schedule should show material to be covered each class. All classroom, clinical, and field hours with corresponding dates and times must be listed. The schedule form is created by the EMT program. Instructions and an example are provided on Form A3 of this standard.
  5. EMT 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. Hospital Affiliation Agreement (Form C1)- provides the regional EMS office and OEMST with an agreement between the sponsor and any hospital providing clinical experience as a part of the EMT course. All clinical experience must be provided by a hospital in the state of Alabama. Any documentation required of the sponsor by the hospital (such as proof of HBV vaccination and malpractice liability insurance) must be attached to the form. A separate agreement (Form C1) is required for each participating hospital.
  7. Ambulance/Rescue (EMS) Agency Affiliation Agreement (Form C2)- provides the regional EMS office and OEMST with an agreement between the sponsor and any EMS agency providing field experience as a part of the EMT course. All field experience must be provided by an EMS agency operating in the state of Alabama. Any documentation required of the sponsor by the EMS agency must be attached to the form. A separate agreement (Form C2) is required for each participating EMS agency.
  8. EMT students must receive a copy of the EMT 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 EMT course application. (Verification Flow Sheet- Part 1)
  9. At a minimum, National Registry skills sheets must be used for verifying EMT skills. A copy of these sheets, along with any other skills sheets that might be used, should be provided in the Initial EMT course application.
2. A preliminary EMT 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 EMT 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.
3. On first course date- EMT students must receive a copy of the EMT 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 EMT course application.)
4. On first course date- EMT 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. EMT 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 Advanced-EMT 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 EMT 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.
  4. Background Screening Policy (Form B4-A)- EMT students must understand that if any clinical or field sessions are included as elements of their EMT course, that agencies providing the clinical or field sites may require background screening. This policy outlines the requirements, procedure, and confidentially of background screening.
  5. Background Screening Participation (Form B4-B)- provides the regional EMS office and OEMS with written acknowledgment from the student that he or she accepts the conditions of the Background Screening Policy should a clinical or field agency have such a requirement.
  6. Drug Screen Policy (Form B5-A)- EMT students must understand that if any clinical or field sessions are included as elements of their EMT course, that agencies providing the clinical or field sites may require drug screening. This policy outlines the requirements, procedure, and confidentially of background screening.
  7. Drug Screen Participation (Form B5-B)- provides the regional EMS office and OEMS with written acknowledgment from the student that he or she accepts the conditions of the Drug Screening Policy should a clinical or field agency have such a requirement.
5. 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
6. Upon completion of the EMT course, the course coordinator will provide:
  1. A detailed final EMT 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:
    1. Roster must show EMT course sponsor, course coordinator, primary instructor, course location, and course starting and ending dates listed in header.
    2. All students listed on the preliminary EMT course roster must also be listed on the final EMT 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
      2. Social Security Number (for National Registry)
      3. EMT Course disposition (Pass, Fail, Pending, Withdraw, Dismissed)
      4. National Registry Skills disposition (Pass, Fail, Pending, Withdraw, Dismissed)
      5. Clinical Rotation disposition (Pass, Fail, Pending, Withdraw, Dismissed)
      6. A place to write the date received by regional EMS office and the approved course number should be provided on the roster.
  2. A copy of each student’s course completion document for all students who successfully complete the educational program. The course completion document will include the following:
    1. Type of course (EMT),
    2. Name of the sponsoring entity,
    3. Location of EMT course
    4. The full legal name of the student,
    5. Course completion date,
    6. The ADPH OEMS EMT 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.
7. The regional EMS agency will maintain complete official course documentation in paper or digital 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. EMT course preliminary roster as submitted to the regional EMS office,
  5. Final EMT 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. Written agreements with facilities utilized by the course for fulfillment of clinical and/or field internship objectives (Forms C1 and C2)
  12. Documentation of the course physician approval of clinical preceptors and/or guest lecturers,
  13. Documentation of clinical preceptor(s) orientation and student scope of practice,
  14. Documentation demonstrating student achievement of all clinical and field internship objectives, including ten patient contacts (PCRs or equivalents)
  15. Documentation recording the individual reasons that student(s) failed to complete the course of study.
  16. Documentation should be provided in the order it is listed in this section.
  17. 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.
1. EMT Course Quality Monitoring
  
  The regional EMS office will monitor and evaluate approved EMT courses for compliance with ADPH OEMS EMT 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. A review of clinical sites and documentation demonstrating student achievement of clinical objectives, including a total of ten (10) patient encounters,
    6. Appropriateness of clinical sites relative to the curricula,
    7. Inspection of the educational facility for compliance with educational standards,
    8. Inspection of educational equipment and training aids for suitability to the curricula, and
    9. 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 EMT 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 EMT course completion certificates and CPR cards for each student.

Pearson VUE Testing Sites in Alabama

EMT Instructor Resources

EMT Course Roster Templates: http://www.bremss.org/uploadedFiles/EMS_Training/EMT_Course_Rosters.pdf
EMT Course Proposed Schedule Form A3: http://www.bremss.org/uploadedFiles/EMS_Training/EMT_Course_Proposed_Schedule_Form_A3.pdf
EMT Equipment List Form A4: http://www.bremss.org/uploadedFiles/EMS_Training/EMT_EQUIPMENT_LIST_Form_A4.pdf
Essential Job Functions Analysis: https://www.alabamapublichealth.gov/ems/assets/essential.job.functions.analysis.form.pdf
Alabama Hospital Affiliation Agreement Form C1: http://www.bremss.org/uploadedFiles/EMS_Training/Alabama_Hospital_Affiliation_Agreement_Form_C1.pdf
Ambulance/EMS Provider Affiliation Agreement Form C2: http://www.bremss.org/uploadedFiles/EMS_Training/Ambulance_EMS_Provider_Affiliation_Agreement_Form_C2.pdf