Our profession is about to take the next step in preparing the work force of the future to manage and lead. Since the passing of James O. Page we have realized that there are few prominent EMS national leaders in this country. As a generation of EMS providers leaves for retirement, the need for competent managers in EMS will be even more important.

Often it is the case that individuals are placed in a role as an EMS manager, supervisor or some other position of authority without having received the training or education necessary to be managers and leaders. Even more common is promoting good technicians to supervisory roles only to have them fail miserably because they lack the humanities-based skills or knowledge required for leadership and dealing with people. Often EMS managers are not trained in the support functions of billing, supply chain management or fleet operations. They must learn as they go.

It was with this need in sight that a group at the Fire and Emergency Services Higher Education Conference held at the National Emergency Training Center in Emmitsburg, Md., began exploring a model course in EMS management. This quickly revealed a need for a curriculum and an EMS professional development model. Without a budget or permission, the team came up with the idea to establish an EMS management curriculum came after responding to requests by fire science programs trying to accommodate organizations that find themselves with an increasing role in EMS and no real training for the specifics needed to operate an efficient or clinically sophisticated system. The FESHE model provided a more direct, low-cost and grassroots process.

To provide a little background, the FESHE Conference was first held in June 1999 and attended by a group of fire science educators directing college programs. The National Fire Academy assembled interested faculty from fire-based associate- and bachelor-degree programs to work with fire service stakeholders to update the fire-based curricula that was established at the 1966 Wingspread Conference.

The goal was to create standardized courses that every firefighter would take, much the same as an architect or engineer completes standard courses regardless of the educational institution attended. The process was done entirely by facilitated discussion and consensus building under the guidance of Ed Kaplan from the NFA. After two years, the first six courses emerged with common course titles, outlines and resources. Model associate's and bachelor's degrees in fire science emerged with elective courses and specialty tracks embedded in both degrees. This now has given rise to the model master's and discussion of a Ph.D. program in fire science.

The results have been well-received. About 65% of fire science programs offer FESHE model courses and are complaint with the model curriculum. The major textbook manufacturers have targeted their products toward these model courses, providing a tremendous amount of educational resources. The portability of a person's degree between any educational institution that recognizes or uses the model curriculum eliminated the student's expense of retaking courses. Research on the impact of the model courses and their effectiveness has started. The model bachelor's-level curriculum is adopted as a component of the International Association of Fire Chiefs' Officer Development Handbook. These courses also match the requirement for the Chief Fire Officer Designation from the Center for Public Safety Excellence.

Then came the need for parallel credentials and equal status for EMS in the public safety field. An inaugural National EMS Management Curriculum committee meeting was held last autumn at the NFA. A follow-up work session was conducted that December as part of the FESHE meeting. Under the charge of Bob Fleming, chair of the NFA Board of Visitors, the EMS Management Curriculum committee falls under the Federal Advisory Committee Act. To maintain compliance with federal law, a report on the committee recommendations and work must be published. The committee's purpose was to establish and explore the idea of creating a model EMS management curriculum. The committee was called together and composed of educators from the majority of educational establishments that offer EMS management degree programs. Invitations were extended to the National Association of Emergency Medical Technicians, International Association of Fire Fighters, IAFC, National EMS Management Association, American Ambulance Association, national state EMS professionals and National Association of EMS Educators.

Under this charge, the group accomplished several tasks. The committee reviewed the pre-meeting work done by NAEMSE and George Washington University to identify the current colleges and universities that offer a four-year degree with a concentration in EMS management. Of the 14 current EMS-related bachelor's degree programs, three programs offer an on-campus bachelor's degree in EMS management. Three other programs offer a degree-completion bachelor's degree in EMS management. There are three versions of EMS management degrees:

• Comprehensive (Maryland, Pittsburgh and Florida): Majority of the program is provided through classes offered at the EMS-oriented department or program. More than 21 semester hours are classes covering EMS management topics.
• Option (GWU and St. Petersburg, Fla.): EMS management program is a major option within a more generalized degree creating a minor. Option means that about 21 semester hours of a 160-hour degree program are EMS management. Some of the more general courses, like management, budgeting, marketing and public policy are provided through the host degree. For example GWU offers health science and St. Petersburg offers public safety.
• Minor (Springfield, Mass.): EMS management program is offered as a concentration within a paramedic or emergency management degree. These programs offer between nine and 15 semester hours in EMS management courses. There are another five EMS management bachelor degree programs that are on hiatus or under development.

This committee is focused on nonclinical academic programs that would lead to a bachelor's or associate's degree in EMS management. A survey of U.S. colleges revealed few degree programs actually offered specific EMS management degrees; those that did were centered near the middle Eastern Seaboard. While it is more common to find a single course in EMS management, the detail and academic rigor to educate someone to serve as an EMS manager is inadequate when compared to other public safety degrees, such as fire science and criminal justice.

Although the initiation of this process was at the NFA, within the fire-based FESHE process the intent was for the third-service and for-profit EMS organizations to embrace this process. The committee developed working definitions of management levels using public safety and EMS as a focus. Four EMS levels were established.

• Supervisor

  A crew chief or leader of a single unit or crew.

• Manager

  Manages more than one crew or supervisors.

• Chief officer

  Oversees more than one manager, is responsible for a major component of an EMS organization, middle manager.

• Executive

  Head of the organization or senior staff.

These titles were incorporated into the visual model similar to what has been done in the past with the fire service higher education model for professional development. In addition to standardizing titles, the committee assigned minimum competencies to each level of management or leadership. Core knowledge for certain subjects and a corresponding college course title were listed as the venue to attain that core competency. While the list is a draft, it is anticipated that public comment may add other competencies.

The focus of the December meeting was to add additional institutions and obtain input and feedback from invited subject-matter experts. After reviewing the work done in November, the committee and experts worked to review and revise the EMS management competencies matrix and propose core EMS course titles and descriptions.

Although the December group revised the EMS management competencies, these require public comment and editing to reflect the correct format for objective descriptions. While the committee was working to transform the 14 attributes and 15 concepts into proposed core EMS courses, other FESHE members made suggestions and provided feedback to the committee about process and the deliverables. From this, the committee identified seven proposed EMS courses.

• Foundations of EMS systems.
• EMS operations.
• Human resource management.
• Management of EMS.
• Quality management and research.
• EMS educator and instruction.
• Safety and risk management.

The question arises as to whether these courses are to be placed in a model associate's or bachelor's degree. There are essentially two types of paramedic training: certificate programs offering paramedic training without college credit, and programs based in colleges that offer college credit or associate's degrees. Two contingencies were seen. One was that these courses could be placed in an associate's degree for those regions that are dominated by certificate programs. In regions that offer accredited or college programs, these courses could build on an existing associate's degree to achieve a bachelor's degree.

The model courses will be placed in the poster presentations for public comment. The committee members then will work on course outcomes and refine the comments from the EMS community, incorporating them into the course outlines. In April, committee members worked on course outcomes and course outlines at the IAFC's Fire-Rescue Med in Las Vegas. In June, the curriculum, course descriptions, course outcomes and two completed courses will be presented at the FESHE Conference in Emmitsburg. An additional informational session will be held at June's IAFF Ninth Biennial EMS Conference in Houston. The final consideration to the curriculum will be presented at the National Association of EMS Educators annual meeting in September in Hollywood, Calif.

When it comes to specific competencies in EMS management, the committee created a list of task and assigned common college courses or existing NFA EMS courses. For example, technical writing often is covered by an English course in most colleges. Competencies in EMS special operations are covered by the existing R-152, EMS Special Operations, at the NFA. Most NFA courses have a college credit rating from American Council on Education. The American Council on Education's College Credit Recommendation Service connects workplace learning with colleges and universities by helping adults gain access to academic credit for formal courses and examinations taken outside traditional degree programs such as those offered by the NFA.

It should again be emphasized that this is a draft document. While the FESHE model moves forward, additions will be welcome. The core of this document will remain a starting place and a source for academic analysis. The success of the model fire science curriculum and courses can be measured by the significant increase in academic materials from the publishing houses. With a set group of common titles, the competition increases to release creative educational products and provide more resources for instructors and students. The common courses, once adopted, will ensure that students can transfer their credits to other institutions for more advanced degrees and avoid duplicating course work.

Much like the fields of engineering, nursing or medicine, EMS must have an establish a set of core competencies specific for EMS management. As the shortage for medical workers continues, the need for competent EMS managers to develop people and oversee EMS systems will only grow.

---

Bruce Evans is the EMS chief for the North Las Vegas (Nev.) Fire Department. He previously served as captain of the Henderson (Nev.) Fire Department. Evans also is the fire science program coordinator at the Community College of Southern Nevada as well as an adjunct faculty member for the National Fire Academy's EMS and injury prevention courses. He has an associate's degree in fire management and a master's degree in public administration.

Online Tools

http://www.usfa.dhs.gov/nfa/higher_ed /feshe_conf/index.shtm
This is the marker and summary of the FESHE conferences.

http://home.gwu.edu/~mikeward/FESHE_EMS.html
This is the FESHE EMS homepage that is hosted by George Washington University.