EMS Continuing Training Requirements

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Dear Vermont EMS Provider,

We are writing to tell you about some exciting changes to the way you will renew your Vermont EMS license from now on. Effective July 1, 2015 all EMS providers with licenses due to expire in 2016 or later will select and document their continuing education (CE) through the National Continued Competency Program (NCCP), an initiative based on continuous quality improvement (CQI), lifelong learning and individual self-assessment. This program was developed by the National Registry of EMTs and will be applicable to all licensed EMS personnel in Vermont, regardless of whether they hold a current National Registry certification. As has been the case since 2011, those with current National Registry certification will be required to maintain it in order to maintain Vermont licensure. (The relatively few providers that never held a NREMT certification and are VT-only licensed will be subject to the same requirements.)

Perhaps the most noticeable change will be an adjustment in the number of training hours you will need to complete per two-year cycle. While the educational requirement for EMRs will increase modestly from 12 to 16 hours, EMTs, AEMTs and Paramedics will see a reduction in the total CE hours required (see chart below). The topic areas will also look differently, however you will play a role in choosing them. These concepts reflect the essence of the NCCP: focused, relevant and continuous education.

Since the early 1970’s, EMS has advanced from the provision of rudimentary care and transportation to the delivery of sophisticated emergency medicine in the field. As entry-level requirements have changed, so too must the requirements for continued competency.

The NCCP got its start in 2010 when a multi-disciplinary task force consisting of representatives from major regulatory, medical oversight and operational components of EMS met to consider revisions to the National Registry of EMTs’ recertification process. The end result is a program that evolves over time and allows states, the local EMS community and individual EMS providers to choose topics that are most relevant to their educational needs.

The Components of the NCCP
The NCCP is comprised of three components: the National Continued Competency Requirements (NCCR) which represent half of the total hours required at each level; the Local Continued Competency Requirements (LCCR) which constitute a quarter of the overall hours; and the Individual Continued Competency Requirements (ICCR) which round out the remainder.

The NCCR topics and hours are determined by the NREMT’s board of directors based on input from EMS researchers, physicians and provider stakeholders. Topics are chosen from evidence-based medicine, changes in the National Scope of Practice Model and science-related position papers aimed at improving patient care, particularly tasks with low frequency yet high criticality. In keeping with the principles of the NCCP, the NREMT will change the national requirements at least every five years (see Chart: National Continued Competency Requirements: Topics and Contents posted on our website).

A portion of Vermont’s local requirements (LCCR) have been determined by the Vermont EMS office based on state-specific training needs (see chart below).
These include protocol updates, skills that merit special focus as part of continuous quality improvement and new topics such as spinal motion restriction. The remaining hours of the LCCR are determined by the EMS districts and/or EMS agencies.

The Individual Continued Competency Requirements (ICCR) are chosen by you. To aid you in the topic selection process, the NREMT offers an online resource called an Assessment Guide.

The ICCP Assessment Guide
All NREMT-certified providers are given access to the Assessment Guide via their online NREMT accounts during the last six months of their certification period. Although it may look like the certification exam, the Assessment Guide is not a test. It is optional, there is no final score, no one but you can access the identified results and it has no bearing whatsoever on your NREMT certification or state license. After completing the Assessment Guide, you will be told if there are topics where additional training would be beneficial.

Please note: The Assessment Guide is only available at this time to providers who hold a NREMT certification at their license level. We have asked the NREMT to make it available to all Vermont providers, and they are considering the request.

Training officers for agencies with at least 10 members will receive a de-identified aggregation of their members’ results so that common areas of weakness can be addressed.

Documenting Education on the Renewal Application
The categories and hours of training may have changed, but the way you document your education will be very similar to how it has been done in the past. If you have a NREMT certification, you will continue to enter your training hours online; VT-only providers will document their education on forms provided by the Vermont EMS office.

Moving existing CE
Since Vermont adopted the NCCP halfway through the 2016 renewal cycle, providers who are due to renew next year have likely begun entering their training hours on the NREMT website. Fortunately, NREMT has created a “Move Hours” button on the application which will allow providers to shift their entries into the new slots. Vermont renewal applications will be revised soon to reflect the changes.

Refresher Courses
Refresher courses using the traditional categories no longer exist in Vermont, but providers who completed one during this renewal period can still get credit for it. A spreadsheet that maps these topics to the NCCP categories can be found on the EMS office website.

Moving Forward
We hope that this move to a more nimble and dynamic process for identifying, completing and documenting continued competency education will result in a more confident Vermont EMS workforce that is motivated to grow stronger in their knowledge and skills.

As with all things new, we anticipate many questions. Be sure to review the Frequently Asked Questions posted on our website, and as always, don’t hesitate to contact us to learn more.