CE Requirements Compared to Other Healthcare Specialties

[Markhk]

I've been doing a lot of thinking lately (dangerous, I know) about how unusual it is that NREMT requires 72 hours of CE for certification.

With the 12-hour limit on distributed education (which is pretty ridiculous, because there are some awesome online classes out there that far surpass that of some of the alphabet soup classes I've been in), does anyone else feel that the current recertification system requires an usually high amount of required hours?

In comparing difference specialties:

Physicians on average require about 20 hours of CME every year (unless you're an osteopathic doc which may need up to 50 hours). (http://www.medscape.org/public/staterequirements)

Nurses on average require about 15 hours every year.
(http://ce.nurse.com/RStateReqmnt.aspx)

Certified PAs require about 50 hours every year
http://www.washington.edu/medicine/som/depts/medex/whoweare/whatisapa.htm

Very few of these have limits on distributed education as far as I can tell.

Based on these numbers, can anyone tell me how in the world NREMT came up with 72 hours every 2 years? Does anyone feel a twinge of anger/injustice?
(Or at the very least, confused with the whole "mandatory/flexible core content" thing?) I'm all about training and keeping skills up to date, but I feel pretty limited by the options NREMT gives to providers on how to achieve this in a financially-economic manner. They don't give me much incentive to maintain my NREMT certification in lieu of just sticking with my state license.

Okay, done venting for now! :glare:

 

[Veneficus]

I've been doing a lot of thinking lately (dangerous, I know) about how unusual it is that NREMT requires 72 hours of CE for certification.

With the 12-hour limit on distributed education (which is pretty ridiculous, because there are some awesome online classes out there that far surpass that of some of the alphabet soup classes I've been in), does anyone else feel that the current recertification system requires an usually high amount of required hours?

Considering the initial education of US EMS providers compared to nurses, PAs or physicians, I would say it is not nearly enough hours. 72 a year might be more reasonable.

Very few of these have limits on distributed education as far as I can tell.

I think this is behavioral in nature. All of the physicians and nurses I know attend many seminars, conferences, research, etc. and are constantly in pursuit of more credentials of some sort or another. That makes getting credit for online education rather superficial. Getting the paperwork for it is also such a pain usually, that people read the articles and take the quizes, but never bother to get credit for it.

Many EMS providers take "refresher courses" or at least sign on the roster of them anyway. Have you ever heard of a "medical/nursing school refresher course?"

I see EMS providers struggle to reach their recert requirements all the time. I also see many physicians with so many continuing educational hours that they always have well over what they need by 3 or more X a year.

Based on these numbers, can anyone tell me how in the world NREMT came up with 72 hours every 2 years?

Given their past history, I would say it was probably a compromise between what they thought was required and what people would accept and still use their service.

(Or at the very least, confused with the whole "mandatory/flexible core content" thing?) I'm all about training and keeping skills up to date, but I feel pretty limited by the options NREMT gives to providers on how to achieve this in a financially-economic manner. They don't give me much incentive to maintain my NREMT certification in lieu of just sticking with my state license.

I gave up my NREMT for just a state licence. NREMT will not get any money from me again.(Just like JEMS) It is a good idea that is extraordinarily poor in implementation.

Okay, done venting for now! :glare:

Simple solution, get another healthcare degree that requires less continuing hours.

 

[MrBrown]

New Zealand will require 40 hours per year for each Ambulance Officer and it we are moving there as funding and resources allow. This year the requirement was 16, next year Brown thinks it will be 24 and at 40 by 2013.

 

[medicdan]

Given the inconsistent nature of content and supervision of Continuing Education, I think it's quite appropriate. In MA, the home for the recent scandals, as just an EMT, I can submit vague applications and receive approval from the state to teach whatever I want (within BLS SOP).
For my department, we've found offering a variety of different classes over time works well. To avoid the end-of-the-year rush, we require every EMT to attend 3 classes every 3 months-- and offer 3 every month. We offer lectures, practical sessions with existing equipment, introduce new equipment, do mock calls (for consistency and skill retainment), and offer online classes.

 

[Markhk]

Considering the initial education of US EMS providers compared to nurses, PAs or physicians, I would say it is not nearly enough hours. 72 a year might be more reasonable.

I don't think it's necessarily hard to get CE hours actually. Personally I have enough CE hours to kill a small elephant, but I find that NREMT is unusually restrictive in applying CEs to their "mandatory core content" section. I mean seriously, how often can we find a lecture specifically on, "Assess and provide care to a near-drowning patient", which is part of the NREMT Mandatory course content of Medical Emergencies?

Personally, I'm surprised NREMT hasn't relaxed their limit on Distributed Education since their release of the mandatory/flexible contents so providers can better find courses that can achieve the goals of recertification.

Simple solution, get another healthcare degree that requires less continuing hours.

On it, but it's going to take at least 4 more years to get the alphabets added to my name.

In MA, the home for the recent scandals, as just an EMT, I can submit vague applications and receive approval from the state to teach whatever I want (within BLS SOP).

I think this is an interesting point, particularly in regards to online training programs. The MA scandal revolved in-classroom sessions. The question I have is, what exactly is supposed to make in-classroom better than online? I swear that "Death by Powerpoint" is the number one cause of altered level of consciousness in EMS providers. And classes like PHTLS I go to rapidly degrade into the war stories, the fire guys getting ticked off at the lifer medics, the PALS instructor who is a respiratory tech starts screaming at the entire class that we should be giving albuterol treatments and getting an ABG...some of THE most SANE CE I've attended where I've learned something are online, and includes the Physio Control 12 Lead program and the Laerdal ACLS recertification program (the one with a software patient simulator, at one point called Microsim). These programs allow us to avoid the distractions, stick with the content (and not war stories) and you have to be awake enough to interact with the computer (which is more than I can say is required of some in-class lectures).

Perhaps I'm just wishing that NREMT would be more flexible in their recertification options, for those of us who don't have the time to spend the time travelling to conferences, going to EMT school again or paying to challenge the NREMT exam.

By the way, I commend your department Dan for being so aggressive in providing CE to your providers. That's the way to go.

 

[SerumK]

I see the requirements stemming from the ratio of:

How much education you received
vs
What you are responsible for
=
CE Requirement

MD
Education: Doctoral degree - 4 years of school and 3-6 years of residency on top of a 4 years degree
vs
RESPONSIBILITY: Primary provider responsible for a patient
=
CE: 20 hours a year

EMT
Training: 100 hours on top of highschool
vs
RESPONSIBILITY: Primary provider responsible for a patient
=
CE: 36 hours a year

What the hell were you complaining about again? EMT training is too short and the CE hours are too low.

 

[SerumK]

Many EMS providers take "refresher courses" or at least sign on the roster of them anyway. Have you ever heard of a "medical/nursing school refresher course?"

There is such a thing as a RN refresher course. They are usually taken by:

1. New graduate nurses who have not been able to find employment for over a year after graduating from nursing school
2. Experienced nurses returning to nursing after a hiatus of more than one year.
3. Experienced nurses wanting to move from a non-acute environment to an acute specialty.

 

[Markhk]

SerumK,

I'm not sure that the solution to fixing the lack of EMT training hours is to make up for it with more CE hours being required. The solution would be to raise the required EMT training hours so EMTs can start with a strong foundation. A step in the right direction is likely to happen with the National EMS Education standards mandating an increase to 150-190 hours for EMTs.

In gathering my thoughts, I suppose my frustration with NREMT is that they are 20 years behind the times when it comes to the recertification side and paperwork. Yes, NREMT loves to innovate when it comes to adaptive testing and creating the next best test question, but they lack innovation when it comes to having students meet recertification such as having an increased willingness to use distributed education - which other medical professionals are not restricted from using.

 

[Akulahawk]

ATC's, in order to maintain their certificate, must do 75 hours CE every 3 years. The states that license Athletic Trainers also have their own CE requirements to maintain the license. I would imagine that most of the time, the CEU's needed to meet one renewal would also meet the other requirements too.

 

[Veneficus]

There is such a thing as a RN refresher course. They are usually taken by:

1. New graduate nurses who have not been able to find employment for over a year after graduating from nursing school.

What?

I keep hearing about a nursing shortage and waiting lists to start nursing programs because there are so many people applying compared to spots.

You are saying there are no jobs out there?

 

[Outbac1]

Here we have to earn 200 credits in two years to reregister. A rough breakdown is:

A minimum of 20 and a max. of 40 pt contacts at one credit per.
A minimum of 10 and a max. of 30 hrs of self study at one credit per hr.
A minimum of 12 credits, no max. at 2cr/hr for conferences etc.
A minimum of 8 credits for mandatory courses (2 cr/hr) eg: ACLS, PALS,CPR etc
A minimum of 32 credits for mandatory Megacodes and Morbity & Mortality sessions. Must do 2 Megacodes and 4 M&Ms.
Other credits for preceptoring a student or giving presentations etc. are earned at 2cr/hr.

Just doing the minimum will only get you 82 of the 200 credits you need to reregister. Just getting the minimums will take 30 hrs. At 2 credits per hour it will take 59 hrs to earn the other 118 credits. This is 89 hrs in two years. Not a terribly difficult challenge.

72 hrs in one year is more but not impossible to do. With 11 months left before I reregister I have 200+ credits and almost all my minimums. Only a megacode to do next year. A megacode is like a practical test. Could be trauma, or medical in nature.
The full details are here under reregistration.
http://www.gov.ns.ca/health/ehs/paramedics/policies.asp

 

[brentoli]

What?

I keep hearing about a nursing shortage and waiting lists to start nursing programs because there are so many people applying compared to spots.

You are saying there are no jobs out there?

I'm not sure if this post is supposed to be taken at face value or not?

 

[SerumK]

What?

I keep hearing about a nursing shortage and waiting lists to start nursing programs because there are so many people applying compared to spots.

You are saying there are no jobs out there?

Are you serious? Most new grad positions have 50-200 applicants per open position. Most BSN graduates from reputable programs are taking 4-6 months post-licensure to land a job. Most new grad RNs are having to apply to 50-150 jobs before they get an offer... LTC and med-surg are competitive.

There's RN jobs out there, but they all say one or two years experience MINIMUM, often in-specialty.

There never was a nursing shortage, just the perception that there might be one at some point.