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Why Can’t Paramedic Students Count Skills While On Duty?

Why Can’t Paramedic Students Count Skills While On Duty?

One of the age old questions within the realm of paramedic education is the reasoning behind “why” paramedic students are unable to count skills that they perform while on duty for their minimum number of competencies as required by their paramedic educational facility.  To be quite honest with you…I struggled with this regulation as put forth by Committee on Accreditation of EMS Educational Programs, more commonly known as CoAEMSP.  It initially seemed to me that a regulator, far removed from the rigors of balancing paramedic education with a full time job and, in many if not most cases, a full time family were being arbitrary and capricious in making this decision!


Just in the interest of fairness and full academic disclosure, you should know that I am a site visitor for CoAEMSEP. I have been privileged to visit programs around the country for the last couple of years and I am not ashamed in the least to say that I have learned from some pretty incredible paramedic program directors that are doing some amazing work!  Sometimes they make their programs shine using “MacGyver Like” skills but the end result is a much better pre-hospital emergency medical care provider.

The second important item to be aware of is that I am NOT an attorney and as such any information in this blog posting should not be construed as legal advice.  I am, however, an experience EMS educator, who, like everyone else, has what I consider and informed opinion on this subject. 


The provision of medical care comes down to how you are licensed and the scope of practice that your license allows.  This posting will not go into the dispute of certification versus licensure, however for the sake of brevity, let’s just work off the assumption that all EMS providers are licensed.  In doing so, there is a skill set of actions that these providers may complete, with little concern about legal action as long as they are not completed in a negligent or harmful manner.  This is commonly known as one’s “scope of practice”. 


Additionally, it is important to remember your legal status changes in regards to the primary function that you a providing at the time.  Many times it is impossible for a patient to differentiate between a student and a licensed practitioner.  That is why it is up to us as providers and preceptors to ensure that we are protecting our patients.  That includes making sure, to the extent possible, as to who is taking care of them.  That also means that patients have the right to refuse to be treated by a student and we MUST honor that refusal.

Another important consideration is “who is financially responsible when something goes wrong”?  Paramedic educational programs have to understand that when they place their students with a field preceptor site, they are losing some control of both the quality and content of the education that occurs.  This is not to say that poor quality is a rampant problem while in the field.  It has been my experience that just the opposite exists.  Most providers are passionate about making sure that the next generation of provider is, at least, as competent as and generally more so than the current!  But…in the worst case scenario, if a provider is functioning as both a paid responder providing primary emergency medical care, many, if not most, times they will be UNSUPERVISED while with the patient.  This is a recipe for litigational disaster!


In orienting both the students and the agencies to the field time experience, which is invaluable to our students it is important to make sure that ALL parties know what the regulational constraints are.  Having a defined role during a shift adds to both the educational experience as well as the professionalism of the career.  The famous words of that well known 1970’s philosopher, Dirty Harry Callahan come to mind here when he expounded, “A man’s (or woman’s) got to know their limitations!”  Make sure you know yours and keep them separate.  In the short run, it may mean more of a hassle for you…in the long run you will be better for it. 

About the author:

Bill Young began his EMS career in 1975 with a small fire department near Williamsburg, KY. They began running first responder calls long before the phrase ever existed. In addition to Kentucky, his career has taken him to Tennessee, Colorado, Georgia, and Kansas. He has served as a street medic, training officer, supervisor, state regulator, and educator. He recently completed his doctoral studies in education at the University of the Cumberlands. Currently, he is an Assistant Professor and the Program Director at Eastern Kentucky University in the Fire and Paramedicine Science Department.

Published on March 10, 2017

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