Council Meeting Highlights - January 26, 2009
The Council of the Saskatchewan College of Paramedics met January 26, 2009, to consider many important issues for the College and its members. Here are some highlights of the meeting:
Emergency Medical Responders
Council used a set of standards (to review these standards, see "Standards for Approval of EMR Programs") to approve two training programs: the Red Cross Emergency Medical Responder (EMR) program and the St. John Ambulance Medical First Responder 2 (MFR2) program. Both programs must provide an outline for a session on an introduction to the profession. In addition, the St. John approval is conditional on provision of the detailed cross reference to the NOCP within 60 days, and assurances that the core and elective sessions corresponding to the NOCP are the ones that will be taught in Saskatchewan.
In recognition of the short notice that EMS services have had of this change in entry requirements, Council approved a transitional phase of one year in which practitioners with valid, current First Responder training could be issued a Restricted License on the condition that they complete the EMR training within six months. This practice will be discontinued in 2010 when practitioners will need the full EMR training to receive their initial license.
Continuing Medical Education
Council considered the longer term direction for continuing medical education (CME). There is a preference to move toward a continuing competency model where practitioners would refresh each of the competencies for their scope of practice over a number of years. There are similar models in place in Alberta and Manitoba. This model will be discussed at the Annual General Meeting prior to its adoption. Council also agreed that access to online CME opportunities should be available for our members on a user pay basis.
Council set the annual CME requirements for 2010 licensure with the understanding that there will be further changes in subsequent years as we work toward our preferred model. (For a comparison of the past requirements (2009) with the requirements for 2010 licensure, see "CME Requirements for Licensure for 2010 Compared to 2009").
As a “rule of thumb” one hour of instruction can be assessed 5 CME credits. CME credits do NOT include Advanced Skills Modules or Mandatory Certifications but MUST include mandatory skills as listed for EMRs and EMTs.
In addition, Council determined that, with approval of the medical director, skill assessment can occur in the mandatory programs (ITLS, ACLS and PALS/PEPP) if proficiency is tested in those programs. Consistent with the Regulatory Bylaws, Section 7(3), all Advanced Skills Modules must have the signature of the medical advisor/director.
The Continuing Medical Education (CME) requirements for 2010 can be summarized as follows:
Continuing Medical Education (CME) Requirements for 2010 Licensure
Emergency Medical Responder (EMR)
- Mandatory: BLS-HCP (C)
- 25 CME credits including Biomechanics of Safe Lifting, Spinal Immobilization, and Mechanical Aids to Breathing including Oxygen
Emergency Medical Technician (EMT)
- Mandatory: BLS-HCP (C), and ITLS Basic
- 40 CME credits including Biomechanics of Safe Lifting and Medications Pertinent to Scope of Practice.
Emergency Medical Technician – Advanced (EMT-A)
- Mandatory: BLS-HCP (C), and ITLS Advanced
- 30 CME credits
- Advanced Skills Module:
- Medications Pertinent to Scope of Practice; and
- 3 Airway Adjuncts (LMA, Combi-tube and King) which can be assessed as part of the ITLS Advanced course if proficiency is tested.
Emergency Medical Technician – Paramedic (EMT-P)
- Mandatory: BLS-HCP (C), ITLS Advanced, ACLS and PALS (or PEPP)
- 15 CME credits
- Advanced Skills Module:
- Medications pertinent to scope of practice
- 3 airway adjuncts: LMA, combi tube and King Airway (may be attained through an ITLS Advanced course if proficiency is tested)
- Intubation, intraosseous infusion, chest decompression and external jugular vein cannulization (may be attained through an ITLS Advanced course if proficiency is tested)
- Cardioversion, vagal manouevers, transcutaneous pacing, intubation (may be attained through an ACLS course if proficiency is tested)
- Pediatric intraosseous infusion, intubation, and cardioversion (may be attained through a PALS or PEPP course if proficiency is tested)
Financial Status of SCoP at End of Fiscal Year 2008
Council received an unaudited report on the financial status of the College at the end of the 2008 fiscal year. The College deficit for 2008 was about $110,000. With no fee increase in 2009, the College can expect to have a deficit of about $300,000 by the end of 2009. This debt will need to be paid down and the annual deficit reduced by increasing fees for 2010 and beyond. It takes approximately a $60 increase in fees to raise $100,000.
Fees
Effective April 1, 2009, the College will charge a surcharge of 50% of the licensing fee ($87.50) for issuing a Restricted License. There is considerable work required by the College office to issue a Restricted License and then to assess and lift the restriction when conditions are met and issue a full license to practice. This fee reflects the cost of that effort. Although the fee is set in the Administrative Bylaws, Section 33.1, Council had waived the fee for the license renewal period up to March 31. 2009.
EMT-P Reinstatement
Council approved the following guidelines for reinstatement of EMT- Paramedics who have not practiced at the EMT-P/ACP level for two or more years prior to the year in which they apply for a license. Council agreed to develop a similar approach for EMT-As.
To be reinstated as an EMT-P, the practitioner must:
- Provide valid, current HCP-(C), ITLS, ACLS and PALS (or PEPP) certifications
- Provide evidence of 30 CME credits in the past two years
- Provide an ALS assessment for EMT-Ps and an Endotracheal Intubation assessment signed by a Medical Advisor
- Attend a patient management integration course at SIAST (this is the course with all the simulations) and successfully complete the Saskatchewan Protocol examination; and
- Undertake ride outs with an approved ACP preceptor arranged by SIAST for a minimum of 16 shifts and a positive assessment of competency by the preceptor.
Registration
Council received a report on 2009 registrations to date. The College has 1730 members registered including 21 non-practicing members. There are currently 47 Restricted licenses issued to members who must complete their certification or CME requirements by March 31, 2009. The breakdown by license level, gender and employment status is shown in the following two tables.
Registrations by Gender
| Certification | Female | Male | Total |
|---|---|---|---|
| EMR | 136 | 180 | 316 |
| EMT | 335 | 686 | 1021 |
| EMT-A | 84 | 124 | 208 |
| Paramedic | 44 | 141 | 185 |
| Grand Total | 599 | 1131 | 1730 |
Registrations by Employment Status
| Certification | Full Time (FT) | OTFT | Total |
|---|---|---|---|
| EMR | 22 | 294 | 316 |
| EMT | 583 | 438 | 1021 |
| EMT-A | 140 | 68 | 208 |
| Paramedic | 154 | 31 | 185 |
| Grand Total | 899 | 831 | 1730 |
Annual General Meeting
Council considered a number of items in preparation for the May 8, 2009, Annual General Meeting. The meeting will be held at Kenaston Place in Kenaston, SK beginning at 10:00 a.m. Council endorsed a list of resolutions for bylaw and legislative changes to be prepared by the Legislative and Bylaws Committee for the AGM. A Call for Resolutions was approved as well as Rules and Procedures for the AGM. Both will be posted on the web site in the near future.
All Council positions are up for election this year. The Bylaws provide for future continuity on Council by staggering appointments of the Members-at-Large – two will be for two years and two for one year appointments (this includes the Fire Representative). Council determined that the length of term for each member-at-large following the election of Council members will be based on the number of votes with the higher vote count resulting in a longer term. Acclaimed members-at-large will be deemed to have the most votes.
The chart below compares the new requirements to those for 2009. As a “rule of thumb” one hour of instruction can be assessed 5 CME credits. CME credits do NOT include Advanced Skills Modules or Mandatory Certifications but MUST include mandatory skills as listed for EMRs and EMTs.
CME Requirements for Licensure for 2010 Compared to 2009
| Past Requirements (2009 License) |
New Requirements (2010 License) |
|---|---|
| Emergency Medical Responder (EMR) | |
| First Aid | Approved EMR program (NOCP standards) |
| CPR-C | BLS – HCP (C) |
| 50 CME points | 25 CME credits including:
|
Mandatory Skills:
|
|
| Emergency Medical Technician (EMT) | |
| CMA Accredited PCP program | CMA Accredited PCP program |
| CPR-C | BLS – HCP (C) |
| 80 CME points | 40 CME credits including:
|
Mandatory Skills:
|
Mandatory Certification:
|
| EMT – Advanced (EMT-A) | |
| CMA Accredited ICP program | CMA Accredited ICP program |
| CPR-C | BLS – HCP (C) |
| 60 CME points | 30 CME credits |
Mandatory Skills:
|
|
Advanced Skills Modules:
|
Advanced Skills Modules:
|
Mandatory Program:
|
Mandatory Certification:
|
| EMT – Paramedic (EMT-P) | |
| CMA Accredited ACP program | CMA Accredited ACP program |
| CPR-C | BLS – HCP (C) |
| 30 CME points | 15 CME credits |
Mandatory Skills:
|
|
Advanced Skills Modules:
|
Advanced Skills Module:
|
Mandatory Program:
|
Mandatory Certifications:
|
Standards for Approval of EMR Programs
In order to have a course approved by SCoP as meeting the standard for licensure at the EMR level, an agency:
- Must demonstrate the program meets or exceeds the National Occupational Competency Profile (NOCP) for EMRs approved by the Paramedics Association of Canada by supplying SCoP with a detailed cross reference of the program to the NOCP;
- Must have quality assurance mechanisms in place including:
- instructor qualifications, training and regular recertification;
- standards for equipment, class size, curriculum, instruction and student materials which meet generally accepted practices for adult instruction;
- regularly scheduled update/revision to keep the program current;
- oversight by qualified practitioners;
- Must have a reliable system for registration and tracking of students, and issuing and maintaining official transcripts and certificates;
- Must be willing to have the program audited at any time by SCoP; and
- Must include, and provide a session outline to SCoP for, an introduction to the profession which covers such things as self-regulation, professional conduct and registration/licensing requirements.