Trusting early learners with critical professional activities through emergency medical technician certification

Abstract

Background: Two dominant themes face medical education: developing integrated curricula and improving the undergraduate medical education (UME) to graduate medical education (GME) transition. An innovative solution to both of these challenges at the Zucker School of Medicine has been the application of the cognitive apprenticeship framework in requiring emergency medical technician (EMT) certification during the first course in medical school as the core on which to build an integrated curriculum and provide entrustable clinical skills.

Methods: Beginning with the Class of 2011, student feedback about the short-term impact of the experience was collected annually. In addition, perceptions of near graduates and alumni were surveyed in 2017 to explore the long-term impact of the experience. Theme analysis was conducted via inductive coding.

Results: Both first-year and more experienced learners report the value of the EMT curriculum as an integrated component of the first course of medical school. Reported positive long-term impacts included the first-hand observation of social determinants of health and interprofessionalism. Negative comments by early learners focused on course logistics, whereas older learners recalled the variability of clinical experiences during ambulance runs.

Conclusions: The integration of the EMT curriculum as a core component of the first course serves multiple purposes: 1) it provides the foundation of a spiral learning approach; 2) it contextualizes the basic sciences within clinical practice; 3) it provides opportunities for students to engage in authentic clinical activities under the guidance of mentors; 4) it introduces students to the interdisciplinary nature of medicine; and 5) it serves as the first entrustable professional activity (EPA) for our students.

Acknowledgments

The authors would like to thank Ms. Leanna Stager for help with references, Ms. Krista Paxton for her administrative support, and Dr. Alice Fornari for her mentorship.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Judith Brenner

Judith Brenner, MD, is an Associate Dean for Curricular Integration and Assessment at the Donald and Barbara Zucker School of Medicine.

Jeffrey Bird

Jeffrey Bird, MA, is the Educational Research & Strategic Assessment Analyst in the Office of Assessment and Evaluation, Zucker School of Medicine at Hofstra/Northwell.

Samara B. Ginzburg

Samara B. Ginzburg, MD, is an Associate Dean for Case-Based Learning at Zucker School of Medicine at Hofstra/Northwell.

Thomas Kwiatkowski

Thomas Kwiatkowski, MD, is a Professor of Emergency Medicine and Assistant Dean for Simulation at the Zucker School of Medicine. He is a co-director of the CPR course (Challenges, Privileges, and Responsibilities: From the Person to the Professional).

Vincent Papasodero

Vincent Papasodero, MBA, is a co-course director of the CPR course, and Assistant Professor at the Zucker School of Medicine at Hofstra/Northwell and Program Director at Northwell Health’s Emergency Medical Institute.

William Rennie

William Rennie, MD, is an emergency medicine physician and clinical anatomist and is an Associate Professor and co-director of the CPR course (Challenges, Privileges, and Responsibilities: From the Person to the Professional) at the Zucker School of Medicine at Hofstra/Northwell.

Elisabeth Schlegel

Elisabeth Schlegel, MSc, PhD, MBA, is an Associate Professor of Faculty Development and Medical Education Research at the Zucker School of Medicine at Hofstra/Northwell.

Olle ten Cate

Olle ten Cate, PhD, is a professor of Medical Education and director of the Center of Research & Development of Education, University Medical Center Utrecht, School of Medical Sciences.

Joanne M. Willey

Joanne M. Willey, PhD, is the Leo A. Guthart Professor of Biomedical Science and Chair of the Department of Science Education at the Zucker School of Medicine.