N.J. Admin. Code § 8:41A-2.4

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:41A-2.4 - Clinical training

(a) An EMT-Paramedic training program shall provide a coordinated course of study, consisting of both didactic and clinical instruction, designed for the purpose of preparing a person to sit for the NREMT-Paramedic Certification Examination.

(b) The clinical portion of an EMT-Paramedic training program shall be conducted by a mobile intensive care hospital.

1. A mobile intensive care hospital seeking to be approved as a clinical training site for the purpose of offering the clinical portion of an EMT-Paramedic training program shall first apply, in writing, to OEMS for approval. Applications shall include clinical resources, training objectives, didactic training site affiliations, the name of the medical director responsible for overseeing the training and other such information as deemed necessary by the Department. Approval of new clinical training sites shall be based on system needs as determined by the Department.

2. No mobile intensive care hospital shall offer, or claim to offer, the clinical portion of an EMT-Paramedic training program until authorized by the Department to do so.

i. Supervision in the clinical setting shall be provided by the EMS Educator, field preceptors or hospital personnel such as physicians, physician assistants, advanced practice nurses, registered nurses and/or respiratory care practitioners, if supervisors have been approved by the EMS Educator to function in such roles. Clinical supervision must be provided by faculty and/or staff qualified through previous academic preparation, training, and experience to teach and/or operate in the clinical setting or settings. There shall be a 1:1 student/instructor ratio for all clinical training.

ii. All clinical training sites shall conduct their training in compliance with the objectives set forth at 8:41A-2.4 through 2.7. All clinical training sites shall maintain accurate records of the students' progress, documenting satisfactory completion of all completed clinical objectives. These documents shall be made available to Department staff upon demand.

(c) Each clinical training site shall employ an EMS Educator. The EMS Educator shall have graduated from an accredited college with at least an Associate's degree, be an EMT-Paramedic or registered nurse and have a minimum of three years experience in a mobile intensive care program providing advanced life support cares. In lieu of a college degree, a person may serve as an EMS Educator if he or she can document, to the satisfaction of OEMS, that he or she has at least two years of practical experience in the actual training of EMT-Paramedic students. The EMS Educator's responsibilities shall include, but are not limited to:

1. Coordinating all activities associated with the clinical portion of an EMT-Paramedic training program;

2. Ensuring that all persons providing clinical instruction to students enrolled in the clinical portion of an EMT-Paramedic training program are clinically competent to provide the necessary training and have received formal orientation to the program curriculum, with particular attention to clinical training;

3. Compiling all relevant student records including, but not limited to:

i. A copy of the student's EMT-Basic certification card;

ii. Copies of the student's CPR, ACLS and either PALS or PEPP-Advanced certification cards;

iii. Documentation of successful completion of the didactic portion of an EMT-Paramedic training program;

iv. A copy of the schedule for the didactic portion of an EMT-Paramedic training program;

v. Original documentation of completion of the stated objectives of the clinical portion of an EMT-Paramedic training program;

vi. Copies of the schedules for the clinical portions of an EMT-Paramedic training program;

vii. Anecdotal records, as needed;

viii. Copies of the required evaluations; and

ix. Copies of the endorsement to take the NREMT-Paramedic Certification Examination, if appropriate;

4. Providing each student with at least four periodic written or verbal evaluations;

i. Student evaluations shall be conducted on a recurring basis and with sufficient frequency to provide both the student and the program faculty with valid and timely indicators of the student's progress towards, and the achievement of, the competencies and objectives stated in the curriculum;

ii. Methods utilized to evaluate students shall verify the achievement of the objectives stated in the curriculum. Evaluation methods, including direct assessment of student competencies in patient care environments, shall be appropriate in design to assure valid assessment of competency. Evaluation methods must be consistent with the competencies and objectives being tested;

5. Ensuring that students have access to patients who present common problems encountered in the delivery of advanced emergency care in adequate numbers and in distribution by age and sex;

6. Ensuring that students are assigned to clinical settings where experiences are educationally efficient and effective in achieving the program's objectives;

7. Developing a final evaluation examination covering all the objectives of the clinical training. Each student shall take and pass that examination prior to receiving endorsement to take the NREMT-Paramedic Certification Examination; and

8. Ensuring that all students perform and demonstrate competency in all required skills prior to endorsing the student to sit for the NREMT-Paramedic Certification Examination.

(d) The clinical portion of an EMT-Paramedic training program shall consist of a minimum of 700 hours of training. The training objectives for each area of the didactic portion of an EMT-Paramedic training program must have been presented before clinical training for the respective area may begin.

1. Hours of clinical training in the following areas are mandated by the program curriculum and the Department:

i. Emergency Department: 100 hours;

ii. Intensive/Coronary Care Units: 40 hours;

iii. Operating/Recovery Room: 24 hours;

iv. IV Therapy Team, if available: 16 hours;

v. Pediatric Unit: 40 hours;

vi. Labor/Delivery/Newborn Nursery: 24 hours;

vii. Psychiatric Unit or Crisis Center: Eight hours;

viii. Cardiology Laboratory: Eight hours; and

ix. Morgue: Eight hours;

(1) The morgue experience may be obtained by the student attending actual autopsies, viewing videotaped autopsies approved by the Department or by attending a course approved by the Department.

2. Clinical training shall also be required in the following areas:

i. Laboratory: Eight hours; and

ii. Respiratory Therapy: 24 hours.

3. A minimum of 400 hours of field experience shall be documented after completion of the didactic portion of an EMT-Paramedic training program.

4. Minimum hour requirements for optional clinical areas may be determined by the EMS Educator.

(e) The student shall provide the EMS Educator with the appropriate completed clinical sign off sheets documenting successful completion of all clinical training objectives.

(f) If a student fails to meet any of the minimum numbers for the performance of the required skills listed in this chapter, the EMS Educator may, in accordance with 8:41A-1.4, make application to OEMS for a waiver of that requirement.

(g) All training requirements for the clinical portion of an EMT-Paramedic training program shall be completed within 18 months of the completion of the didactic portion of an EMT-Paramedic training program. A student may be eligible for a six-month extension to complete the clinical training requirements.

1. Any such request shall be made to the Department and shall:

i. Be made in writing by the EMS Educator responsible for the student and delivered no later than 30 calendar days before the expiration of the clinical portion of an EMT-Paramedic training program;

ii. Include the student's name, didactic training site, didactic completion date, and the name of the mobile intensive care hospital providing clinical sponsorship;

iii. Include an explanation of the need for the extension; and

iv. Contain an endorsement of the request by the EMS Educator and a statement reaffirming clinical sponsorship.

2. The Department shall advise students of the outcome of their request, through their EMS Educator, within 30 calendar days of receipt of the request.

3. Only one such extension shall be granted.

4. Students who receive an extension shall sit for the first NREMT-Paramedic Certification Examination offered after the extension expires.

(h) Any student failing to complete the clinical portion of an EMT-Paramedic training program within the time span identified in (g) above shall be required to complete a didactic course of study equivalent to the refresher curriculum, the balance of the clinical time required and any additional time the EMS Educator or OEMS deems reasonably necessary to demonstrate competence in the required training objectives. In no instance shall the total training period exceed 36 months from the beginning of the didactic portion of an EMT-Paramedic training program.

(i) Students shall not transfer clinical sponsorship during the course of training unless the change is first endorsed by both the original and the intended sponsors. Consistent with 8:41A-1.4, a student may request a waiver from this requirement.

N.J. Admin. Code § 8:41A-2.4