Systematic Program Evaluation For EMS Education Programs

What is an educational program evaluation, and why do we have to do it?

With the recent decision by NREMT to register only those candidates who have graduated from nationally accredited programs, EMS program directors nationwide are working to assure that their programs meet the national accreditation criteria. The Commission on Accreditation of Allied Health Education Programs (CAAHEP) (2008) standard IV B 1-2 states that:

“Programs must periodically assess effectiveness in achieving goals and learning domains… Outcomes assessments include but are not limited to exit point completion, graduate satisfaction, employer satisfaction, job placement rates, national registration rates, etc.”

According to CAAHEP, program evaluation should be a continuing and systematic process with internal and external validation in consultation with employers, faculty, preceptors, students and graduates. In short, the basis for developing a systematic program evaluation plan is to answer two simple questions:

§  How do we know that the program is meeting its objectives?

§  How do we know that the program is producing qualified personnel?

 

Historically, most academic programs and institutions have used external reviewers to validate the quality of a program. This external review provides assurances to constituents, whether they are students or patients, that the organization is meeting the very minimum of standards. In EMS education, this has not been the case. Program quality has been evaluated solely by those offering the program, or in many cases, has not been evaluated at all.

The purpose of any external review process is to assure compliance with established standards and to allow program leaders to continually improve. It allows students seeking a specific education to objectively compare the quality of programs they are considering. Additionally, having a systematic plan for evaluation is crucial in preparing for upcoming accreditation site visits and demonstrating to others the quality of a program, as compared to established benchmarks, thresholds, or national statistics.

Instructors in the classroom have used some of the components of program evaluation for many years. The most common of these is the student opinion survey. From these survey results, instructors have adjusted and adapted their courses in an effort to improve. It is common to hear faculty discussing pass rates on national exams, or to have instructors informally discussing recent program improvements or changes. Gather a group of state instructors together and before long the conversation turns to a comparison of admission requirements or attrition in programs, or the lack of preparation of students, etc. With changing requirements regarding accreditation, the goal now is to take those informal discussions and formalize them into a sound program evaluation plan.

Components of the plan

Before program leaders develop a program evaluation plan, it is important to identify key items about which they want to learn. The plan should answer:

§  What do we want to know?

§  What should we measure and how should we measure it?

§  What are the thresholds/expected outcomes?

§  What will we do to fix identified problems?

 

Typically, high risk, problem-prone, or commonly occurring issues have been assessed. For example, if ambulance directors complain that graduates of a program don’t seem to be “road-ready,” educators may come up with a plan to improve the readiness of future graduates. Or, if pass rates on national exams are lower for one instructor as compared to another, the program may choose to have those instructors collaborate to improve pass rates for that first instructor.

The first step should be to get together a committee consisting of people who know the program well and can help identify problems or concerns. Sometimes, because of a lack of available data, no problems have been identified; in those cases, the data collection can begin by having the committee look at some of the required components. At the very minimum, every plan should address the following items:

a.      Exit point completion: This is frequently referred to as attrition or retention. How many students started the program? How many students finished the program? Typically, most programs allow for a 10% attrition rate. Higher attrition indicates a need to look at system processes such as availability of tutoring, admission requirements, etc.

b.      Graduate satisfaction: Student opinion surveys remain an excellent way to evaluate the program. These should be program-based rather than instructor-based, however.

c.      Employer satisfaction: Employers of graduates should be surveyed objectively to identify strengths and weakness of entry level employees.

d.      Job placement rates: Programs need to assess whether their graduates are employed in their chosen field of study, or if they have chosen to continue their education.

e.      National Registry/state licensing exam pass rates: Leaders should assess pass rates on licensure examinations. Most programs establish thresholds at about 90% first time pass rate. It is useful to compare these numbers to national and state databases.

 

Once the data is collected, then program leaders are obligated to develop a plan to address outcomes that don’t meet thresholds. These remediation plans should be written and adhered to, and all program constituents should be aware of the plan.

In future articles, we will discuss how leaders can begin the data collection process and develop remediation plans. For additional information about the program evaluation process, visit the CAAHEP standards and guidelines. Many sample evaluation plans are available on the World Wide Web.

 

© 2008 by Jacqueline B. Vaniotis