Meeting & Agendas

In attendance: Robert Hartman, Bryan Parker, Stephanie Stager, Johnny Campbell, Terri King, Kenny Schnell, B. Duke Kimbrough, M.D., Jim Swisher, Beth Holimon, Andrew Lugo, Bradley Leah ACC: Pat Recek, Robyn Richter, Steven Villiavicencio, Don Gwynn, Ginger Floyd and Rebecca Brock

X. Area Hiring Processes Committee a. Interview process i. Williamson County will have another process in August. Applicants must now be a graduate of an accredited, collegiate program. ii. San Marcos/Hays County – Hiring process in January. iii. Marble Fall EMS – Hiring process in April

a. Annual Report i. Budget is in your packet; the X-19 b. Program Resource Survey and the Self-Study Survey- for the Advisory committee i. You also have in your hands the Program survey and Self-Study survey which the advisory committee will need to complete prior to leaving today as they will need to be collated and sent along to Co-A as part of our documentation. c. Library Resources ( handout)

Dr. Kimbrough – Comments

Discussion of area protocols for the safety and protection of the EMS provider.

XIV. Other topics from the floor……………………………………………….Committee i. Pat Recek – Information on the upcoming ACC Bond Proposition. ii. Steven for clinical providers – Concern over IV fluid shortages I.V. Dr. Kimbrough will get the names of venders from ATCEMS for fluids. If the providers have expired fluids, please send them our way for testing purposes.

XV. Adjourn – Kenny Schnell motions to adjourn. Motion is seconded. Meeting adjourned.

a. In house and registry pass rates EMT- August 1, 2013 – August 1, 2014 we had 148 EMT students take the National Registry exam and pass on the first attempt. We have 1 student who has taken the test twice without success, but they waited 6 weeks between attempts. Our pass rate currently stands at 98%. The national rate for the first attempt is 71% so we are well above average. The ACC “above pass” rate percentages for airway, cardiology, trauma, medicine and ops are between 88% - 75%. The state topic percentages for “above passing” are between 51-48%. Our scores are above both state and national averages. AEMT: Topic levels are finally showing up because we have now had enough people take the exam since its inception for the numbers to be statistically valid. From January of 2013 we have had 21 take and pass the exam, so we have a 100% pass rate. However, in topic performance airway we had 43% “at passing,” 43 % at “near passing” and 14% or 3 students “below passing” at this level. In Medical we had 48% “above passing,” 52% “near passing” and no one below passing. The other topics, cardiology, trauma and ops were in the 81-90% range. The plan to increase scores will come from the EMSP 2137 -Emergency Procedures 1 class which is the lab that readies the students for skills testing at the registry level. Students have been testing the AEMT level through a Fisdap® exam for a participation score. This exam is currently free because Fisdap® is validating their questions. The test is still in review but we were able to get student scores. The scores were not excellent but they give us information on how to help the students review. Beginning Spring of 2015 students will get homework for review of every topic area that they are not currently studying. They will then get an opportunity to test with Fisdap® before testing at the Registry level. We will watch the scores for validation of the homework review process and then see if that helps us with registry. This is not a popular exam to take because it is expensive and most students will be finished in three semesters, so they wait and spend their money on the paramedic exam. Paramedic – Since August 1, 2013, 38 graduates attempted the National Registry exam all passed on the first attempt .The program pass rate is still at 100%; topic scores are above average in all areas.

a. Fall 2012 – Fall 2014. There was a gradual decline in enrollment, but it correlates with the gradual decline in overall enrollment throughout the college. b. EMSP - Spring 2012 - Graduated – 18 - Enrolled – 97. EMSP – Summer 2012 - Graduated – 7 - Enrolled – 103. EMSP – Fall 2012 - Graduated – 8 - Enrolled – 109. EMSP - Spring 2013 - Graduated – 14 - Enrolled – 107. EMSP – Summer 2013 - Graduated – 18 - Enrolled – 84. EMSP – Fall 2013 - Graduated – 7 - Enrolled – 86. EMT – Spring 2012 - Enrolled – 54. EMT – Summer 2012 - Enrolled – 58. EMT – Fall 2012 - Enrolled – 57. EMT – Spring 2013 - Enrolled – 61. EMT – Summer 2013 - Enrolled – 70. EMT – Fall 2013 - Enrolled – 84. c. The college as a whole has had a decrease in student population as the economy gets better; people are finding jobs, which create less of a need for people to go back to school. One of the providers in the city is now hiring EMT students; they are doing needs assessment from within and then we hope to schedule a time to go and speak to their employees about completing their degrees. Financial Aid and grants have decreased and students are unable to fund their education. d. Program Competition: UT Health Science Center is doing contract paramedic courses in some of the ESDs. These are faster, expensive courses that offer a certificate for the completer. EMTS is another certificate course in the area that does a shorter course for paramedicine.

a. Curriculum Changes………………………………………….Rebecca Brock i. EMSP 2352- Research class is now a fully hybrid, the class meets twice a week for the first and last two weeks and then once a week on Wednesday for the rest of the semester. The primary instructor is Peter Wheeler and we are pleased with the way the course is working. ii. Summer classes: Last year we discussed and voted to remove the 4th and 5th semester courses in the summer due to student, faculty and provider stress. The fourth semester has 190+ clinical hours and the didactic courses are Medical Emergencies and Special Populations. These courses required the students to be in the classroom on Tuesday/Thursday from 8am-5:20 pm in the afternoon. The fifth semester has 240 hours of clinical with classroom obligations on Monday and Wednesday from 8 am – 1:30pm. They had only eight weeks to complete clinicals and keep up with their classroom obligations. We decided it was a “failed” experiment. This past summer was like a breath of fresh air; better for everyone. Students who originally were upset by adding a semester to their educational pursuit are back from their summer break and in a good frame of mind to learn after resting and working. We are teaching our 1st, 2nd and 3rd semester courses in the summer along with one daytime and two night time EMT courses. Still busy, but much better. iii. With regard to SB 497 -60 credit hour Associate degree legislative mandate: An email was sent to you this summer with the information about possible changes to our degree plan, the letter from the GETAC committee supporting the changes was also included. In return emails you agreed with the waiver process and the curriculum we set up. The ACC curriculum committee convened a sub-committee to hear the rational for department waiver requests, which if approved, would be forwarded to the Texas Higher Education Coordinating Board ( THECB). Our waiver request was approved, however we will not find out what THECB will allow until February. We have requested to reduce the current degree plan from 69 to 64 by removing all three card courses, EMSP 1147, 1149, and 2135 PALS, PHTLS and ACLS using a one credit Medical Terms class, instead of a two credit hour class, and removing one of the weight lifting courses. We did this because we were asked by our VP of Instruction to make a good faith effort. If we are not allowed a waiver then we will remove the other four credits in order to get to the 60 hour limit. This means removing Medical Terminology entirely and also removing our HPRS 1303- End of Life Issues class which is three credit hours. These educational modules would need to be added back into the EMSP curriculum. Pat Recek, Interim Dean of Health Sciences stated that Dr. Cook, the new provost for ACC, wants students to have all of the skills that they need in order to be successful. He is going to require students to take an EDCU 1300 special course that would help students with skills like testing and studying methods. EDCU 1300 can be a 1, 2, or 3 credit hour course. Health Sciences will look at developing a course that would be tailored specifically to our students. Dr. Kimbrough stated a concern about losing the speech credit because our current generation of students has more trouble speaking with strangers in a foreign setting. He requested that the college take this into account when they begin development this course. The new degree plan goes into effect the Fall of 2015. iv. Benchmarking: We discussed benchmarking last year and have instituted the requirement for graduation. We did have to make some changes based on new interpretations of the CoAEMSP standards. We had initially made an overall group of 20 for pediatric patients but did not place any stipulations on numbers in the age groupings. CoAEMSP stated that we must have at least two patients in each pediatric sub-group. Our biggest hold up was neonates, but we think that has been dealt with given a new clinical which Robyn will discuss. In order to make sure students are on task for success we have their mentors pull down their compliance sheets from Fisdap®. If the student is lacking patient contacts in a certain area the mentor discusses it with the student and the student is most often sent back to the clinical to get what they need. For instance students needing intubations were sent back to OR with specific instructions for those skills. As a result of the faculty and students working together all of the students met their benchmarks for the spring of 2014. We are on task this semester to meet all requirements for our December graduates as well. v. Several of us went to the National Association of EMS Educators Symposium in September and one of the items discuss was the new testing strategy for National Registry at the Paramedic level. Our paramedic students are currently prepared for 14 skills of which they must perform 12, including 8 discreet skills and 4 didactic/knowledge skills. National Registry has mandated Portfolios beginning Fall of 2016, at the Paramedic level. With that change we will quit doing all the discreet skills at that level (which they are now doing at the AEMT level) and do two scenarios and all of the knowledge skills. We will test both Oral Scenarios and both of the Cardiac skills for testing. This is of course all subject to change from the Registry until it actually begins. All students will have a portfolio showing the summative account of all discreet skills testing and proof of scenario testing. In order to get ready for this we are documenting all scenarios in the classroom. For instance when we do a pediatric scenario on croup, the student who led the team gets credit for the patient contact and any correctly initiated treatment plans.

We are in our self-study year and the paperwork is due November 1, 2014. To that end we have been surveying our students and you have the results of the Program resource survey in hand. At a recent faculty meeting we discussed the findings and possible methods to help with the learning environment. As you can see the overall scores were quite high. The areas we see need for improvement in were: i. Dissemination of information to the students regarding what you as an advisory committee do for the program. We decided that the student delegate would be our helper with dissemination of information. In a Blackboard® announcement to the students we requested that if they had suggestions for us that they write those comments on paper, fold them and put the delegates name on the outside and place them in Eric Merino’s metal box by his desk. To date we haven’t received any but the hope is that if they have a concern this will make it easier to get that information to us and we can act on it in a timelier manner. ii. Clinical orientation seems to overwhelm them. There is a lot of information in a very short period of time over two days; it causes confusion. The clinical instructors will develop a “cliff note” version of the 1st day handout every semester. This version will not take the place of the first day handout but it will simplify some of the information. iii. Storage for students and the air-conditioning received the lowest scores. We do not have a storage area for students to put their belongings. This has always been a source of low scores for us on this survey. One of the items discussed was to have some cabinet space left open for them to place their bags so they are not on the floor at their feet while they work. We are working on that, but we also have storage issues of our own that we are working on. Steven Villavicencio commented on trying to better utilize the space we have by creating a ‘morgue’ for our manikins. It will need to be a custom job. Becky : Space is a continuing issue as the area we have was never meant to house 100 students. It was built for a max of 40 students. We were to be in the third build out at the Round Rock Campus, and the second build out is on the current bond vote slated for November of this year. It will be awhile before EMS has space at the Round Rock Campus. We will also speak to Becky Cole about the possibility of having lockers for our students. iv. The students struggle with our conditioned air. It is very cold in the classrooms and labs, and they wear sweatshirts often. I have redacted some of the information on the survey because it was a bit to colorful, but you get the idea that they want us to do something about it. We will continue to discuss the problem with the facilities folks but I can tell you they are in our area a lot looking at control of flow issues. v. In our last reaccreditation there was concern that students were not given enough time with physicians. Dr. Kimbrough has instituted new in house clinicals since then and this clinical is scenario driven. He is with students for 6 hours over the first two clinical semesters. They are in groups of four so he gets plenty of time with them. He does a differential diagnosis lecture for the 2260 students, exit interviews for our seniors and always helps with National registry exams. One of the suggestions made was to incorporate Dr. Kimbrough into the first semester classes, but we would also like to incorporate doctors from the ED that have shown an interest in our students. There are several who used to be paramedics that have stated they would like to be involved. The DC requested that if Advisory Board members knew of doctors that were Paramedics in the past or interested in our students, to please let us know so we can invite them to come and lecture for us in the future. vi. Wi-Fi in this building is a problem that we will be talking to the campus manager about because it is a safety issue. The school uses emergency alerts to contact students about weather related issues and other emergency response items. If they want to study close by the department they cannot get Wi-Fi so they often can’t get to their notes on blackboard. Computer room access is another issue and what we really need is a computer room of our own along with a study area combined that has student storage. That would be great. Unfortunately, even though that particular item was requested in our EMSP Academic Master Plan, the school has not consented to building it for us. vii. Bryan Parker ( EMSP Student Advocate): Some of the furniture in our “area” has been ‘thoroughly used’. We would suggest that new furniture be acquired. viii. The students also did a self –study survey which was completed by survey monkey and sent straight to Co-A. We will not have the outcome of that survey until the site visitors come in the spring.

VII. New Equipment in house: We received word while we were at our NAEMSE conference that we will get Perkins money again this year for another Laredal ®JuniorSim. So we will have two once it gets here. It has been ordered and we will budget for one more when given the opportunity. We really need three to move things along in the special pops lab.

a. About 130 student (including EMT’s) doing clinicals. b. EMT – Spring 2013, we added San Marcos/Hays County EMS to our list of providers for the EMT students. They now get to see all three different providers along the I-35 corridor in each of their three rotations. c. This summer we were approach by administration from North Austin Medical Center and they requested our students for their facility. Currently we have 4th semester students going to North Austin Medical Center for 1 ER rotation, 1 L&D rotation and 1 NICU rotation. We lost our Pedi ICU at Dell, but North Austin has offered opportunity as soon as their PICU and Pedi E/R open; we are scheduled to start there in the Fall of 2015. University Hospital @ Brackenridge has a new 17 bed Behavioral Emergency Department now and we have moved our student Psychiatric rotation from the ED too that unit. d. We have 22 students that are doing clinicals in the 4th semester and 15 students completing their practicum; the sites have helped us by adding to their number of training officers. e. Discussion- The committee ask if the program saw any value in the Community Paramedic Program. The answer from Professor Richter was yes, that we emphasize the importance of differential diagnosis which would help in a continued program and we like to let our students know that there is something in the career beyond the ambulance. f. Motion from Chair-Kenny Schnell– Community Health Paramedic. ACC-EMSP pursues curriculum and clinical time for a course on community para-medicine. All in favor none opposed. Motion passed.

a. New Industry Standards/Practices Committee i. New equipment on the units? New SOC, or COGs ii. In Williamson County the Lucas® devices are on units and Commanders respond to all cardiac arrests. b. Additions/Deletions in Medication Formularies………………………Committee i. Brilinta – platelet inhibitor added by San MarcosHays County EMS ii. ATCEMS will have new COGs out Feb 4, 2015 which will bring many changes. Levophed will replace dopamine. (Dr. Kimbrough)