In May 2023, UCHealth University of Colorado Hospital launched a first-of-its-kind program, with educational support from faculty at the University of Colorado School of Medicine, to help fill the growing need for first responders in Colorado.
The Medical Education on the Delivery of Innovative Care (MEDIC) program provides the training needed to become a paramedic or certified emergency medical technician (EMT), and also offers continuing education and expanded emergency medical services (EMS) certifications.
Now, a year later, program leaders and educators are celebrating the first paramedic cohort’s graduation. Fourteen paramedic students have completed training, some bringing their families and firehouse crews to celebrate their achievement.
Andra Farcas, MD, and Angie Wright, MD, assistant professors of emergency medicine, wrote the paramedic course curriculum, adapted classes to match each cohort’s work schedules and offered hands-on education opportunities in the hospital.
A key focus for their curriculum is incorporating health equity principles. Leadership sought direction from Jacqueline Ward-Gaines, MD, assistant professor of emergency medicine, who has decades of experience as an emergency medicine physician and leading diversity, equity, and inclusion (DEI) efforts.
“We learned a lot about different learning types, different student needs, and I hope we continue to be adaptive while maintaining the integrity of our quality education,” Wright says. “Our courses help our students not only pass their national registry exams, but save lives.”
A student from the MEDIC paramedic program at graduation in 2024, surrounded by fire staff colleagues.
Crafting a first-of-its-kind program
To allow full-time employees to work directly in their community to take these courses and earn certifications, MEDIC takes on a highly adaptable model that can evolve to fit each cohort’s needs. Faculty members say it’s one reason why the program is so unique and the first-of-its-kind in the United States.
“Traditionally, people with full-time jobs would have to travel to get these certifications, like at an off-site hospital or college, which contributed to the EMS workforce shortage,” Wright says. “We're customizing the shape of the class based on what our students, who work full time, need. For our first paramedic cohort with Aurora firefighters, we needed to design the class schedule around their fire schedule. The second cohort was in class three nights per week. Our next cohort will involve hybrid in-person virtual learning. All we ask is that our students stay motivated for the schedule we’ve adapted.”
Wright and Farcas worked together to assess EMS textbooks, chapter by chapter, and picked out the clinically relevant pieces. For both leaders, it was important for the clinical educators to have teaching backgrounds and to have “walked a mile in these students’ shoes,” Wright says.
Wright and Farcas recruited several professionals to teach paramedic classes, including trauma surgeons, flight nurses, flight paramedics, burn surgeons, toxicologists, geriatric specialists, and even CU’s legal staff to educate on medical legal concerns and ethics. Emergency medicine residents were also brought in to teach and give perspective on EMS experiences.
Desi Harris, UCHealth’s clinical quality coordinator with over 30 years of prehospital experience, leads the EMT course education. With the EMT course designed as a hybrid learning environment, Farcas emphasizes the importance of hands-on learning.
“We learned a lot from our previous EMT cohort, and that night courses three days a week can be hard on everyone,” she says. “There will be a lot of hands-on learning one day a week, shadowing us during our shifts, while students learn at their own pace at home.”
UCHealth EMS providers assist a patient on a gurney. Photo credit: UCHealth.
Focus on health equity
“Health equity training needs to be a part of paramedic training across the country,” she says. “If we start there, and work with our providers, there's no limit to how great our [nation’s] healthcare can be.”
In addition to introducing a brand new health equity curriculum to the MEDIC program, Ward-Gaines leads the DEI efforts for the CU Department of Emergency Medicine and directs the Denver Health Emergency Medicine Residency DEI committee.
In class, Ward-Gaines wants to ensure that students have an understanding for diversity of patient populations, diversity of caregivers, and especially, awareness of personal bias. Ward-Gaines also encourages students to research their potential patient populations and make a deeper connection to the community.
“It's so important to everything we do,” she says. “When we highlight equitable care as educators, everything else falls in place. We want to continue to grow and be the best in this area of education.”
With EMS providers being the first contact for someone who may be experiencing a crisis, Ward-Gaines explains the cruciality of the language in caring for the patient.
“The vernacular that EMS providers use for patients undergoing substance use is imperative; we can't tackle this issue without those who can talk to patients and get them in treatment programs,” she says. “It’s important not to shame the patient.”
While it can be challenging to track the success of new health equity training in the MEDIC program and the impact on the community, she will track student success by assessing their attitudes and confidence in performing health equitable care. For future cohorts, she’d like to introduce community surveys to people who have been cared for after calling 9-1-1, and whether it was well-received.
“Health equity training needs to be a part of paramedic training across the country,” she says. “If we start there, and work with our providers, there's no limit to how great our [nation’s] healthcare can be.”
From pupils to protectors
Wright, Farcas, and Ward-Gaines echo the same sentiment about working closely with students over the past year and seeing their growth.
“We’ve gotten to know each of these graduate’s individual strengths and know where they started from; we look at them now and they’ve come so far,” says Farcas. “These providers will be taking care of our immediate communities. Some will be out east, some will be spread out across Colorado, and we’ll be seeing [some of] them on the receiving end this time, when they're transporting patients to us in the emergency department. That will be a full circle moment.”
“These cohorts have been awesome to work with, I would want them to care for me if I was a patient,” Ward-Gaines says.
“A student from my second cohort presented me with a gift; it was a patch from the Freedom House Ambulance Service, which the first ever EMS group in the United States led by African American providers.”
The Freedom House Ambulance Service patch that student Caiden Dopke gave to Ward-Gaines
The second paramedic cohort is currently underway, completing their 500 hours of hands-on training, and other certification cohorts will begin this summer.
