Students enrolled in the paramedic education program must complete academic coursework, lab simulation exercises, and clinical and field internships in the following modules.
The academic curriculum for the Core Concepts module includes patient assessment, pharmacology, and airway management.
Interns learn techniques to help them obtain a good patient history and to perform a physical exam, using a systematic approach to performing general survey. Through the use of simulation and standard patients, interns focus on perfecting their assessment skills, performing assessments rapidly, understanding the importance of the findings, and determining the appropriate intervention to treat their findings. Paramedic interns will transition these assessments into practical application in both the clinical and field environments.
In the Core Concepts module, interns also learn about more than 40 drugs carried on ambulances today and more than 70 inter-facility transport drugs. At the completion of this module, paramedic interns have an intimate knowledge of the drug classification and its mechanism of action. Interns also begin to master the mathematical concepts needed for medication calculations and drug administration.
The airway portion of this module is approximately three times longer than that of the average paramedic program. We believe this intense focus on airway management is a benefit to the field providers. The interns learn the process of airway management through the placement of supraglottic airway devices, endotracheal and nasal intubation, the use of glide scope and Airtraq, as well as maneuvers and techniques for proper airway management.
Paramedic interns practice a variety of clinical applications related to patient assessment, pharmacology, and airway management.
During our Live IV labs, interns progress from small to large bore IV’s, preparing them for successful IV starts on patients in the clinical and field environment. Interns learn about Intraosseous access, as well as External Jugular access. Paramedic interns learn and develop a safe and effective technique to deliver drugs in emergent situations. In their drug application labs, interns practice calculating a dosage and administering a drug.
At the end of the Core Concepts module, our interns have performed over 100 simulated intubations on high fidelity mannequins and have performed airway maneuvers over 80 times using high fidelity simulation. More importantly, interns are measured on their ability to use critical thinking skills in making the appropriate airway management decision. Prior to entering the operating room or managing live airways within the clinical setting, the interns are examined to ensure competency. Our interns have complete success in meeting state and program requirements for live intubation and live airway management.
This module does not include specific certification courses but lays a solid foundation that prepares interns for success in future modules. Interns are prepared to successfully demonstrate competency during the airway portion of ACLS and before beginning a clinical practicum.
Center for MEDICS students practice patient assessment skills with the SimMan Essential, which simulates realistic patient presentation by producing heart and lung sounds, as well other sounds and movements that patients might make.
Paramedic interns utilize IV skills trainer arms to learn how to safely and effectively start an IV, and how to check that medication or fluid is infusing correctly. In addition, we use an IV skills digital simulator to assist students with their technique and muscle memory about IV starts. The skills simulator by Laerdal™ allows the student to start a virtual IV. Intraosseous access or IO access is obtained with the use of the EZ-IO™. Interns practice with simulated bones until they reach an acceptable level of comfort and proficiency.
Our simulation experts and instructor for the airway portion of the Core Concepts module are certified in The Difficult Airway Course™, a class endorsed by the American Academy of Emergency Medicine that requires participants to prove competency in all difficult airway management techniques utilizing state-of-the-art tools. Center For MEDICS interns use Laerdal™ Adult Airway Management Trainers, whose lifelike upper torso and head simulate real-world complications that may arise when practicing a variety of intubation, ventilation, and suction techniques. For surgical airway training, the Cricoid Stick Trainer is used. Needle and surgical cricothyrotomy skills can be practiced on this model with interchangeable rigid and soft tracheas that also articulate to a range of adult mannequins.
The Medical module is one of the most in-depth curriculum modules within paramedic school. It is in this module that the paramedic intern learns the art of differential diagnosis, with a strong focus on detailed physical assessment. Interns learn about individual disease processes by body system, and the interventions that can be performed outside the hospital. Paramedic interns begin to put it all together as they now know how to assess a patient, treat with medication, and intervene in a way that saves lives.
The Medical module includes a focused cardiology component, which provides interns with a solid understanding of the cardiac system and pre-hospital treatments used in cardiac emergencies. Interns learn the anatomy and physiology of the heart, electrophysiology, and 12 lead EKG interpretations. These crucial interpretation skills dictate treatment plans for cardiac emergencies. Interns use a systematic approach to 12 Lead EKG interpretations to ensure superior patient care.
During this pre-clinical phase, all paramedic interns accompany the program’s Medical Director on emergency department teaching rounds and gain additional exposure to the clinical environment by attending morbidity and mortality rounds.
While in the classroom, interns interpret over 400 EKGs under the direction of our Medical Director. In their clinical internship, paramedic interns are exposed to another 90 EKGs while creating a treatment plan for their patients. Once interns begin their field internships, they are confident and competent in providing excellent pre-hospital care to their patients.
Interns are put through simulation exercises on a daily basis during the Medical module. Interns are faced with very difficult presentations to help them refine their skills in applying a systematic approach toward excellent patient assessment and creating a treatment plan while delegating to their team.
Our simulation experts have created a realistic environment with state of the art simulation equipment to teach and train interns in cardiology. Center for MEDICS has three Advanced Life Support Patient Simulators, which are realistic interactive training mannequin that simulate a wide range of medical emergencies that require advanced life saving skills. For high fidelity simulation, Center for MEDICS uses SimMan™ Essential, a realistic, full-body adult, wireless patient simulator that offers comprehensive clinical functionality to teach the core skills of airway, breathing, cardiac, and circulation management. SimMan® Essential is powered with our iPads and can be used in the SimMan® apartment or other environments. We also use the LUCAS2™, a mechanical CPR device, and Lifepak™15 for all monitoring activity and electrical therapies. In this module, paramedic interns perform cow heart dissection in an anatomy lab to assist them in developing a strong understanding of the cardiac anatomy.
Very few programs devote more than a few days to instruction on the topic of Special Patient Populations. At Center for MEDICS, we believe that the subject of pediatrics and geriatrics deserves a much more comprehensive study. The Paramedic students study a range of topics in pediatrics, from lifespan development to applied embryology, from neonatal to adolescents. During this module, the students learn about pediatric care in both the emergent environment and chronic care situation. These special populations vary drastically from the average adult patient, thereby requiring very specialized treatment plans. Attention is given to birthing babies pre-hospitaly, as well as caring for the newborn (NRP) and the infant. In addition, the students focus on the geriatric patient in a chronic care situation as well as emergency situations. This module helps paramedic students become more aware of these varying patient needs and interact more effectively and appropriately in the field with these populations. Certification courses covered during this module include S.T.A.B.L.E and PALS.
Upon completing this module, interns are eligible to begin the Labor and Delivery component of their clinical practicum. In the labor and delivery department, the interns are required to participate in three live births. The Center for MEDICS curriculum recognizes the value of providing students with opportunities that reach outside the structured teaching program. To this end, electives are facilitated, encouraging students to study and gain experience in a wide range of extracurricular clinical environments. Some Center for MEDICS interns may choose to spend time in a neonatal Intensive Care Unit.
High fidelity simulation is used throughout this module, beginning with the use of Laerdal’s™ PROMPT Birthing Simulator. The PROMPT Birthing Simulator allows instructors to effectively teach the complexities associated with birthing, while allowing learners to practice the skills required for successful deliveries. As the cycle progresses, the interns care for the SimNewB, an interactive simulator designed by Laerdal with the American Academy of Pediatrics to meet the training requirements of the NRP course. With realistic newborn traits and lifelike clinical feedback, SimNewB is ideal for training for the specific needs of neonates. It helps improve team dynamics, builds confidence, and facilitates practice in a risk-free environment. The interns then learn to assess the pediatric patient, using the low fidelity SimBaby™. SimBaby is the advanced infant patient simulator for team training. With realistic anatomy and clinical functionality, SimBaby allows learners to practice and perfect their skills in a risk-free environment. In addition, pediatric airway management is practiced on the Laerdal® Infant Airway Management Trainer. The pediatric mannequin that Center for MEDICS utilizes simulates an 8-year-old patient.
The paramedic’s role in trauma care is not only to understand the objectives of the trauma care system, but also to be able to accurately assess the patient, perform the correct interventions to control any significant threats to life, and rapidly transport the patient to the appropriate facility. This module defines trauma and the system in which pre-hospital providers function. Every year, approximately 155,000 deaths result from traumatic injuries. Our paramedic interns are trained on the types of injuries they may see and how to treat those injuries safely and efficiently for a strong patient outcome.
Although the paramedic interns see traumatic injuries every day in the field, training for an advanced level of care can be lifesaving to the patients. Our interns perfect their basic skills on immobilization, back-boarding, splinting, and BLS trauma airway management. They apply critical thinking skills that allow them to multi-task and provide advanced lifesaving interventions such as cardiac monitoring, needle chest decompression, fluid resuscitation, and advanced airway management. Interns are given the opportunity to receive trauma patients within the hospital internship, and to perfect their skills treating patients during the field internship, where they are first on the scene and need to lead their team to swift and accurate assessment, treatment, and transport of their patient.
Interns use the SimMan® Essential in an industrial environment, or as a patient in a Mass Casualty Drill, so that they can practice and train to feel more comfortable in the field. Interns practice needle chest decompression on the Laerdal ® Pneumothorax Trainer. With bilateral tension pneumothoraces and decompression portals in each axila and subclavian region, the Pneumothorax Trainer is specifically designed for training professionals in chest decompression. Within the TCCC class, interns practice ruggedized IVs and sternal IOs with advanced simulation equipment. In addition, interns are trained on the appropriate use of CAT tourniquets and suturing, and they participate in a surgical cricothyrotomy airway lab.
In the second to last element of their paramedic education program, students participate in a ten-week clinical practicum of at least 250 hours. The practicum in which Center for MEDICS students participate exceeds state and national requirements in terms of number of hours as well as duties performed.
The philosophy behind the required clinical internship is to offer students the opportunity to practice the skills they’ve learned throughout the various course modules at Center for MEDICS, with the support of seasoned professionals. Interns complete patient assessments, EKG recognition and interpretation, IV starts, electrical therapies, airway management, and medication administration through various routes. Interns may also spend time in other departments that may intrigue them, including radiology, electrophysiology lab, and the morgue, for example.
Students may complete this practicum at one of several sites in the greater Boston metropolitan area, including Beth Israel Deaconess Medical Center, Mt. Auburn Hospital, Cambridge HealthAlliance (Everett, Cambridge, and Somerville campuses), UMass Memorial Medical Center and St. Vincent’s Hospital in Worcester, and Metro West Hospital in Natick and Framingham.
Paramedic students are expected to meet the objectives outlined within each of the departments in which they rotate, which can include the ER, ICU, Labor & Delivery, OR, and others. The practicum allows students to become comfortable in stationary environments with seasoned preceptors, and sets up the transition to the field internship that follows.
The last requirement of the paramedic education program at Center for MEDICS is a 250-hour internship that takes place during the students’ final ten weeks. After completing this requirement, students prepare for and take the practical exam for certification.
The field internship provides an opportunity for students to experience the types of situations and responsibilities they can expect to encounter in a paramedic career. Interns accompany paramedics in ambulances for at least 250 hours and participate in at least forty patient encounters. Interns learn to determine the best way to move a patient, depending on the complaint and situation, and receive instant feedback from the preceptor or EMT accompanying them on the call. In at least half of the situations, each intern acts as team leader, giving them practical and realistic experience in sizing up a scene and thinking critically about how to proceed.
Nearly two dozen sites in the greater Boston area, as well as several out of state sites, participate in the Center for MEDICS field internship program, allowing students to ride in their ambulances with their professional teams. The out of state sites, which are located in NJ, NY, NH, CT, and CO, allow paramedic students to experience different types of ambulance systems (county, regional, etc.) as well as different states’ protocols and operations.
Center for MEDICS is pleased to offer each intern the opportunity to participate in at least two critical care ground transport opportunities with Boston Med Flight, a leader in critical care air and ground transport.