Impact of COVID-19 on initial emergency medical services certification in the United States

Jonathan R Powell; Jennifer Cotto; Jordan D Kurth; Rebecca E Cash; Mihaiela R Gugiu; Ashish R Panchal

doi:10.1002/emp2.12808

Impact of COVID-19 on initial emergency medical services certification in the United States

J Am Coll Emerg Physicians Open. 2022 Aug 25;3(4):e12808. doi: 10.1002/emp2.12808. eCollection 2022 Aug.

Authors

Jonathan R Powell^{1

2}, Jennifer Cotto¹, Jordan D Kurth¹, Rebecca E Cash³, Mihaiela R Gugiu¹, Ashish R Panchal^{1

2

4}

Affiliations

¹ National Registry of Emergency Medical Technicians Columbus Ohio USA.
² Division of Epidemiology The Ohio State University College of Public Health Columbus Ohio USA.
³ Department of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA.
⁴ Department of Emergency Medicine The Ohio State University Wexner Medical Center Columbus Ohio USA.

Abstract

Objective: As the COVID-19 pandemic began, there were significant concerns for the strength and stability of the emergency medical services (EMS) workforce. These concerns were heightened with the closure of examination centers and the cessation of certification examinations. The impact of this interruption on the EMS workforce is unclear. Our objective was to evaluate the impact of COVID-19 on initial EMS certification in the United States. In addition, we evaluated mitigation measures taken to address these interruptions.

Methods: This study was a cross-sectional evaluation of the National Certification Cognitive Examination administration and results for emergency medical technician (EMT) and paramedic candidates. We compared the number of examinations administered and first-attempt pass rates in 2020 (pandemic) to 2019 (control). Descriptive statistics and 2 one-sided tests of equivalence were used to assess if there was a relevant difference of ±5 percentage points.

Results: Total number of examinations administered decreased by 15% (EMT, 14%; paramedic, 7%). Without the addition of EMT remote proctoring, the EMT reduction would have been 35%. First-time pass rates were similar in both EMT (-0.9%) and paramedic (-1.9%) candidates, which did not meet our threshold of a relevant difference.

Conclusion: COVID-19 has had a measurable impact on examination administration for both levels of certification. First-time pass rates remained unaffected. EMT remote proctoring mitigated some of the impact of COVID-19 on examination administration, although a comparison with mitigation was not assessed. These reductions indicate a potential decrease in the newly certified workforce, but future evaluations will be necessary to assess the presence and magnitude of this impact.

Keywords: COVID‐19 impact; certification examination; certified workforce; emergency medical services; patient care workforce; remote proctoring; workforce.