EMS INTERNSHIP OVERVIEW

INTRODUCTION

This Intern Course is intended to provide the

EMT-Basic, EMT-Intermediate, or EMT-Paramedic

candidate with a clear understanding of the expectations of them as a BLS or ALS precepting employee.

• This program will be an instrumental evaluation tool during the initial months of your probationary period. Your performance in accordance with this program will weigh significantly in your advancement off of probation or in the consideration of termination. • It is essential that you have a full and complete

understanding of all aspects of this course.• It is our mutual goal for the Intern to

successfully complete their Internship and be released as Department BLS/ALS Provider.

PROGRAM MANAGEMENT

• This course assignment is a comprehensive overview of the internship program.• Separate assignments will be made for

each of the three phases of the program with specific paperwork included.• A specific assignment for Daily Assignment

paperwork will be made upon your successful completion of this assignment.

ACCOUNTABILITY

• Any questions or concerns should be addressed to your assigned Field Training Officer (FTO) • If the FTO cannot answer the questions, they

will be responsible for reaching out to the EMS Program Manager.

PURPOSE

The Field Internship requirements have been developed to ensure that all individuals providing out-of-hospital care at the BLS and ALS level have received appropriate training, and are capable of providing safe and competent care on a consistent basis.

COMMUNICATION

• It is your responsibility, the EMS Intern, to assure that your precepting FTO has all the associated paperwork to sign off on.• It is your responsibility to maintain your

approved paperwork and provide digital copies to your Captain for advancement considerations as outlined in the Phase description section

EXPECTATIONS

• All departmental personnel are expected to complete the EMS Internship as a required portion of their probationary period.

• This internship is a critical phase of your probation period• The intern is expected to demonstrate the knowledge gained

through their EMS certification process in the actual pre-hospital care situations.

• This Internship program also provides the Department with a mechanism to ensure competency to perform in a minimum staffing role.

• As an intern, providers will be authorized to perform all skills as associated with their Certification Level according to the current approved protocols and directives.

• All skills and interactions will occur under the direct supervision of a Field Training Officer.

• Upon completion of the Internship the Department’s Operational Medical Director (OMD) will review the Intern’s progress, evaluations, and comments to determine if the Intern should be released at their appropriate EMS Level to function as Department Minimum Staffing. 

• The internship occurs in three phases. The Internship will be signing an acknowledgement of their participation in the program upon completion of this assignment.

• Several documents will download through your participation in this assignment, make sure to save them properly and print accordingly.

PHASE I

• The Intern shall develop their EMS Knowledge, Skills and Abilities (KSAs), and demonstrate their successful performance as required by the program.

• The intern will demonstrate without prompting or assistance each skill required and be able to explain the associated criteria for the use of each skill in a mock setting. The LFTO or FTO will document their performance by completing the appropriate National Registry skill sheets and KSA form.

• The Intern shall ride as a third on the unit and observe the actions of the crew and perform skills as directed by a FTO.  Only skills that the Intern has been signed off on their “Knowledge, Skills and Abilities Evaluation Form – Appendix G” as Successfully Evaluated shall be performed by the Intern.  

• Summary: As the intern becomes comfortable with his/her role and proves to be a functional member of the team, then he/she may move onto the next phase.

• TIMELINE: The intern must spend at least one (1) week or three (3) shifts in this phase and should take no longer than two (2) weeks or five (5) shifts.

• NOTE: This phase can be run concurrently with Intern’s Ambulance/Medic Driver Program.

PHASE II

• The Intern shall ride as the officer (Attendant in Charge) of the unit.

• The Intern will perform all assessments and interventions for the patient.

• The Intern will make all call in reports to the ER, or designate accordingly to a team member.

• The Intern will document all activities according to their scope of practice.

• Staffing: There should be a minimum of three personnel on the unit.  The assigned driver may be a medic or EMT in accordance with regular staffing for the department.  The assigned FTO shall be in the patient compartment, with the Intern, overseeing the patient care and prompting the when and where needed.  A post call discussion should be done after every call to discuss the performance of the Intern.

• SAFETY NOTE: If at any moment the Intern is not comfortable with the call type or situation the LFTO/FTO should immediately take over the call.

• TIMELINE: The length of this phase is to be no less than two (2) weeks or five (5) shifts and no longer than two (2) months or twenty (20) shifts.

PHASE III

• The Intern will continue to ride as the officer (Attendant in Charge) of the unit on all calls.

• The Intern will perform all assessments and interventions for the patient.

• The Intern will make all call in reports to the ER, or designate accordingly to a team member.

• The Intern will document all activities according to their scope of practice.

• Staffing: There should be a minimum of three personnel on the unit.  The assigned driver may be a medic or EMT in accordance with regular staffing for the department.  The assigned FTO shall be in the patient compartment, with the Intern, overseeing the patient care and prompting the when and where needed.  A post call discussion should be done after every call to discuss the performance of the Intern.

• However, once the Intern and the LFTO/FTO feel comfortable, the unit minimum can decrease to 2, with the LFTO/FTO acting as the Medic Driver for the Intern.

• Expectations: There should be little to no prompting from the LFTO/FTO during this phase. Once the intern demonstrates confidence in his/her abilities and has satisfied the program objectives with the recommendation of the LFTO then the internship will be considered completed.

• TIMELINE: The Intern must spend at least one (1) month or ten (10) shifts in this phase and should have completed the entire program no greater than eight (8) months from the beginning of the program.

FORMAL EVALUATIONS

• Formal Evaluations will be completed at the end of each phase of the internship, by the intern’s LFTO and reviewed by the EMS Program Manager.

• After this review, the Formal Evaluation will be placed in the intern’s training file.

• A copy should be included in the internship Manual – which is maintained by the Intern.

• If the internship takes longer than one month within any phase a Formal Evaluation shall be completed for each month time period

SCORING

• An intern shall attain a minimal rating of three (3) in each category on the final evaluation in order to be eligible for promotion to the next phase or to minimum staffing.

• Department standards have been developed to both standardize and provide objective criteria for the rating system.

• These standards will be addressed in a separate assignment.

DAILY EVALUATIONS

• The performance of an intern will be closely monitored and evaluated by their assigned FTO.

• During the internship, the intern shall be expected to demonstrate the appropriate application of the knowledge, skills and abilities associated with their EMS certification level.

• All ratings shall be based upon adherence to the EMS medical protocols for the State and City at the time of their internship.

• Each medical incident involving both, BLS and ALS treatments or assessments should be reviewed with the intern and evaluated as soon as possible following the call utilizing the daily performance evaluation form

• The intern is responsible for keeping track of all calls run for the day and completing the daily evaluation up to the chief complaint section.

• The LFTO or FTO will complete the rest of the evaluation and have it available for review by the end of the shift. This evaluation session is to be a learning experience for the intern from the observations noted by the LFTO or FTO.

• The intern’s strengths and weaknesses are to be discussed during the evaluation session. Once completed both daily forms shall be scanned by the intern and sent to the LFTO and the intern’s direct supervisor

EVALUATED AREAS

• Scene management• Initial Assessment• History• Physical Exam• Protocols• Reassess• Professional• Communication

• Skills• EPCR• Driving

COMPLETION

• Following the third phase evaluation, the LFTO can suggest a recommendation to either complete the internship or extend the internship.

EXTENSION

• The extension period of the internship will consist of an additional thirty (30) days or ten (10) shifts after the formal evaluation for that particular phase if recommended by the LFTO.

• The completion of the internship process is a job requirement for the Firefighter/EMT and Fire/Medic.

• Failure to successfully complete the internship after the extension period may result in the immediate suspension of all practices, and may lead to dismissal.

• An extension would be considered when an intern shows consistent improvement, but has not yet reached the minimum level of competency required.

• An extension of an internship may be recommended for reasons to include, but are not limited to the following:

• Inability to perform adequate patient assessments

• Inability to determine appropriate field protocols

• Inability to anticipate appropriate hospital orders

• Inability to demonstrate appropriate assertiveness

• Inability to interact properly with patients

• Inability to accept constructive criticism/guidance

• Poor communication skills• Indecisive behavior in the field

situation• Inadequate number of patient

contacts• Prolonged absence from the field

(a cumulative of at least ten (10) shifts or one (1) Month)

• Any behavior or extenuating circumstances agreed upon by the intern’s LFTO or Supervisor

DOWNLOADS

• Several documents will download with your participation in this program.

• It is your responsibility to save those documents to your user profiles document file in order to have them for future use and reference.

FINAL RELEASE

• Full certification as the Officer of the BLS or ALS unit for independent practice and to serve as minimum staffing is achieved when the intern successfully completes the following:

• Submits a completed Intern Manual to the EMS Program Manager

• Successful completion of the 100 Question Protocol Test with a score of 80% or better, administered by the EMS Program Manager or his designee.

COMPLETE INTERN MANUAL

• The Intern Manual will only be considered complete if it includes:• Properly completed Daily Performance Evaluations.• Properly completed Formal Evaluations minimum of three (3) for BLS

and ALS Certified Transport

• Completed Knowledge, Skills and Abilities (KSA) form with NREMT Skills Sheets attached.

• Receives a satisfactory final formal evaluation from his/her LFTO (minimum rating of 3 in each category.)

• Minimum of 50 patient contacts, At least 25 of them being ALS (ALS Providers)

• Minimum of 20 patient contacts (BLS Providers)

PROTOCOL TEST

• Should the Intern not successfully pass the Protocol Test, they should Complete an additional one (1) week or (3) shifts prior to completing Version B of the 100 Question Protocol Test.

• Should the Intern not successfully pass the 2nd Protocol Test, they should repeat Phase 3 of the Internship. Upon Completion of Phase 3 they should complete Version C of the 100 Question Protocol Test.

• Should the Intern not successfully pass the 3rd Protocol Test, their Internship will be considered unsuccessful. Employee would have to restart a new Internship should they desire release as a provider.

OFFICIAL APPROVAL

• The EMS Program Manager will review and confirm the above documentation and evaluations. All information will be reviewed with the Department Assistant Chief of Operations and Operational Medical Director for approval and final release of the Intern at the appropriate level.