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University of Maryland Maryland Fire and Rescue Institute
Report To
Maryland State Firemen’s Association Executive Committee
The following report is a synopsis of significant events that have occurred within
the Maryland Fire and Rescue Institute since our last meeting.
MFRI Statistical Report for FY-2012
The following statistical information reflects the quantitative measurement of MFRI training and educational programs for FY-2012.
Emergency Services Programs: 1,678
FPS 1,115
SPS 316
CDs 161
Seminars 87
Students by Programs: 34,327
FPS 23,864
SPS 5,979
CDs 2,433
Seminars 2,051
Student Hours by Program: 829,690
FPS 719,927
SPS 91,350
CDs 9,035
Seminars 9,378
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Students by Discipline: 34,327
FIRE 7,497
EMS 7,248
ALS 2,197
RES 2,199
MGMT 4,301
HM 2,525
SPECIALTY 3,876
CDs 2,433
SEMINARS 2,051
This report consists of numbers but please consider the work of the MFRI faculty,
staff and Field Instructors who make this system function each and every day. They are to be commended for what they contribute to the success of our students and programs.
MFRI Student Transcripts
Effective September 1, 2012 MFRI students will be able to request unofficial student transcripts at any time for themselves through the MFRI Student Zone, a feature of the MFRI website. In order to make a request for their unofficial transcript students will use their name, birth date, and SSN to uniquely identify themselves to the system.
Students will receive a PDF of their unofficial transcript documenting their MFRI course work. They can print this PDF file or save it to their local computer. In the event of a discrepancy, the student will be provided directions on how to submit the appropriate documentation to correct their record. Students who require an “official” transcript will continue to use the current system for that.
The addition of this feature to the MFRI Student Zone will provide immediate feedback to students by leveraging our IT infrastructure to quickly respond to their request any time of the day.
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EMT Program Effective July 1, 2012
MFRI has completed the statewide “Instructor” roll-out classes for the MFRI EMS Instructors who will be instructing the new EMT Course effcective July 1, 2012. In additon, MFRI is in the process of completing two “pilot” EMT classes to the new educational standards. MFRI has also created and reviewed the examinations utlized for the module exams. This work has been accomplished in prepreration for the implementation of the new 165 hour EMT Course that will be the curriculmn used for all EMT courses that begin after July 1, 2012.
MFRI requested additonal financial respources in our FY-2013 operating budget request for the funds necessary to cover the costs associated with the new course and its increase in hours. Governor O’Malley has included in the state budget sent to the General Asembly the necessary funds to provide for the new EMT course. The additoinal funding necessary to present the new EMT course has been approved by the General Assembly and is in our FY-2013 budget. Thanks to all who worked to make these training resources possible.
MFRI Medical Clearance Policy Analysis
The MFRI Medical Clearance Policy was implemented on July 1, 2011. Since that date, there have been 122 classes conducted in Field Programs for which students were required to obtain medical clearance. There were 2,470 students seated in these 122 classes. More than 75% of the students served in these classes obtained medical clearance through a departmental physical or evaluation by a licensed healthcare provider of their choice.
Of those opting to complete the online MFRI Medical Clearance Questionnaire, nearly three‐quarters were approved for participation without further evaluation. Of those referred, the vast majority had pre‐existing medical conditions or significant risk factors for cardiovascular disease. These medical issues were identified to the student and they then completed medical physicals before participating in the class.
Overall, the implementation of the MFRI Medical Clearance Policy has been very successful and beneficial toward improving firefighter health and safety. The policy has been well received by fire departments and fire service organizations statewide. A complete analysis of the one-year history of the MFRI Medical Clearance Policy is attached to this report for your information.
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Pro Board Accreditation Review
This July the National Board on Fire Service Professional Qualifications, (Pro Board) visited Maryland to conduct the five-year accreditation review of the MFSPQB certification system. The MFSPQB, MFRI and the ATRA’s all participated in this very important review that determines whether or not the MFSBQB will be nationally accredited to certify to the various NFPA standards. A complete and thorough review was conducted that included the review team visiting MFRI and two ATRA’s within Maryland.
During the exit interview, there was unanimous praise by the Accreditation Review Team for the Maryland system, its accomplishments and management. Noteworthy Program Elements and Observations:
• Responsiveness to the needs to their constituents to provide training and support when and where needed
• High level instructor credential process • MFRI regional offices and ATRAs share resources, both facilities and
equipment, to provide maximum access for constituents • Students must pass medical clearance (for specified courses) in order to
attend training • A thorough academic dishonesty policy for students, instructors and those
involved in the evaluation process • Involved in research, such as firefighter location system, to improve the safety
of firefighters everywhere • One of the strongest factors for the system are the barriers that have been
removed to allow collaboration between volunteers, career and firefighting organizations
• MFSPQB and MFRI have made certification a culture in the state of Maryland for fire service professionals which allow mobility within the state for career growth
• An organized process for portfolio review that allows for checks and balances within the system
My thanks to the MFSPQB who under the leadership of Chair Michael Robinson
and it’s Board have done an outstanding job of building and maintaining an excellent certification system within Maryland. Thanks also to the MFRI faculty and Staff who work day in and out to make the system work successfully for the benefit of the fire service.
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MFRI Instructor Injury and Change to EVOC Class
In April of this year, a MFRI Field Instructor Dominick Troiano was seriously injured during an EVOC class in Southern Maryland. I am very pleased to report that Dominick after several days in Shock Trauma and several weeks at Kernan Rehabilitation Center is doing well and is expected to continue his instructor duties in the near future.
As a result of this accident MFRI conducted a thorough “Injury Analysis” of the event by the MFRI Risk Management Committee. This group as a result of the investigation made a series of recommendations to improve the safety of our programs and to prevent such an occurrence in the future.
This group recommended that the “Left/Right Lateral Evasive Maneuver” be eliminated. Instead, focus should be placed upon a current evolution entitled “Controlled Braking Exercise” to meet the needs of our students and job performance requirements. The “Left/Right Lateral Evasive Maneuver” has students change lanes in an “offensive” manner, meaning that it does not emphasize the use of brakes. The “Controlled Braking Exercise” is similar in that it simulates a sudden move around an obstacle, but requires the student to come to a complete stop, which this group considers a more “defensive” and safe driving maneuver.
Besides having the advantage of allowing students to experience an evasive maneuver in a training environment, a clear concern of our instructors, the “Controlled Breaking Exercise” does not require anyone to be positioned on the travel portion of the grounds used for the evolution and at risk of being struck by a trainee’s vehicle. This recommendation and other EVOC curriculum changes have been approved and will be implemented in the near future.
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Overview The MFRI Medical Clearance Policy was implemented on July 1, 2011. Since that date, there have been 122 classes conducted in Field Programs for which students were required to obtain medical clearance. There were 2470 students seated in those 122 classes. More than 75% of the students served in these classes obtained medical clearance through a departmental physical or evaluation by a licensed healthcare provider of their choice. Of those opting to complete the online MFRI Medical Clearance Questionnaire, nearly three‐quarters were approved for participation without further evaluation. Of those referred, the vast majority had pre‐existing medical conditions or significant risk factors for cardiovascular disease. During the 122 courses conducted, there were 37 incidents reported involving 36 students. Of those 36 students, only three were approved for participation after completing a MFRI Medical Clearance Questionnaire. Two of these students sustained minor musculoskeletal injuries. The third experienced a new onset cardiovascular event, but had no predisposing factors or past medical history that would have predicted the event. Overall, the implementation of the MFRI Medical Clearance Policy has been successful. The policy has been well received by all stakeholders. Program Administration Implementation of the Medical Clearance Policy has gone very smoothly within the Institute. The regional offices are doing an excellent job of communicating the policy to the students that preregister for the six courses that require medical clearance. The prospective students that complete the online medical clearance questionnaire are receiving a response on average less than 24 hours after electronic submission. While the process is working well, it would be helpful for both the reviewer and the regional office staff if the students were required to provide some information regarding the class for which they are registered. It is recommended that a field for the type of course and course location be added to the online questionnaire. Prospective students are more likely to know these two pieces of information than the log number, even well in advance of pre‐registration. While gathering log number would be ideal, having the course type and location will meet the need to simplify the process of matching students without over‐complicating the online questionnaire.
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54%21%
15%
8%
2%
Figure 2Age Distribution as Portion of
Students Evaluated
16‐24
25‐29
30‐39
40‐49
50+0
10
20
30
40
50
60
70
16192225283134374043464952555861
NUmbe
r of Stude
nts
Age in Years
Figure 1Age Distribution
Age, Gender and Morphometry
Medical Clearance Questionnaires of 769 prospective students were evaluated between July 1, 2011 and June 30, 2012. The prospective students ranged in age from 16‐62 years with an overall mean age of 26.33 years. The age distribution was skewed towards the younger segment of the population as we would expect (Figure 1). More than half (54%) of the prospective students were between 17‐24 years old and nearly three‐quarters of the prospective students were under the age of 30 (74%). Only 10% of the prospective students were over 40 years old (Figure 2). Male students accounted for 81% of the Medical Clearance Questionnaires evaluated during this period. There was no significant difference in the average age of male and female students evaluated (Table 1).
Prospective students self‐reported height and weight on the Medical Clearance Questionnaire. This information was used to calculate Body Mass Index (BMI) that was used to classify individuals as underweight, overweight or obese. Prospective students were classified using the World Health Organization (WHO) criteria (Table 2).
TABLE 1: AGE AND GENDER Questionnaires Submitted Average Age of Students
Males 626 26.31 Females 143 26.46 Total 769 27.33
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3%
37%
33%
19%
7%
1%
Figure 4BMI Classfication
Underweight
Normal Weight
Overweight
Obese Class I
Obese Class II
Obese Class III
TABLE 2: INTERNATIONAL CLASSIFICATION Classification Principal Cut Off Point (BMI)
Underweight <18.50 Normal Range 18.50‐24.99 Overweight (Pre‐Obese) 25.00‐29.99 Obese > 30.00 Class I 30.00‐34.99 Class II 35.00‐39.99 Class III > 40.00
The BMI of the 769 prospective students ranged from 16‐47 with an overall mean BMI of 26.63 (Figure 3). More than half (60%) of the prospective students are classified as overweight or obese based on BMI (Figure 4). BMI may not correspond to the same degree of fatness in different populations due, in part, to different body proportions, but the health risks associated with increasing BMI are continuous and thus these findings should still be considered cause for concern. Male students had a slightly lower average BMI (26.53) as compared to female students (27.08). When analyzed by student age, there was a slight increase in BMI as age increased (Table 3).
TABLE 3: AGE AND BMI Questionnaires Submitted Average BMI of Students
16‐24 Years 418 25.46 25‐29 Years 157 27.26 30‐39 Years 117 28.50 40‐49 Years 60 28.88 50‐62 Years 17 28.88
0
20
40
60
80
161820222426283032343638404244
BMI
Figure 3BMI Distribution
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73%
27%
Figure 5Evaluation of Medical Clearance Questionnaire
Approved Referred
Evaluation of the Medical Clearance Questionnaire
Prospective students answered a series of questions designed to identify cardiovascular disease risk factors, existing medical conditions or injuries that might limit the student’s ability to perform job related duties. Based on the information provided on the Medical Clearance Questionnaire, 558 prospective students (72.56%) were cleared to participate without further medical evaluation (Figure 5). Nearly three quarters (74.60%) of male students and 63.64% of females students evaluated were approved via the Medical Clearance Questionnaire (Table 4). There was a decrease in the percentage of prospective students cleared via the Medical Clearance Questionnaire as age increased, especially in those students 40 years of age or greater (Table 5).
TABLE 4: GENDER AND CLEARANCE Approved Referred
Males 467 (74.60%) 159 (25.40%)
Females 91 (63.64%) 52 (36.36%)
Total 558 (72.56%) 211 (27.44%)
TABLE 5: AGE AND CLEARANCE Approved Referred
17‐24 Years 324 (77.51%) 94 (22.49%)
25‐29 Years 119 (75.80%) 38 (24.20%)
30‐39 Years 81 (69.23%) 36 (30.77%)
40‐49 Years 29 (48.43%) 31 (51.67%)
50‐62 Years 5(29.41%) 12 (70.59%)
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There were 211 prospective students referred for further medical evaluation. More than 90% of those students were referred based on existing cardiac or respiratory disease or significant cardiovascular disease risk factors (Figure 6). The prospective students referred had an average of 2.2 cardiovascular disease risk factors. In the entire population of prospective students evaluated, the number of cardiovascular disease risk factors increased significantly with increased age (Table 6.)
TABLE 6: AGE AND RISK FACTORS Average Cardiovascular Disease Risk Factors
17‐24 Years 1.17
25‐29 Years 1.36
30‐39 Years 1.97
40‐49 Years 2.45
50‐62 Years 2.61
While we are not able to quantify the number of students that were unable to obtain clearance after being referred, we know anecdotally that there have been instances where students have failed to receive clearance from a licensed healthcare professional.
66%
27%
7%
Figure 6Reason for Physician Referral
Cardiac Respiratory Other
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Medical Clearance Questionnaire Sampling
One of the concerns expressed prior to implementation of the Medical Clearance Policy was that the referral criteria would be perceived as inflexible or too strict. Of the 211 prospective students referred for further evaluation, only three students contacted MFRI to express concern over that decision. In most cases, it can be assumed that the individuals referred fully understood the rationale for that decision. The following examples describe a few of the students referred based on the online medical clearance questionnaire.
A 62‐year‐old overweight (BMI 26) male with a history of cardiac arrhythmia and open‐heart surgery currently on medication for hypertension.
A 57‐year‐old obese (BMI 33) male with a history of hypertension, heart attack and
stroke.
A 46 year old overweight (BMI 28) male, smoker with history of heart attack and open heart surgery, high cholesterol, and a family history of cardiovascular death prior to age 55 on medication for heart disease and hypertension
A 29‐year‐old morbidly obese (BMI 41) female, smoker with diabetes and high
cholesterol.
A 23‐year‐old overweight (BMI 29) female, smoker with a history of asthma.
An 18‐year‐old male with a history of surgery for bilateral hip dysplasia and a residual difficulty in bending, kneeling and climbing.