Medical Education & Training Center During the Pandemic

The Resiliency of EMT and Paramedic Education

at National Medical Education & Training Center During the Pandemic

March 13th, 2020, President Trump declared a State of Emergency in the United States, I was asleep in my hotel room in New Delhi, India. The media had reported the President was shutting down the U.S. boarders and locking the country down for two weeks to “bend the curve.” I was awakened early in the morning on March 14th India time by the constant buzzing of my cellphone on the nightstand. As I wiped the sleep from my eyes, I could see a number of people including my wife had been calling and texting me throughout the night. I began to read the text messages and listen to my wife’s voicemail I could hear the concern in her message telling me I had to get home.

I had been in India speaking at an EMS conference in Chennai and had flown north to Delhi to do some sightseeing. Covid-19 had just begun to enter the United States but was only on the West Coast before I left for the trip. India had only had a few cases scattered about the country and not a threat at that time. In the week I had been travelling, the world began to change in a significant way. I called my wife; she was worried the virus was still a real unknown. She was asking me to cut my trip short and come home now! She told me I only had until Friday March 14th at Midnight (U.S. Time) to get home before the boarders were going to be closed. This meant I had to fly out of Delhi that night at the latest to make it. I was not able to change my flight with British Airways but was able to book a one-way flight home on KLM arriving in Boston on March 14th at noon. Throughout my flight,

Brad Newbury I grew concerned for my firefighters at the fire department I serve as a Shift Commander, and our staff and EMS students at National Medical Education & Training Center (NMETC) where I serve as the President/CEO. I pulled out my computer on the plane and began to write down a list of things I would have to do as soon as I hit the ground in Boston.

NMETC is located in West Bridgewater, Massachusetts about 30 miles south of Boston. We are a full-service Emergency Medical Services education school that was founded in 2010 by my wife Kimberly and me. Our school focuses on initial education and training of EMT’s and Paramedics. In 2006, I had created a unique live interactive hybrid online Paramedic program. I was able to prove the concept for online EMS programs and in 2010 we launched our school with both campus classes at our facility and an international hybrid online paramedic program. We began enrolling students in our hybrid programs from around the United States and across the globe. In 2015 we were awarded CAAHEP programmatic accreditation

for our paramedic program and our school began to grow rapidly. Our online programs are live and interactive held in virtual classrooms and supported by our learning management system. Students receive the same live lectures that our local students get at our school in person. In 2015, I conducted an academic comparative analysis study looking at our campus vs online/hybrid learners and we found that our online/hybrid learners had better outcomes than our campus students.

First stop from the airport was at NMETC to speak with our staff. When I walked in, it was business as usual. The staff were all working, and we had paramedic students in the skills lab going about their day.

I thought to myself, why did I come home early? I gathered our senior leaders, and we began discussing a number of issues we would face due to the National two-week travel ban to the U.S. Our Director of Student Services Lindsey Tanguay immediately brought up our Icelandic paramedic students who were due to travel to our school for skills lab starting on March 23rd. We made plans to notify our Icelandic students of the problem and let them know we were working on solutions. We had another major issue; we also had an entire cohort of paramedic students travelling to our school for skills training arriving on March 29th. The logistics began to weigh heavy on our staff as we needed to make some immediate decisions and notifications to our students. team in one of our classrooms and we discussed the challenges to come. After the meeting, our staff took their computers and all went home, “for two weeks”. Our business was well positioned to withstand the rigors of a pandemic (who knew?) the online administrative and educational infrastructure we had developed over the years allowed us to continue serving our students and never missing beat.

Wednesday, March 19th I met with our senior leadership team in our virtual classroom from my home office to make plans for the future. We asked ourselves what if this lasted longer than 2 weeks? What if, what if, what if! I serve as the Assistant Director of Prehospital Education for the Disaster Medicine

Fellowship at the Beth Israel Hospital in Boston, and we had studied pandemics and emerging infectious diseases. I had a sickening feeling this was not going to be over in 2 weeks, but I did not want to socialize my views just yet to our staff. had also received a directive from the Massachusetts Department of Health Office of Emergency Medical Services (OEMS) stating all in person lectures, skills training, clinical and field internship rotations had been suspended until further notice.

NMETC is a fairly large EMS institution and we now had hundreds of students impacted by the stayat-home order, the travel ban, as well as our inability to host skill labs at our campuses. I gathered our leadership team again in an online meeting, and we discussed the problem. We agreed we needed to communicate with our students but not just via email. Our students needed to hear from me personally and be able to ask questions. Lots

Monday, March 17th the Governor of Massachusetts issued a stay-athome order for non-essential workers and our skill labs came to a crashing halt. I gathered our entire One thing I knew we needed to do now, was to lead! Leadership is important in time of crisis and our team needed to communicate with our staff and our students. We made notifications to all our students that our online education would continue, and all scheduled campus lectures would be held online. The pivot was seamless as we already had over 10 years of experiences delivering online education to EMS students. As the “Bend the Curve” 2-week time out, moved beyond the 2 weeks we knew we were facing deep challenges at our school. Our scheduled lab skill trainings and our skills boot camps for our distant students would be impacted in a significant way. We of fear and unknown existed and the students’ concerns were valid. We scheduled Town Hall meetings with every class. I wanted to assure the students we would support them throughout this pandemic. We were all in this together and I wanted the students to know we understood their fears. I made a personal promise to each of our students that whatever happen, NMETC the organization and me personally would ensure they had an opportunity to finish our course and reach their goal. Those meetings were instrumental in calming the fears of our students and giving them an opportunity to get their questions answered from our team, even if we just reassured them, we would support them throughout this lock down. Once we communicated with students and staff, we began to think about ways we could support our students in a deeper way. Our educators began looking intimately

at our programs and we decided to dig in and create new resources and content for the students. We built additional lectures, made some new skills videos and created scenario recordings using multiple instructors online with some new technology in simulation. We then released it to our students.

Our leadership team also began to think about “What’s next?” What does opening back up look like? When do we think it will be? Based on all the information and data that we had we began making assumptions. Our best guess was to plan for a June 1st opening. The logistics were staggering, even if we were correct on the timeline, we had a huge uphill climb to recover for 3 months of skills training sessions which had been postponed. We also made contingency plans in case we were wrong on the

dates. Lindsay worked diligently to create numerous plans and shuffling dates and skills boot camps, and planning for what if the opening date became a moving target. One big challenge we also faced were the restriction state to state on travel. Each state began to allow travel with some severe restrictions on quarantining for 10-14 days, mask wearing and Covid-19 testing prior to and after travelling back home. Lindsay was spot on in her prediction and OEMS sent out a directive to all schools allowing in person skills training on June 1st, 2020. We still were not allowed to have live in person lectures on campus yet. A huge win for us however, the restrictions were severe. One of the largest challenges was the limited number of students allowed in one room at any given time. We had to create a plan of action which needed to be approved by OEMS as to how we were going to operate within the guidelines they required. Everything from temperature screening, Covid-19 questionnaire at the door prior to entering our school, to an extensive list of rules that must be followed throughout the student’s participation in the lab. With all the restrictions, we could not have one large cohort of student come all at the same time. We developed a plan to allow students to pick their skill session dates based on their ability to travel to our school. They could choose from five different bootcamps. We had to be flexible as the restrictions were constantly changing. The team came together to solve a number of problems, we asked each other hard questions that required real solutions. One in par-

ticular was “Can we get cadavers for our skills training?” Each cohort of paramedic students attends a cadaver lab at our school to help codify their intubation skills. The cadavers are flown in from around the country and delivered to our school. Was this going to be possible? We contacted the organization we work with, and they were excited to hear from us. The owner assured me they had plenty of specimens, as all the medical schools had stopped in person skills training. We needed this good news and it was full steam ahead!

OEMS required we train all of our instructor staff and students in the use of PPE. We developed online training programs and distributed the content to everyone required to have it. We developed an accountability tracking system to ensure everyone had taken the online course and we could prove it had been completed. Many would argue, the rules for businesses to continue to operate amidst the pandemic were challenging and at times unintelligible. Execute! We had a plan, built the Covid training and now we needed to get ready for our first group of students. We gathered our staff and educators to discuss the reopening plan with restrictions required by OEMS. Our team was excited to get back in the game and with mission to serve our students we were ready to safely open the school! The next 130 days would be a world wind of activity. Our plan had us catching up all of our EMT and Paramedic cohorts skills labs by December of 2020, a loft goal. In those 130 days, 118 of those days we held skills training at our campus. A

massive feat for our educators, a show of true commitment to our students and our mission. During the entire time we held skills training, from June 1, 2020, until today, we did not have one case of Covid-19 transmitted at our school! Clinical and Field internships were slow to open. This delayed a number of our students from completing their program. Our Clinical team, led by the Director Debra Downey worked tirelessly, to work with our hospitals and ambulances service partners to ensure a safe return of our students. Eventually a number of facilities and services began to allow students to continue their learning and our students became an integral part of the care of sick patients during the pandemic crisis. Although many were not able to care for known Covid patients due

to hospital policies, they supported the hospitals with helping care for the others and they collectively gained invaluable experiences. We learned many lessons along the way. Upon reflection, one of the major reasons for our success was our ability to lead through crisis and pivot to support our students in ways other educational institutions may not have. Our mission of training EMS providers “to take care of people” grew stronger as we knew our community needed our students to help immediately and be available for the future. The real disappointment came for our international students, specifically in Iceland as the EU travel ban to the U.S. remained in place throughout 2020 and continues to be in place as the writing of this article. We do anticipate the travel ban to be lifted by the end of the summer and we plan on welcoming our Icelandic students to a special skills training session just for them in September. Other countries, particularly from the Bahamas, St. Croix and Cayman Islands were allowed to travel to the United States by the fall of 2020, those students have been completing their programs.

The real heroes of our story are our students. They persevered through all the challenges the pandemic threw at them and came out the other side as certified/licensed providers ready to take the baton and lead the next generation into whatever our world has in store for them next. Many students struggled with lots of challenges. Some students overnight became teachers themselves to their children, the study time they used to have diminished as their jobs and EMS services needed their help taking care of their communities. They were on the front lines responding alongside our instructors, doing their duty and serving others during the worst pandemic in our lifetime. Through it all, we saw the resiliency of our future providers and it made me, our staff and educators proud to have had played an important part in their education. We look forward to watching their careers grow.

Bradford Newbury MPA, NRP

Bradford Newbury MPA, NRP is Captain/ Paramedic with over 36 years of experiences in firefighting and prehospital medicine. Brad also has an extensive background as an educator and as an innovative entrepreneur, where he serves as the President and CEO of National Medical Education & Training Center. Brad is a graduate of Harvard University’s T.H. Chan School of Public Health’s Division of Policy Translation and Leadership Development and the Harvard Kennedy School’s Center for Public Leadership’s- National Preparedness Leadership Initiative- Executive Education Program. He obtained a Master’s Degree in Public Administration from Anna Maria College (AMC) and a Bachelor’s degree in Fire Science from AMC as well.

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