Preparedness of the Emergency Medical Services Educational System: Pandemic Barriers and Adaptations.

Objectives: The emergency medical services (EMS) educational infrastructure plays a critical role in maintaining a resilient and stable EMS workforce. Clear disaster preparedness strategies/initiatives are needed to maintain this pipeline during emergencies. Our objective was to build a basis for the EMS educational program's disaster preparedness planning by identifying educational barriers and adaptations experienced through the COVID-19 pandemic. Methods: We held focus groups with EMS educational program directors (PDs) to identify educational barriers and the adaptations they used during the COVID-19 pandemic. PD participants discussed topics in small online groups of 3-6 PDs and 2 facilitators. Thematic analysis was performed to identify emerging themes. Initial coding of the transcribed conversations was performed with themes aggregated and categorized as barriers or adaptations. Results: A total of 35 PDs were enrolled across 8 focus groups. Barriers and adaptations were grouped into 6 domains: regulatory, primary institution/program, faculty/educators, technology use, curriculum, and students. PDs and faculty noted increased workload, increased feelings of stress, and uncertainty in situations where online learning was not in place. New or enhanced technology implementation was essential to program continuation. Program, lab, and clinical structures changed substantially with a rapid increase in the use of simulation, scenarios, and distance learning to adapt to the lack of clinical and field sites. Conclusion: As EMS initial educational programs addressed the pandemic, significant barriers resulting in unique real-time adaptation were noted. To prepare for future educational interruptions, lessons learned from previous widespread system interruptions can be leveraged for informed educational system disaster planning.