In 2007, a group of educators came together and formed the Community Healthcare Emergency Collaborative (CHEC), with the charge to create an MIH-CP training curriculum that gives students the competencies, knowledge and professional skills to function as a community paramedic. They chose a community health worker curriculum as the basis, but expanded its medical aspects. The first course was taught in Minnesota by Hennepin Technical College in 2009.
A second edition of the curriculum was developed in 2010 for use by Colorado Mountain College in Eagle, Colo. A local education committee reviewed the four-module curriculum to determine what would work in the community. Twelve students took the course but only three completed the requirements—MIH-CP was such a new concept that the other nine students were enrolled to just “check it out.”
A new group of subject matter experts and educators were brought together in 2011 to review the second edition and revise it to the third and current version. The four modules were transformed into seven, expanding the student’s knowledge about the healthcare system, primary care and public health, the social determents of health, and cultural competency.
Heavy emphasis is placed on community, including patient navigation, conducting health assessments and creating a community-specific web of resources. A section on personal safety and wellness was added, as well as a clinical and lab section, which includes information about expanded history taking and assessments, documentation, and chronic disease management.
The curriculum’s structure is based on contact hours and clinical hours, and can be adjusted to meet the needs of the state, region or educational institution running it. The program has established competencies and a framework, which lists the minimum core specifications in receiving a certificate of completion. The curriculum was developed with the experienced provider in mind—students who lack a significant amount of prior EMS experience may not be successful in completing the program.
The length of the program is dependent on the level of the student entering the program. The core educational experience is a didactic course estimated at approximately 100–200 hours. Estimated hours for the clinical foundation also vary based on the education and experience of each student, but the MIH-CP services being provided and the need in the community also affects course duration, which ranges from 50–200 hours, averaging 100 hours.
Seeking to establish standardization and identify future goals for development, CHEC conducted a survey of the current and planned offerings of the curriculum in 2013. The results showed 35 colleges were teaching or ready to teach the curriculum and 12 were planning to teach it in the future. Since then, 12 additional courses are being taught and over 100 are in the planning phase.
California just used the CHEC MIH-CP curriculum in a statewide MIH-CP course for 13 regional MIH-CP pilot programs in February 2015. The didactic course was completed by 77 of 79 community paramedics in a six-week, fast-track course; they’re currently working on the site-specific clinical portion.
Evolution & Continuing Education
A new group of educators and subject matter experts who are running successful MIH-CP programs have come together to update the curriculum to the fourth edition. The changes will be made based on an extensive evaluation of MIH-CP courses and recent results from an institutional review board-approved study.
The CHEC is also involved in supporting and developing continuing education (CE) for MIH-CP providers, working with several conferences to provide CE sessions and identifying areas where the core curriculum can be expanded as the focus and scope of MIH-CP programs evolve.
Anne Montera, RN, BSN, is co-director of the team that’s updating the CHEC MIH-CP curriculum. She’s also a public health nurse consultant who works in grant coordination and implementation for various projects in Colorado and across the nation.