CONTINUING EDUCATION COORDINATING BOARD OF EMERGENCY MEDICAL SERVICES
CE Hour Assignment Guidance
Purpose:
To provide guidance for CECBEMS reviewers in the determination of hour assignments for Distributed
Learning accreditation applications.
Background:
The Continuing Education Coordinating Board for EMS (CECBEMS) is a continuing education (CE)
accrediting body that services educational institutions, not-for-profit educational organizations and forprofit companies that provide emergency medical services CE. The CECBEMS Board of Directors is
comprised of one appointee and one alternate from each of nine sponsoring organizations including
NAEMT, NAEMSP, NASEMSD, ACEP, NAEMSE, NCEMSTC, NREMT, ACOEP and AHA. The
sponsoring organizations are also charged with appointing, from within their membership, educators that
serve CECBEMS as volunteer accreditation application reviewers. The reviewers selected are physicians,
nurses, paramedics and Emergency Medical Technicians (EMTs) who have demonstrated expertise in
EMS operations and educational practice.
CECBEMS recognizes that Distributed Learning (DL) is an instructional model that allows instructor,
students, and content to be located in different, non-centralized locations so that instruction and learning
occur independent of time and place. The distributed learning model can be used in combination with
traditional classroom-based EMS continuing education, can operate independently as a traditional
distance learning course, or can be used by educators to operate a virtual classroom through television,
satellite, telephone, or Internet technology.
While a variety of distribution methods are available to the EMS educator, CECBEMS is particularly
aware that the Internet-based World Wide Web (WWW) by its very nature is an efficient method to
distribute educational resources and information rapidly. We expect that as technology improves, and
access to high speed connections to the Internet increases, more and more EMS personnel will be in a
position to benefit from education delivered on-line. Further, the volunteer EMS community comprises
greater than 90% of all EMS providers. These providers are often hindered from seeking CE hours by
extended travel time from rural areas wherein attractive CME programs may be hours away. The ease
and convenience of completing required CME from the comfort of one’s home or station house computer
makes DL based CME programs very attractive.
The rapid growth of EMS practice-related DL offerings has required CECBEMS to establish a specific
review procedure for DL applications and a DL policy to help guide applicants in accreditation
requirements. Further, just as DL applicants have had to adapt, the non-traditional/DL offerings have
proven difficult for some reviewers to accept. Unlike the traditional classroom setting, DL presentations
are not governed by an instructor. The presentation rate or content breadth cannot be immediately
adjusted based on concurrent student feedback. Nor can the student have direct contact with the presenter
that allows for adaptation of the presentation to meet the student’s needs. In the DL format, the rate of
presentation/absorption and subsequent comprehension of the presented material is completely dependent
on the reading comprehension skill-level of the student/reader. (1,2)
Reviewers of DL accreditation applications are required to identify several requirements such as
timeliness of references, well-defined objectives, course pre-requisites and retrospective feedback
mechanisms. Reviewers are also asked to recommend the number of CE hours deemed appropriate for
each presentation based on applicant request, length of presentation and the time required for the reviewer
to complete his/her assessment. This particular phase of the review process may be considered overly
subjective as it is based on the reading speed and comprehension skill level of the reviewer and not of the
average student/reader. The accomplishments and acknowledgements of individuals who are selected by
CEH Assignment Guidance
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CONTINUING EDUCATION COORDINATING BOARD OF EMERGENCY MEDICAL SERVICES
CECBEMS’ sponsoring organizations to become reviewers may also indicate well-developed reading and
comprehension skills that may not be representative of typical EMS providers.
A review of current literature describes the average adult reading speed at 150-250 words per
minute.(1,2,3,4,5,6,7,8,9,10)
Rationale:
Applicants request Continuing Education Hour (CEH) credit assignments that consistently differ from
what CECBEMS reviewers are willing to assign. The lack of a standard CEH policy creates subjectivity
causing confusion and dissension that undermines the accreditation process. Therefore, an objective CEH
assignment guidance is necessary.
By providing this document, the CECBEMS Board of Directors hopes to provide its reviewers with
objective guidelines toward the assignment of CEH for DL applications. Further, we expect to reduce or
eliminate a common complaint among applicants, increase consistency between reviewers and
standardize the application review process.
CEH determination:
Each presentation is comprised of a finite number of written words that are “consumed” by the reader in a
finite amount of time. On average, adults read between 150-250 words per minute. (1,2,4,8,9,10) Thus, a onehour presentation will consist of roughly 10,000 words with appropriate charts, graphs and case
presentations that support the written objectives. Current literature suggests that student interest and
comprehension decrease dramatically after the first hour of any CE session. Therefore, any applicant
requesting more that one hour’s worth of CE will be required to provide justification for such by
matching course objectives with additional content. Further, applications that request two or more hours
should be broken up into hour-long presentations as “volumes” of the subject matter presented, e.g.
advanced airway-1, advanced airway-2, etc. The examples outlined below will be used to assist you in
determining appropriate CEH designations for each application.
Discussion:
We know that DL presentations have a varying degree of difficulty. A lesson on how to apply an arm
splint is typically not as challenging as a presentation on 12 lead EKG interpretation. Therefore, it is
necessary that we apply some uniform means of increasing CEH determinations based on “degree of
difficulty” of the presented material. CECBEMS reviewers are asked to increase CEH assignments by
0.5 hours above the initial hour if the presented material can reasonably be considered complex and the
objectives are supported by content.
Lastly, DL presentations should include a post-test that complies with the CECBEMS item-writing
policy. Please add an additional 10 minutes for every 10 questions in the post-test.
Example 1:
A DL application contains a BLS presentation review of basic airway techniques, including measuring
and insertion of NPA and OPA and bag valve ventilation. The material is limited to simple terms and no
new techniques are discussed. The applicant supplies a presentation length of 10,000 words.
10,000 words / 200 words per minute = 50 minutes
10 question post test that meets CECBEMS item writing standards = 10 minutes
Total CEH assignment for 10,000 word presentation = 60 minutes
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CONTINUING EDUCATION COORDINATING BOARD OF EMERGENCY MEDICAL SERVICES
Example 2:
An applicant submits a 16,000-word program on the Recognition and Treatment of Chest Trauma. The
presentation is very detailed and includes illustrated x-rays, diagrams, CT scans and arterio-grams that
depict chest anatomy and clinical representations of various trauma-related chest abnormalities. Included
in the discussion are detailed treatment guidelines and a comprehensive chart that aids in the diagnosis of
various trauma-related complications.
16,000 words / 200 words per minute = 96 minutes
CECBEMS reviewer assignment based on degree of difficulty = 30 minutes
20 question post test that complies with CECBEMS item writing standards = 20 minutes
Total CEH assignment for detailed 16,000 word presentation = 146 minutes
For this program we can comfortably assign 2.5 hours (150 minutes) of CEH time.
Please refer to the following chart for CEH assignments:
CECBEMS CEH Determination Chart
Length of
Presentation
10,000 words
Minutes
Assigned
Posttest
Added Degree
of Difficulty
Total
Hours
Posttest
Total with 20
Q P-T and DOD
50
10
60
1
30
1.5
20
1.83
11,000 words
55
10
12,000 words
60
10
65
1.08
30
1.58
20
1.91
70
1.16
30
1.66
20
1.99
13,000 words
65
14,000 words
70
10
75
1.25
30
1.75
20
2.08
10
80
1.3
30
1.83
20
2.16
15,000 words
16,000 words
75
10
85
1.4
30
1.91
20
2.24
80
10
90
1.5
30
2
20
2.33
17,000 words
85
10
95
1.58
30
2.08
20
2.41
18,000 words
90
10
100
1.6
30
2.16
20
2.49
19,000 words
95
10
105
1.75
30
2.25
20
2.58
20,000 words
100
10
110
1.83
30
2.33
20
2.66
21,000 words
105
10
115
1.91
30
2.41
20
2.74
22,000 words
110
10
120
2
30
2.5
20
2.83
23,000 words
115
10
125
2.08
30
2.58
20
2.91
24,000 words
120
10
130
2.16
30
2.66
20
2.99
25,000 words
125
10
135
2.25
30
2.75
20
3.08
26,000 words
130
10
140
2.33
30
2.83
20
3.16
27,000 words
135
10
145
2.41
30
2.91
20
3.24
28,000 words
140
10
150
2.5
30
3
20
3.33
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Total Hours
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CONTINUING EDUCATION COORDINATING BOARD OF EMERGENCY MEDICAL SERVICES
References:
1. Bailey, R.W. (1996). Human Performance Engineering: Designing High Quality Professional User
Interfaces for Computer Products, Applications and Systems, Prentice-Hall: Upper Saddle River, NJ.
2. Bailey, R.W. and Bailey, L.M. (1999). Reading speeds using RSVP, User Interface Update – February
1999.
3. Karat, C.M., Halverson, C., Horn, D. and Karat, J. (1999). Patterns of entry and correction in large
vocabulary continuous speech recognition systems, CHI 99 Conference Proceedings, 568-575.
4. Lewis, J.R. (1999). Effect of error correction strategy on speech dictation throughput, Proceedings of
the Human Factors and Ergonomics Society - 1999, 457-461.
5. Omoigui, N., He, L., Gupta A., Grudin, J. and Sanocki, E. (1999). Time-compression: Systems
concerns, usage, and benefits, CHI 99 Conference Proceedings, 136-143.
6. Williams, J. R. (1998). Guidelines for the use of multimedia in instruction, Proceedings of the Human
Factors and Ergonomics Society 42nd Annual Meeting, 1447-1451.
7. Ziefle, M. (1998). Effects of display resolution on visual performance, Human Factors, 40(4), 555-568
8. Gresswell, B (1998) . An Evaluation of the Advanced Reading Course. Unpublished dissertation for the
Master of Science degree in Educational Psychology, University of NewcastleTyne, United Kingdom,
www.anglefire.com/nb/improvedreading/science, accessed 6/24/03.
9. http://www.Stepware.com, accessed 6/24/03
10. http://www.the-reading-edge.com, accessed 6/24/04.
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