Priority	Rationale
Affective competency outcomes during COVID	Interpersonal relationship building and de‐escalation skills are necessary to ensure affective domain competency. The lack of in‐person assessment and patient interaction should be investigated to ensure we continue to meet affective competency.
Alternatives to clinical rotations	With limited access to clinical rotations, we should identify alternatives such as simulation lab, telemedicine, or field internship.
Changes in student characteristics	We should understand if student demographics and volume has changed from pre‐ to post‐pandemic.
Cognitive competency outcomes during COVID	Has COVID impacted the ability to reach competency in the cognitive domain? As programs adapted to COVID, it is unclear if student outcomes differ pre‐ and post‐pandemic, including impact on certification examination success, the role of distance learning and simulation, and program requirements for completion.
EMS education program availability and accessibility	Education programs should remain open and accessible to students. It is unclear how many are still operating, if class offerings or sizes differ (eg, only day vs day and night prior), and the impact of these changes.
Faculty availability, structure and size	We should understand if faculty demographics, size, and structure have changed from pre‐ to post‐pandemic. This includes availability of faculty to teach, education of faculty to teach on different platforms, shifting of lecturers to simulation instructors, and attrition of current educators.
Faculty health and safety	Faculty must be kept safe while performing in‐person instruction. Their perceptions of risk are unclear.
Faculty stress and anxietya	Understanding of faculty mental health concerns is necessary. COVID‐related stresses can lead to increased mental health concerns that should be recognized and explored.
Future of EMS education after the pandemic	The changes programs made in response to COVID have changed EMS education. How will future graduation rates be impacted? Will these changes continue beyond the pandemic?
Hospital/ambulatory site access	EMS programs rely on both hospital and ambulatory sites to meet continued competency. Programs need advocacy assistance in removing barriers (eg, liability, PPE, shortages of personnel and preceptors, and inherent value of EMS workforce) to keep these experiences available.
How is and how much simulation is being used	EMS education programs are increasingly using simulation technology in various ways. We need to understand the ways simulation is used, the simulation curriculum being developed, and impact on ability to interact with patients.
Impact of lack of field and clinical experience	It is unclear if there is an impact on student and patient outcomes if field and clinical experiences are limited.
Impact of program changes on future employment	The students who are completing programs adapted during the pandemic must still meet the needs of employers.
Keeping EMS education accessible for all students	Distance learning creates obstacles for students and educators, such as internet infrastructure and assuring access for students with different needs.
Medical director involvementa	Medical director approval of pandemic related changes is necessary. The extent to which medical directors are involved with educational changes and program advocacy is unclear.
Pandemic‐specific topics of education	Specific topics are unique to COVID and should be considered when educating students. These include airway management, cardiac arrest management, handling of death and dying patients, and appropriate use of PPE.
Prehospital internship access	EMS programs rely on pre‐hospital internship access to ensure competency. Programs need advocacy assistance in removing barriers (eg, liability, PPE, shortages of personnel and preceptors, and funding) to keep these experiences available.
Program funding	With the increase in alternative EMS education platforms, the impact on costs and funding models is unclear.
Program instruction changes due to COVID	Programs have made changes in response to the pandemic, including transitioning to online/distance learning, flipped classrooms, and independent study. The effectiveness and impact of these changes are unclear.
Psychomotor competency outcomes during COVID	Has COVID impacted the ability to reach competency in the psychomotor domain? As programs adapted to COVID, it is unclear if student outcomes differ pre‐ and post‐pandemic, including the role of simulation and requirements for completion.
Recruitment/enrollment	We need to understand current demands, barriers to recruitment and enrollment, and needs for the EMS education pipeline. These include perceptions of risk, accommodating diversity in student populations in recruitment efforts, and detailing the value of EMS education.
Regulatory body requirementsa	Programs are responsible to sometimes multiple regulatory bodies to provide evidence of student competency. How do programs continue to define competency in order to meet regulatory standards?
Simulation accessibility	All EMS education programs and students should have access to simulation. It is unclear if programs can afford simulation labs or have training to provide this type of education.
Student health and safety	Students must be kept safe during clinical and field internships. Students should be trained in proper use and have access to PPE. Students are also facing increased life stress.
Student perception of competencya	Confident student self‐perception is important to morale building. Do students feel competent to practice having missed significant portions of in‐person learning and practice?
Student stress and anxiety	Understanding of student mental health concerns is necessary. COVID‐related stresses can lead to increased mental health concerns that should be recognized and explored.
Substitution of simulation for clinical/field contacts	It is unclear how simulation can or should replace live patient encounters. What are the differences between learner and patient outcomes with simulation versus real world learning? Can minimum entry‐level competency be obtained with simulation alone? How does this compare to practices for physicians and nurses?

Abbreviations: EMS, emergency medical services; PPE, personal protective equipment.

^aAdded in Round 2.