ABSTRACTS
Expanding Access: How Higher Education Leaders Drive InnovationAuthor: Nichole S. Berge PhD, NRP | EMS Director/Adjunct Facutly | North Fork Special Service District Associate Authors:
Introduction Rural communities experience persistent gaps in access to Emergency Medical Services (EMS) education, limiting career opportunities and contributing to health disparities. While previous studies have described barriers to rural EMS training, little is known about how higher education leaders develop innovative programming to address these challenges. This study explored the lived experiences of leaders implementing EMS programs designed to improve access for rural students. Methods A transcendental phenomenological design guided this qualitative study. Purposeful sampling recruited 13 higher education leaders responsible for EMS education in the United States. Participants completed a three-part data collection process, including qualitative questionnaires (n=13), semi-structured individual interviews (n=11), and focus groups (n=2), conducted virtually via secure video conferencing. Data was analyzed using the modified van Kaam method to identify common themes. Credibility was supported through triangulation, member checking, and peer debriefing. Results Three primary themes emerged: (1) Cognitive Commitment to Rural Equity, where leaders viewed expanding EMS access as an ethical obligation; (2) Behavioral Flexibility in Leadership, reflected in the use of hybrid delivery models, adaptive scheduling, and local faculty to increase participation; and (3) Environmental Constraints and Support, highlighting how institutional backing and community partnerships enabled innovation while policy barriers and limited funding impeded progress. A subset of leaders reported internal resistance to change among faculty and discomfort with online tools among students. Conclusions Higher education leaders play an essential role in reducing EMS education disparities in rural areas by developing flexible and innovative programming. Findings suggest that sustained institutional commitment, adequate funding, and policy advocacy are necessary for long-term success. Limitations include a small, purposefully selected sample and reliance on self-reported perceptions, which may affect generalizability. Future research should examine the impact of these leadership strategies on student outcomes and workforce development.
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