Module 2: Instructor Administration, E-Learning & Training Site Management

Steps to Become an AHA Instructor

Becoming an AHA Instructor involves 4 key steps:

1. Be accepted by an AHA Training Center (TC) before enrolling in an Instructor Essentials Course, with a completed Instructor Candidate Application on file.
2. Possess current AHA Provider status in the discipline for that Instructor Essentials Course and be proficient in all skills.
3. Successfully complete the Instructor Essentials Course (both online and hands-on sessions).
4. Be successfully monitored teaching a course within 6 months after completing the hands-on session.

Role of Faculty in Instructor Essentials Courses

Training Faculty (TF) play a critical role in teaching the hands-on session of the Instructor Essentials Course. Their responsibilities include:

• Facilitating discussions focused on desired outcomes.
• Listening to instructor candidates' responses and providing feedback.
• Observing and coaching instructor candidates' actions.
• Giving positive and corrective feedback.
• Keeping discussions and activities on track.

Course Preparation: Room, Materials & Staffing

Careful preparation is essential for a successful Instructor Essentials Course. This includes:

• Room Requirements: Ensure good acoustics, cleanliness, adjustable bright lighting, instructor-controlled video, adequate seating, and firm surfaces for skills practice.
• Course Materials: Obtain all necessary equipment, support materials (posters, pocket reference cards), and course completion cards from your TCC or an AHA distributor.
• Faculty-to-Instructor Candidate Ratio: Ideally, 1 faculty member should conduct an Instructor Essentials Course with up to 7 instructor candidates (1:7 ratio) to facilitate group activities and individual coaching.
• Using Lesson Plans: Review lesson plans before the course to understand objectives, your role, and needed resources. During the course, follow lesson plans, ensure resources are ready, and help candidates achieve objectives.

Overview of AHA eCards

The AHA is transitioning to **eCards** as the primary course completion document. eCards offer enhanced security, efficiency, and convenience compared to traditional paper cards.

Benefits of eCards:

• More secure with a 3-point verification (TCC, Instructor, Student).
• Information is populated electronically, reducing errors.
• Easily verifiable by employers online.
• Can be issued immediately, reducing student wait times.
• Reduces paperwork and administrative costs.
• Students can print a physical copy (full or wallet-sized) if desired.

Issuing eCards to Students

Only TCCs (or designated TC representatives) can order eCard inventory. eCards can be issued to students through the AHA Instructor Network in a few ways:

• TCCs/TC Admins/eCard Location Admins can assign eCards to Instructors for distribution to students.
• TCCs/TC Admins/Instructors can issue eCards directly to students using the "Assign to Students" link.
• eCards can be issued via the Roster Manager screen by checking student names and clicking "Assign eCards."

Claiming and Viewing eCards (for Students)

Students claim their eCard via an email link from `eCards@heart.org`, or by visiting the eCards Search page and entering their details. They must confirm information, set up a security question, complete a survey, and then can view, save, or print their eCard. Students can also opt-in to claim/view their eCard via SMS text.

Employers can verify an eCard on the eCards Search page using the eCard Code.

eCard Security & Accountability

• An eCard issued to a student but not claimed **cannot be reclaimed by the TC/Instructor and re-issued** to another student.
• The edit function is only for misspelled names or business email changes of the original student.
• Instructor's ID number (assigned by the Instructor Network) must be included on all provider cards.
• TCs cannot sell or give course completion cards to other TCs or non-AHA organizations.
• Course rosters contain personal data and must be protected; never give a roster to a student in place of a card.
• All course completion cards must be in students’ hands no later than **20 business days** after the course completion date.

Validity Period: All AHA course completion cards are valid for two (2) years through the end of the month in which they were issued, with the exception of Heartsaver Bloodborne Pathogens (one year).

Replacement of Lost/Damaged Cards: TCs are responsible for reissuing replacement cards if lost or inaccurate, using the same dates as the original. Do not refer students to the AHA for replacements. Students can access their eCards at ecards.heart.org/student/myecards.

Requirements for Instructor Alignment

An Instructor candidate must complete all requirements and align with an approved primary AHA TC to be authorized to teach and issue course completion cards.

• No fees are paid to the AHA for alignment; any TC fees are discretionary.
• TCCs may require a meeting or monitoring by a designated TF before acceptance.
• TCs may deactivate an Instructor for non-compliance with AHA or TC policy.
• TCs are not obligated to accept all Instructors; they determine who to keep on their roster.
• An Instructor may align with more than one TC (secondary alignment).
• All aligned Instructors must adhere to AHA guidelines.
• Instructor candidates taking an Instructor Course at the TC they will align with need a valid provider card, successful Instructor Essentials completion, meet TC requirements, and be monitored teaching their initial course within 6 months.
• If aligning with a different TC, a signed Instructor alignment agreement is needed, and the new TC will monitor the initial course.

Instructor Development: Teaching, Mentoring & Renewal

The AHA encourages continuous professional development for Instructors. Key aspects include:

• Interfacing with Instructors: TCs are responsible for providing guidance, current information (Bulletins, Memos), conducting updates, and maintaining accurate Instructor records.
• Instructor Renewal Criteria: Instructor status can only be renewed by TF at the Instructor's primary TC. Criteria vary by discipline (refer to the Instructor Manual), but typically involve teaching a minimum of 4 courses (ILT or skills portions) every two years and attending required updates.
• Special Exceptions to Teaching Requirements: Waivers or extensions may be granted for active military duty, illness/injury, or limited course offerings, at the discretion of the TCC in consultation with TF.

Instructor Deactivation & Revocation Process

• Deactivation: For eCards, the original issuing TC emails `Atlas.support@heart.org` with specific Instructor details and reason. This action cannot be reversed, and inventory is not returned.
• Revocation: A decision by the AHA, meaning the privilege to claim Instructor status, align with a TC, and issue cards is no longer allowed. Reasons include falsification of records, non-adherence to guidelines/curricula, issuing non-AHA cards, continued poor instruction after remediation, exam security breaches, or inappropriate conduct.

Instructor Roles & Titles for RQI or HeartCode Complete (HCC)

For TCs participating in Resuscitation Quality Improvement (RQI) or HeartCode Complete (HCC), Instructors may hold specific roles:

• **Instructor — Quality Implementation:** Change agents, orient staff to protocols, support digital education, identify/resolve concerns.
• **Instructor — Advanced Resuscitation Quality:** Team training, mock codes, prebriefing/debriefing, analyze performance trends.

These roles have specific renewal criteria. An Instructor teaching classes and performing RQI/HCC roles can hold both statuses, but both must be maintained every two years to continue teaching in the classroom.

Training Sites (TS) Overview

An AHA Training Site (TS) operates with the authorization of an AHA TC. US TCs are required to provide TS information on Atlas. Minimum requirements for a TS include:

• Has a business legal name.
• Teaches AHA courses according to official AHA Guidelines.
• Maintains at least five AHA Instructors who train more than a combined 250 people each year.
• Owns and maintains all equipment needed for teaching AHA courses, including manikins with feedback devices (equipment may not be borrowed from the TC).
• Meets minimum technical requirements (latest browser, knowledge of AHA Training Network applications).

TS Responsibilities & Management

A TS must:

• Conduct AHA courses following PAM guidelines and discipline-specific Instructor Manuals.
• Meet the same standards as TCs for equipment and Instructors.
• Maintain course and Instructor records (same as TC requirements) and submit reports to the TC.
• Appoint a coordinator approved by the TCC, and TCC must designate TF for each discipline taught at the TS.

The TC is responsible for ensuring its TSs comply with all policies and procedures outlined in the manual and the TC's own policies. A signed letter of agreement/understanding should be on file with each TS.

Training Boundaries & International Recognition

Within the United States: TCs (including affiliated Instructors and TSs) may only offer courses in the geographic territory defined as the United States (excluding territories like Puerto Rico, Guam, etc.).

Training Outside of Home Country: Requires special permission from AHA’s ECC International Department due to quality assurance and legal complexities. An International Training Application must be submitted at least 6 weeks prior. AHA Instructors must comply with the Program Administration Manual—International Version.

Recognition of Status:

• Provider Card: Recognized by all AHA TCs worldwide.
• Instructor Card: Recognized nationally and internationally. Instructor status supersedes provider status; a valid Instructor card means provider status (for the same discipline) is current.
• Training Faculty: TF appointment is not transferable between TCs. A TF member transferring to another TC will need to re-establish TF status with the new TC.
• Heart and Stroke Foundation of Canada (HSFC): HSFC Provider cards are recognized by AHA for admission to renewal or Instructor Essentials courses. HSFC Instructor cards are recognized by AHA TCs in the same way as an AHA TC-issued Instructor card.

AHA Course Formats

AHA offers various course formats to provide flexibility in educating healthcare professionals and lay responders:

• Instructor-Led Training (ILT): Traditional classroom-based courses taught by an instructor.
• Blended Learning (eLearning / HeartCode®): An online instructional portion followed by a hands-on skills session (practice and testing) with an AHA Instructor or a compatible manikin system.
• Resuscitation Quality Improvement® (RQI®): A proprietary AHA program for continuous, low-dose, high-frequency training to support mastery of high-quality CPR skills in the workplace.

Flexibility Options: Instructors can tailor courses using optional lessons, practice sessions, and adjusting lesson flow, while adhering to core curriculum. For instance, in Heartsaver, instructors can use customized agendas like Office or Educator specific outlines.

Instructor Material Requirements: All Instructors are required to have their own current copy of Instructor Manuals and Provider Manuals/Student Workbooks for each discipline they teach.

Student Assessment: Exams & Skills Testing

To receive a course completion card, students must attend and participate in the entire course, pass required skills tests, and pass required exams.

Provider Course Exam:

• Must use the current version of the exam, accessed by TCCs on Atlas.
• Exams are copyrighted; cannot be altered or posted online.
• Administered in a proctored setting (for ILT).
• **Open-resource policy:** Students may use reference materials (Provider Manual, notes, Handbook, etc.) during the exam. Open resource does not mean open discussion.
• No AHA-mandated time limit for completion, but TC/Instructor can determine one.

Provider Course Skills Testing:

• Instructors evaluate each student's didactic knowledge and proficiency in all core psychomotor skills.
• No AHA course completion card is issued without hands-on manikin skills testing.
• AHA no longer offers a "challenge" option; all students must complete a provider course every 2 years.
• Instructors have flexibility in hands-on sessions (e.g., breaking up agenda, 1:1 student-to-manikin ratio, mock codes).

Remediation

If a student does not pass a skills test or exam, they require **remediation**. This is the opportunity to review the material immediately after the test. Remediation is not provided *during* a test.

• Instructors guide students to identify and resolve weaknesses.
• After remediation, students retake the skills test or an alternate version of the exam.
• If remediation is unsuccessful, students must retake the provider course.

Virtual Training Options & Guidelines (HeartCode BLS)

The AHA provides guidelines for conducting virtual skills sessions for HeartCode BLS. Key points:

• **Class Size:** Should not exceed a 3:1 student-to-Instructor ratio; combined courses are prohibited.
• **Individual Testing:** Virtual skills testing must be done individually (1 Instructor:1 student) via breakout rooms or individual appointments.
• **Instructor Requirements:** Must be BLS-aligned and current, and be monitored teaching at least one virtual course with each renewal.
• **Student Prerequisites:** Students must complete the HeartCode BLS online portion and confirm their online completion certificate.
• **Equipment:** Students must have all required equipment on-site (AED trainer, manikins, pocket mask, etc.) for live video observation.
• **Technical Requirements:** Adequate sound and camera positioning are essential for assessing high-quality CPR; sustained loss of connection requires rescheduling.

Note: As of September 1, 2023, virtual skills are **not allowed** for advanced healthcare provider courses (ACLS, PALS, PEARS, ACLS EP). Virtual training remains an option for Heartsaver-level courses.

AHA Seal Usage Guidelines

The **ECC Authorized Training Center (TC), Training Site (TS), Training Center Coordinator (TCC), and Aligned Instructor Seals** promote affiliation with the AHA. Strict guidelines govern their use to maintain brand integrity.

Rules for Use:

• Seals must be used by authorized entities (valid TC Agreement, aligned TS, current Instructor card).
• Must always contain a line defining the TC affiliation (e.g., "[TS name] is aligned with [TC name] in [City, State, Country]").
• Must conform to AHA standards and Branding Guidelines, and be enforced by the TC.
• Must be used in its entirety with all three elements (AHA logo, red/gray circles, text).
• Must be used with reference to AHA ECC, CPR, First Aid, or other lifesaving courses.
• Must be visually separated from the TC/TS/TCC/Instructor logo by clear space.
• Must be smaller in height and width than the TC/TS/TCC/Instructor name/logo (ideally 50% or smaller).

Permissible Uses: Seals may be used on schedules, announcements, brochures, flyers, posters, temporary automobile signage, AHA ECC course advertisements (print and online), web pages, telephone directory/Yellow Pages ads, and email signatures, provided all conditions are met.

Prohibited Uses: Seals **may not** be placed on letterhead, business cards, permanent building signage, specialty items (cups, pens, T-shirts), supplementary educational materials not published by the AHA, or non-AHA textbooks/charts. They should also not be used on any advertisement or notice that does not exclusively refer to an AHA ECC course.

Teaching Observation Tool (TOT)

The **TOT** is a voluntary tool designed to help resuscitation educators improve their teaching through **peer coaching**. It focuses on thoughtful observation to facilitate collegiality and experimentation among instructors. The observer learns from the teacher by looking for effective strategies, and then peer educators meet to discuss key strategies.

Key Points:

• Not a mandatory evaluation; its purpose is not to grade or pass/fail instructors.
• Eliminates formal structured feedback in favor of collaborative improvement.
• Focuses on the idea that improving student performance requires a complex set of teaching skills.

Reference & Resources

The AHA provides various resources to support Instructors:

• **Acronyms:** A comprehensive list of AHA-related acronyms (e.g., ACLS, BLS, ECC, PAM, TCC, TF, TS).
• **US AHA Phone Numbers:** Dedicated support lines for TC inquiries, general inquiries, and eLearning technical support.
• **Atlas (atlas.heart.org):** The primary platform for TCs and Instructors, providing up-to-date resources, reference information, survey opportunities, and electronic submission of reports.
• **PAM Forms:** PDF forms for Instructor Candidate Applications, Training Faculty Candidate Applications, Instructor Records Transfer Requests, etc.
• **Scientific Statements:** Access to relevant scientific literature, such as "Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest."