This course must follow the guidelines established by the NC Office of EMS. The Office of EMS must approve courses that include portions delivered via distance education. The curriculum for the Paramedic Refresher Educational program shall be the 2009, or most current release of the United States Department of Transportation (US DOT) National Highway Traffic Safety Administration (NHTSA) National Education Standards. The Paramedic Refresher Educational program must be conducted by an approved Advanced Educational Institution as defined in the rules of the North Carolina Medical Care Commission. The lead instructor for the Paramedic Refresher Educational program must be a NC credentialed EMS Instructor as defined in the rules of the North Carolina Medical Care Commission. Student prerequisite/entry requirements: Currently holds a valid North Carolina, NREMT or other State EMS Credential at level or a North Carolina EMS Credential (Paramedic) that has expired within the last two (2) years.