I am a certified State License Test Evaluator. Over the past eight years I have seen testing for EMT B and I levels devolve from scenario-based skills testing - requiring assessment, life threat treatments, and patient packaging - to an assessment with stated interventions and one skill being demonstrated, to the newly proposed paper examination only test.

I believe this progression (or regression) will be dangerous for future patient care and will reflect badly on the professionalism of EMTs as well. The liability implications in allowing newly minted EMT's to enter the prehospital care arena (especially in volunteer services) with no certification of their ability to actually perform hands-on patient care is staggering.

State testing was also supposed to provide feedback to training institutions on perceived shortfalls in both didactic and psychomotor realms of learning. With the removal of skills assessments for licensing, only assessment and basic knowledge will be tested. The State says it is relying on training institutions to certify skills however the level of psychomotor training differs from institution to institution depending on the amount of practice time allocated and given and the skill of the instructors.

I would like to solicit comments from this board on this matter...

Thank you

This is an old post - over 6 months, but I concur. I am a Federal agent that was a local police officer and sergeant for 10 years prior. I am just now going National in EMT - Basic training. Taking the NREMT soon. Scenario based training is always relevant and preferable over written materials and 'memorization of key terminology' only based examinations. I think at the National level there is a concern that we don't have enough practicioners. The 'dumbing down' effect happens when you want more folks to get their foot in the door. I do think that States' and National do rely on the schools and the service providers to develop the skills before and after testing. So the idea is the test as many as you can to pass, then let the providers field train their folks to standard, after the schools have taught the very basic skills needed to 'begin'. We have to remember that different folks have different skillsets when it comes to tests. So, a practical, scenario based written and psychomotor is great - but should not be the all decision making authority. In the same vain, some are great at written didactic stuff, but not so great in practicals...