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State Testing Changes


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#1 octopusrex

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Posted 22 August 2009 - 06:41 AM

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

#2 inteldawg1970

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Posted 09 February 2010 - 10:42 AM

QUOTE (octopusrex @ Aug 22 2009, 07:41 AM) <{POST_SNAPBACK}>
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...

#3 ScottR

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Posted 29 September 2010 - 11:09 PM

Just to bump this discussion again.

Each state is different in how it requires testing for the psychomotor evaluations. I have been talking with state EMS agencies nationwide over the past 12 months and there is a very diverse field out there in how psychomotor performance is evaluated. Many states are still requiring the state administered psychomotor test. Others require the training program to verify. In my opinion, the training programs are more qualified to do this than the states. And I say this carefully... A state administered psychomotor examination is a snapshot of a student. It really truly only requires rote memorization on the part of the students for %90 of the skills sheets. The only sheets that require any additional thinking are the patient assessment for medical and trauma, and these can be memorized well enough to get through. A legitimate education program sees the entire progression of the student through the psychomotor portion of the education. Instructors get to evaluate how a student is really performing over a period of time, and not at a single attempt at a station. I believe that the educational programs should be administering a psychomotor exit test as well the mirrors the state test, but that they should have corrected any deficiencies in the student prior to the end of formal education. The state administered exams are a large expense to taxpayers that I don't think fully assess to the same level as a competent instructor would.
The catch to this thought is that you still have to worry about those programs that just take the money and feed the students out the other side with little regard for their ultimate success as a care provider. This is where I feel the state roles should come to play. All educational programs should be monitored, and their student success rate watched. If they are having a large failure rate on the 1st attempt at the NREMT exam, this should be a huge red flag that something is wrong. I think site visits and state 'accreditation' should be used as a checks and balances on the education programs.

I say all this because I am in a state the requires a state psychomotor exam, and it is an added financial burden to students, state, and the program to deal with. My student success rate on the state psychomotor is exceptional as is the 1st time pass rate of our students on the NREMT exam. This is due to the fact that our students all must pass every NREMT skills station for their level prior to graduating our program. My students spend a large amount of time working with fully scripted and moulaged patients during their training, in real to life scenarios. We expect our students to be good enough to treat our family members when they graduate and keep that goal before all our instructors.

It is a catch 22 either way. My biggest issue is the lack of consistency at the EMT-Basic level nationwide. At least at the advanced level there is NREMT consistency nationwide. Maybe the new Educational Standards will help in this area. I'm sure it will be debated long after I'm gone.



Scott