Controversial Exam for D.C. EMT's

[under-dreaming]

This is why it is important to stay nationally registered. Stay current.

[crotchitymedic1986]

Ok, in ten years i will plop down a diagram of a human cell and ask you to draw a cytoplasm, a mitochondrion, a vacuole, and describe its function --- or ask you indepth questions about cushings syndrome, and we will see how you do.

[WolfmanHarris]

Don't forget to ask me about the bear attacks.

So we jump to the defense of incompetence out of fear that we might not be up to snuff ourselves? Sound ass backwards to me.

How about, if you're worried you couldn't pass the test you needed to certify/license in the first place, you stop wringing your hands about who's head is on the block next and remedy the situation.

Two explanations can be taken from this. Either A) the test is evaluating a knowledge base that is not important to practice and therefore much will likely be forgotten in the intervening years. or the test is evaluating a knowledge base that should be important to practice but rote learning and habit have replaced knowledge to allow the provider to continue to do the job without knowing the background.

If A) the education and testing is not relevant to the job. If the providers have allowed themselves to atrophy and should remedy that instead of the tired "well we don't need to know that stuff on the streets."

I have had questions on tests I could not for the life of me remember (including today). But my answer wasn't to call B**s**t on the test. It was to realize I had stuff that needed to be reviewed more.

[spenac]

The test they are required to pass is the National Registry which is the minimum for an entry level person. If you have been in the field 1, 10, 20 years and not advanced beyond the minimum education needed to do your job you need to get out. The National Registry is to prove you have the minimum amount of education to do your job. Where is the problem requiring people to have the minimum of education? Why not just remove these people from EMS and let them just do the fire thing that want to do?

[JPINFV]

Ok, in ten years i will plop down a diagram of a human cell and ask you to draw a cytoplasm, a mitochondrion, a vacuole, and describe its function --- or ask you indepth questions about cushings syndrome, and we will see how you do.

Trick question. You can't really draw the cytoplasm.

[spenac]

Another gripe is why complain about a bear being mentioned, fix the trauma, or answer call medical control if it is a choice. Then 99.9% of emt's and paramedics should demand that the question about when we stick our fingers into a vagina should be removed as they will never do it in the field. Honestly your probably more likely to get a bear or other similar animal attack to deal with than have to make an airway for a stuck baby or to keep pressure off the umbilical cord. Go take the 1 week refresher course and then go take the test.

[crotchitymedic1986]

My guess is that it is a little A&B doc, and although I took on this arguement somewhat tongue in cheek, I dont think a single test (of any kind) should be used to fire someone. I agree that you should stay current, and should train as often as possible. I also believe that companies do have a responsibility to train their employees. But to take away someones income, their health insurance, their retirement on the basis of one test, while ignoring all other areas of job performance is criminal.

Now if you want to administer a test to pre-hires, and not hire them based on thier failure to obtain a minimum score, I am fine with that. But firing a quality medic over one test score is not fair, and yes I believe you can be a quality medic without remembering every part of the "cell".

[VentMedic]

Another gripe is why complain about a bear being mentioned, fix the trauma, or answer call medical control if it is a choice. Then 99.9% of emt's and paramedics should demand that the question about when we stick our fingers into a vagina should be removed as they will never do it in the field. Honestly your probably more likely to get a bear or other similar animal attack to deal with than have to make an airway for a stuck baby or to keep pressure off the umbilical cord. Go take the 1 week refresher course and then go take the test.

Exactly.

In Florida we deal with alligator and shark attacks which can present with similar trauma to a bear.

California has wild mountain lions attacking in the suburbs and caged lions attacking in the zoos (recent attack in SF).

Pit Bulls or other dogs?

Whatever the animal, scene safety and working the trauma are the issues.

All of this should not have been a surprise since the Paramedics had to retest their skills earlier this year.

It almost sounds like Collier County (Naples) where 30 days was not enough for them to prepare.

It also sounds like the FD trained their own to pass their local exam and not much more beyond that.

[WolfmanHarris]

The reason we use testing though is it's standardized and provides an objective way to compare people of the same (on-paper) qualification. It shouldn't be the only way we evaluate them as their are test competent medics who should not be on the road, but I believe it's a good starting point to separate the wheat from the chaff. Let someone show that they know their stuff, than worry about how much the patient's like them. Not the other way around.

I kept an incompetent first responder on my campus team way longer than I should because they were sweet and nice, and minded their p's an q's and patients and teammates liked then. I also believed I could rehab them and make them a half-decent first aider despite evidence to the contrary. It took me eight months, being called in by our oversight board to account for it and an incredibly messy separation of this individual from the team. If I'd based knowledge and technical competency in front of the people skills I would have seen it right away. And this is a damned campus first aid team.

When evaluating we need to establish base levels of competency before muddying the water with the person. If I worry any time I evaluate a student in my standard first aid, or lifeguarding classes about how they need this for work; or how bummed they'll be when they flunk, I'm doing them and myself a disservice. An instructor/trainer shouldn't write off a student based on a single test, but they also shouldn't push someone through until they get that bare pass just because they like them and would like them to succeed.

[reaper]

This is exactly why NR should not allow "grandfather clauses"! If a state wants to use NR, then all EMS personnel in the state should be required to take their cert exam, to renew.

You can have a 20 year medic that has been doing everything wrong for 20 years, with no knowledge of the correct way to do things. Why should they be allowed to continue this way?

If states are changing to NR to have a standardized testing, then all should meet those standards!

Oh, and yes, I had to retake NR after 10 years, since I had let it expire. I actually took it twice, because they lost my first results. I passed it both times on the first try. It is not that difficult of a test, mostly common sense!