National Registry, WHATS WRONG with it ? I'll tell you

[FormerEMSLT297]

I have not been on here for a while but today i feel the need to RANT and RAVE. A co-worker of mine recently finished his Medic class, and took the NR- Practical exam. He got very good grades throughout the program, interned with me and others and we all felt he was progressing nicely. Got a 90 something on the class final, and sat down the other day to take the NREMT-P practical skills station.

HE FAILED 3. One he knows what he did wrong right after he did it, and the other 2 he has NO IDEA.

I asked him if they gave him back the skills sheets, and he said "NO, they don't do that"

I said "how are you supposed to know what to study" to which he shrugged his shoulders.

now I was fortunate enough to pass the practical on the first go around, so i didnt need the sheets back.

And in New York, where I have been certified for 25+YEARS, if you fail a skills station, they give you back the sheet with the "critical failure" on it, i.e. FX management, you forgot to check pulses.

So my question is this. NR is supposed to profesionalize, EMS, make it better, blah, blah, blah, and yet, you can not even get your skills sheets to know where you deficiencies are... WTF ????

Now that is just WRONG in my opinion. Is it like that in Nursing school ???. Is it like that in Medical school...

Then here's the KICKER, the Instructor asked "ANY COMPLAINTS, but before i take them if you have complaints it will need to go up for review, and you can not get your pass/fail today....

I dont know about you, but this does not seem like the way to "profesionalize EMS" IMHO, intimdating students into not asking questions, and then not telling them the area of deficiencies so that they can work on it....

Some one who has a clue, and maybe can EXPLAIN a rational REASON for this ....

PLEASE POST UP....

I'd also like to hear from MD's, DO's RN's CRNA's etc. to see if this practice is donw with other "professions".... Thanks

RANTING COMPLETED .... for now.

Edited May 21, 2009 by FormerEMSLT297

[fiznat]

I've helped proctor a few national registry exams, and I'll tell you around here we let people know why they failed. You should probably consider the possibility that this incident has more to do with your local administration than it does the NR altogether.

That said, when you take the MCAT (or any other professional exam) you don't get a detailed report back listing the exact questions you got wrong. You simply get your score. National Registry practical testing isn't so complex that people shouldn't be able to learn the sheets and do well. If your friend missed three stations, chances are he did something stupid in each one and he should probably practice the sheets a little more before he goes back. Even "good students" are capable of making mistakes. Is it really that big a deal?

Edited May 21, 2009 by fiznat

[FireMedic65]

It is the NR policy not to tell the people testing why they had failed. If you are telling these students this, you could get yourself and the program in huge trouble.

Reasoning why, in my opinion why you are not told, is to make you THINK. "Damn, what did I do wrong? What did I miss?" You don't know, so now what? You go back and STUDY EVERYTHING AND GO OVER IT ALL! If you forgot to check a lead after a rhythm change, why should you be told this? You should know better! If you aren't told, you wonder what you did wrong, and you go over the skill/station over and over and over, study the material, study the procedures, study the things that are bad, the things that are right. Telling a person what they do wrong doesn't help you in the long run. Sure, it would be nice to know, but not being told, forces the person to go back and study everything so when they are in the real world, they don't kill someone.

by the way... it's pretty hard to fail a station if you pay attention and know what you are doing.

Edited May 21, 2009 by FireMedic65

[mshow00]

It is the NR policy not to tell the people testing why they had failed. If you are telling these students this, you could get yourself and the program in huge trouble.

Reasoning why, in my opinion why you are not told, is to make you THINK. "Damn, what did I do wrong? What did I miss?" You don't know, so now what? You go back and STUDY EVERYTHING AND GO OVER IT ALL! If you forgot to check a lead after a rhythm change, why should you be told this? You should know better! If you aren't told, you wonder what you did wrong, and you go over the skill/station over and over and over, study the material, study the procedures, study the things that are bad, the things that are right. Telling a person what they do wrong doesn't help you in the long run. Sure, it would be nice to know, but not being told, forces the person to go back and study everything so when they are in the real world, they don't kill someone.

by the way... it's pretty hard to fail a station if you pay attention and know what you are doing.

You must have forgotten about the stupid amount of pointless stress placed on those testing. It is not hard to fail, but very very easy. One simple stupid mistake and you second guess everything you did. I don't learn from that kinda crap, I second guess everything from that point on ineffect making myself useless. When was the last time you showed up on scene and only got information to questions you ask? People are always throwing (often useless) information at you as soon as you get out of your ambulance. I just took (May 16th) the NR practical and passed on my first try. IMHO the NR needs to be more "real life" and less scare the crap out of you stressful.

Edited May 21, 2009 by mshow00

[FireMedic65]

You must have forgotten about the stupid amount of pointless stress placed on those testing. It is not hard to fail, but very very easy. One simple stupid mistake and you second guess everything you did. When was the last time you showed up on scene and only got information to questions you ask? People are always throwing (often useless) information at you as soon as you get out of your ambulance. I just took (May 16th) the NR practical and passed on my first try. IMHO the NR needs to be more "real life" and less scare the crap out of you stressful.

Yes, welcome to real life. NR wasn't just thrown together in a weekend by a couple of pranksters looking to piss everyone off. One simple mistake happens, you fail.. yes. What happens in real life if you forget one simple mistake? EMS is problem solving, critical thinking, helping people, etc etc. In the perfect world, you will walk into a scene with the patient supine, calm and answering every question with the best info possible. Sadly, we do not live in the perfect world. We have to be detectives, drudge through piles of firth, work in cramped spaces, deal with horrible smells, frantic people, screaming people, rude people.. pretty much everything gets thrown at us. If you ask me, NR is a cake walk compared to the real world.

This reflects the practical portion. The written is a whole different story.

Edited May 21, 2009 by FireMedic65

[VentMedic]

I'd also like to hear from MD's, DO's RN's CRNA's etc. to see if this practice is donw with other "professions".... Thanks

For the RRT, the clinical simulations are now computer based and consist of 10 patient scenarios. If you screw up, it is doubtful you will see the same scenarios again. You just study as much as you can for all age groups from neonatal to geriatric. The fees for testing are also considerably higher than the NR. Initial test is $390. Each redo for just the simulation part is $200 and $150 for the written.

RT's credentialing agency, the National Board of Respiratory Care, also has a Continuing Competency Program. This is in addition to the state requirements to ensure standardized national requirements for continuing education and recredentialing. The requirement also exists for each specialty credential obtained through the NBRC such as Neo/Pedi Specialist, Pulmonary Function Testing and Sleep Disorders.

[croaker260]

I said "how are you supposed to know what to study" to which he shrugged his shoulders.

now I was fortunate enough to pass the practical on the first go around, so i didnt need the sheets back.

And in New York, where I have been certified for 25+YEARS, if you fail a skills station, they give you back the sheet with the "critical failure" on it, i.e. FX management, you forgot to check pulses.

So my question is this. NR is supposed to profesionalize, EMS, make it better, blah, blah, blah, and yet, you can not even get your skills sheets to know where you deficiencies are... WTF ????

Now that is just WRONG in my opinion. Is it like that in Nursing school ???. Is it like that in Medical school...

Then here's the KICKER, the Instructor asked "ANY COMPLAINTS, but before i take them if you have complaints it will need to go up for review, and you can not get your pass/fail today....

I dont know about you, but this does not seem like the way to "profesionalize EMS" IMHO, intimdating students into not asking questions, and then not telling them the area of deficiencies so that they can work on it....

Some one who has a clue, and maybe can EXPLAIN a rational REASON for this ....

This too is NREMT Policy. It is to ensure that complaints are REAL complaints and not just "I failed now I want to cause a problem..."

YOu have to submit your grievence before you are given your results.

Keeps every one honest, good policy in my mind.

I asked him if they gave him back the skills sheets, and he said "NO, they don't do that"

I said "how are you supposed to know what to study" to which he shrugged his shoulders.

The NREMT test is not an educational process. That was supposed to be done before you took the test. Giving your test back is good EDUCATIONAL process, but poor CERTIFICATION practice.

Let me put it another way.

In our FTO program, we have a very long "Phase II" where both evaluation and education take place. But then we have a "Phase III" for 48 hours. it is EVAL ONLY. No correction/education, nothing. You either have your stuff together..or you dont. Helps make sure that when you are "released"..your READY.

You pass or you fail. You only learn the general areas you fail. if you fail, you go back to Phase II, for more education and evaluation.

Just look at the mess in DC fire and with the FDs in collier county trying to spoof their exams by learning the questions, not the material.

There are several things I would change int he NREMT abouttheir stations, etc. But the PROCESSES and ADMINISTRATIVE PROCEEDURES for the most part are right in line with national stanadards for defensibility and objectivity.

Edited May 21, 2009 by croaker260

[Ridryder 911]

Aike what was said, it is a credentialing process NOT an educational one. Sorry, its a testing not a teaching examination. At least now, they are allowed to obtain the skill list in which when I took mine was a sacred sheet and no one was allowe to even know the steps. If he had studied properly, and praticed well; chances are they would had passed.

It's a shame we have to have a skill test, but thank goodness we do. Appearently they are not teaching in detail enough at the training and educational facilities. Instead of criticizing the test (which actually has a high pass rate in comparrision to medical boards) maybe look at the one taking it.

I will also state as one that has multiple license and medical board certifications, no one is allowed to know what they missed as it would also ruin the credibility of the test.

Rr 911

[Diazepam618]

To the op, in my opinion the NR is the biggest scam in the world, thank god I don't need to have a glow in the dark patch to alllow me to do my job, no one in my department has a NR cert except the new medics who just got out of school, ems does not need another organization to increase standards, I said it once and I'll say it again this is a stepping stone jobe, not a career at least where I come from, but that is just what I see year to year, and nothing has changed.

[JakeEMTP]

Benzo boy, NR does not increase standards. It tests providers to see if the educational standards put forth by the DOT are being taught. How many times do we need to post this. You and your knuckle draggers would do yourselves, and more importantly your patients a favour by entering into the NR process, but I digress.

You may consider EMS a stepping stone job, but the majority of providers I know are in this for the long haul. I realise in SoCal you have little opportunity to actually provide for your patients due to your limited protocols, but on this side of the country, we can actually function as a medic as paramedicine is meant to be practiced.