I-99' Practical Examination

[UMSTUDENT]

So I successfully passed my practical examination. I take my CBT this week and hopefully I'll have my card fairly soon! One more year and I'll hopefully be a paramedic.

What was interesting was the number of students who didn't pass the practical. I kind of realized that the entire thing is entirely dependent on the evaluator you get. Many, many well qualified, highly prepared students did not pass the exam. Many of the evaluators I had were very relaxed, some even going as far as to say that they knew if we were competent and were not there to fail me. Other students reported having total idiots who barely paid attention, or who obviously didn't care. It seemed that by the end of the day there was a definite correlation between what evaluator you had, for what station, and if you passed. After the exam there was some extensive discussion among the participants and it seems that some five students failed static cardiology over the same single strip and the treatment modality of that strip. Then, during retest, they were all given the same strips again. It sucks because they keep people in the dark during the exam by not allowing students to talk about testing for fear of failing. So no one really knows the inconsistencies until after the exam.

Days like yesterday just seem to make the registry process seem like a joke. They get so called "experts" from the local area that are apparently familiar with the testing process. Some of them are very professional and others are just a joke. One of my evaluators seemed to be hearing impaired, stared out the window, and I had to prompt him to ask me a required question, which he said "not to worry about." Sure, I loved it, but it showed the blatant inconsistencies during the evaluation process. Several students made complaints during the day. There were a lot of complaints from students about unfamiliar equipment or equipment that was not even provided. None of the complaints seem to have been addressed, including blatant errors that evaluators made while grading.

I passed, but I felt for a lot of my classmates. I noticed several things during the test that were fairly shady, but I tried to quickly adapt and think on my feet. I also quickly realized that if you kissed a$$, said sir and mam a lot, and were just generally polite that a lot of things would get written off. Granted, I realize these are things that are qualities of a good paramedic, but it is not what most of these students were prepared for by any means.

[Dustdevil]

Unfortunately, this seems to happen all too often. And sadly, it is a reflection of the quality of people in the field. The nimrods checking you off have no more training than you do. And their expriences bring bias to the process. Not to mention, they have usually been doing this long enough that they are bored by the process and do not devote the attention they should to it.

First time I ever took NR, I had already been in the field for over a decade. Needless to say, I knew what I was doing. I still failed three stations. The megacode examiner stood there and carried on a personal conversation with some chick throughout the whole examination, only stopping to occasionally look at me and change the rhythm. Yet he failed me, saying I had not said "clear" prior to one of the many shocks I delivered. Like he would have even noticed. :roll:

Then there was the idiot with the NY/NJ (same thing) accent who thought I had said "four milligrams" when I had said "a FULL milligram." Yeah, like after a decade of practice I would give an old lady 4 milligrams of atropine. :?

And yes, you don't realise these things, that could have been cleared up on the spot, until it is all over and too late.

Not a big fan of skills testing for licensure anyhow. No other medical profession does it. And schools should be educating to a standard that ensures competency anyhow. There should be no question when they graduate that they know their skills. I say increase education to assure competency, significantly increase the difficulty of the written exam, and drop the skills exams altogether.

[chbare]

I am not a big fan of this psychomotor testing as well. My experiences with NREMT have been positive however. When I took my EMT-I, we set up the stations with our equipment the night before the written and practical. The stations were se up IAW the registry requirement lists. On the day of the exam, the NREMT rep was in early and gave us a very professional brief and then we too the written. Following the written, we rotated through the psychomotor stations. The stations were in separate rooms and no one other than the examiner, the equipment, the student, and an actor (if this was required) were allowed in the rooms. The examiners were all professional and gave the students 100% attention. All of the examiners took extensive notes. In addition, the NREMT rep rotated through the stations and walked the halls to ensure everything was running smoothly. He was immediately available for any problems and debriefed each student individually regarding their station performance. This was very well run; however, it was just luck of the draw.

Why the big story? I simply want to make a point. You can take a psychomotor exam in 10 different places, and have 10 different experiences. You have no standardization. NREMT psychomotor testing is like socialism. A neat thought, but a disaster in application. With a standardized written exam, all students can be tested to the same standard. Everybody is placed under the same conditions and required to meet the same standards.

We call psychomotor testing clinical or practicum in nursing school. If you are a physician, it is called residency. You should be competent prior to taking your board exam. No other medical profession has a psychomotor exam station as part of their board exam process. Unless you consider defending your thesis a psychomotor exam, but that is a different story.

Congrats for passing your exam.

Take care,

chbare.

[UMSTUDENT]

Unfortunately, this seems to happen all too often. And sadly, it is a reflection of the quality of people in the field. The nimrods checking you off have no more training than you do. And their expriences bring bias to the process. Not to mention, they have usually been doing this long enough that they are bored by the process and do not devote the attention they should to it.

First time I ever took NR, I had already been in the field for over a decade. Needless to say, I knew what I was doing. I still failed three stations. The megacode examiner stood there and carried on a personal conversation with some chick throughout the whole examination, only stopping to occasionally look at me and change the rhythm. Yet he failed me, saying I had not said "clear" prior to one of the many shocks I delivered. Like he would have even noticed. :roll:

Then there was the idiot with the NY/NJ (same thing) accent who thought I had said "four milligrams" when I had said "a FULL milligram." Yeah, like after a decade of practice I would give an old lady 4 milligrams of atropine. :?

And yes, you don't realise these things, that could have been cleared up on the spot, until it is all over and too late.

Not a big fan of skills testing for licensure anyhow. No other medical profession does it. And schools should be educating to a standard that ensures competency anyhow. There should be no question when they graduate that they know their skills. I say increase education to assure competency, significantly increase the difficulty of the written exam, and drop the skills exams altogether.

Glad to see others have had the same experience. I agree that there needs to be a complete overhaul of how we test students. I'm personally more in favor of a mandatory internship where you are evaluated by medics in the field followed by an exam that more accurately test a student's knowledge.

I've heard that the computer based exam I'm to take tomorrow is much harder than the test in the past. A few of our students have already taken the exam and reported it to be extremely difficult, but unfortunately still a little misrepresentative of a paramedic's true skill set. I was told that a lot of the exam is based on rare toxicological emergencies. Questions on snake bites, etc. We’ll see how it goes. We had a fairly detailed instruction on toxidromes, etc so I think I’m fairly prepared