# Strange school policy?



## chilipepper25 (Aug 14, 2010)

I don't know how EMT-B courses are typically structured, but in mine we study about 5 chapters per week and then have a computerized test on those, along with other little chapter quizzes that must be completed online. These quizzes and tests are all based on the book "Emergency Care and Transportation of the Sick and Injured". 

Now my issue is that though we are allowed to go back and see what mistakes we may have made on the quizzes, the school has a strict policy against allowing us to know what we missed on the main weekly tests themselves, and the instructors are not at liberty to tell us what we need to brush up on. I find this ridiculous and frustrating. What's the big secret? How can such a foolish policy be advantageous to finding out what we don't know? 

Would it not be sensible - when dealing with LIVES - to be able to know where our weak spots are? Is it the same with the National or State tests, that you are not allowed to review your mistakes?


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## rescue99 (Aug 14, 2010)

chilipepper25 said:


> I don't know how EMT-B courses are typically structured, but in mine we study about 5 chapters per week and then have a computerized test on those, along with other little chapter quizzes that must be completed online. These quizzes and tests are all based on the book "Emergency Care and Transportation of the Sick and Injured".
> 
> Now my issue is that though we are allowed to go back and see what mistakes we may have made on the quizzes, the school has a strict policy against allowing us to know what we missed on the main weekly tests themselves, and the instructors are not at liberty to tell us what we need to brush up on. I find this ridiculous and frustrating. What's the big secret? How can such a foolish policy be advantageous to finding out what we don't know?
> 
> Would it not be sensible - when dealing with LIVES - to be able to know where our weak spots are? Is it the same with the National or State tests, that you are not allowed to review your mistakes?



Terminal tests are not supposed to be reviewed because they aren't teaching tools.


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## feldy (Aug 14, 2010)

for the national, you cannot see what you got wrong or even the areas you got wrong. State tests can vary. MA tells you how many you got right in each of the modules (resp, cardiac, medical, trauma, spec ops). But not the exact question. 

I do find it odd that even in class you cannot get feed back. I would understand a midterm or a final but weekly quizzes? To me those are supposed to be teaching tools. 

You should ask you teacher if you could sit down with them and go over some things that you are unsure of, even if it means going to class early or staying late after class.


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## JPINFV (Aug 14, 2010)

rescue99 said:


> Terminal tests are not supposed to be reviewed because they aren't teaching tools.



I'm going to disagree with this because people remember much more what they get wrong on exams than what they get right. The exam itself is very much a teaching tool in addition to a testing school. In fact, the only exam at my school we don't get easy feedback on is the OSCE patient exams, and those we can always go talk either to the course director or the standardized patient program people to find out what we did wrong. Outside of that, every point, be it quiz, exam, or final, are accounted for.


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## AtlantaEMT (Aug 14, 2010)

That is pretty crappy.  Without me being able to review my tests and quizzes I would have not done as well as I did in my school.  I did a 5week EMT-I class and we'd go through 3-5 chapters a day and test every week.  We even got to do practice EMT-I 85 and 99 (though we are 85) exams and review the answers with the explanations as to why say anser D was correct.  Those helped me grasp so many more things than just reading the book and taking quizzes.

What kind of school do you go to?  Is it a state funded school, private school, etc?  Maybe it is a state thing.


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## JPINFV (Aug 14, 2010)

A few other things to think about.

If it's about exam security (i.e. copies being passed around), then have students answer either via scantron or on a seperate answer sheet. Hand back the answer sheet, scantron, or scantron printout (which are awesome since they tell you both what your answer and the accepted answer choice) and post the exam for a limited period of time.

Second, without the exam, the students lose the ability to learn the material by constructing 'well written challenges to the questions' (YMMV on the "well written" part). If PhDs, MDs, and DOs teaching medical students make mistakes when crafting questions and answer choices testing their specialty area, I am more than willing to bet that paramedics teaching EMT and paramedic classes end up making mistakes on their exam.


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## chilipepper25 (Aug 14, 2010)

Well it IS a private school in the process of accreditation. The most frustrating thing is that the policy is not explained by anyone. If we ask the instructors why the policy exists the answer is always "Don't know. That's just the way it is."  The tests are not on paper nor scantron, they are computer based tests with the questions in a different sequential order for each person, plus there are cameras trained on us in the computer lab and we are closely monitored during the testing, so I don't believe it's a test security issue. 

I just can't think of a good enough excuse for this - most of us score in the same range - between 83 and 95 on a good day lol - and we're all foaming at the mouth after the test wondering which few we missed, going over our reviews and quizzes and it is not clear what we're struggling with. Immediately after the test is over your results pop up and you are told how many questions you missed but not what they were or even what area. 

Oh well, I guess that's just the way the wind blows. Sucks though.


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## feldy (Aug 15, 2010)

chilipepper25 said:


> Well it IS a private school in the process of accreditation. The most frustrating thing is that the policy is not explained by anyone. If we ask the instructors why the policy exists the answer is always "Don't know. That's just the way it is."  The tests are not on paper nor scantron, they are computer based tests with the questions in a different sequential order for each person, plus there are cameras trained on us in the computer lab and we are closely monitored during the testing, so I don't believe it's a test security issue.
> 
> I just can't think of a good enough excuse for this - most of us score in the same range - between 83 and 95 on a good day lol - and we're all foaming at the mouth after the test wondering which few we missed, going over our reviews and quizzes and it is not clear what we're struggling with. Immediately after the test is over your results pop up and you are told how many questions you missed but not what they were or even what area.
> 
> Oh well, I guess that's just the way the wind blows. Sucks though.



First of all, you said that the school is in process of accred. You may want to make sure that you can/ will be allowed to get a state license since the school you are at is not accredited yet. If you wont be allowed to, get out now unless you are just in it for the learning/course credit but not to ultimately obtain a certification. It would be unfortunate if you paid all that money and put all that time in and in the end, you would have to take the course again elsewhere at an accredited school.


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## jjesusfreak01 (Aug 15, 2010)

feldy said:


> First of all, you said that the school is in process of accred. You may want to make sure that you can/ will be allowed to get a state license since the school you are at is not accredited yet. If you wont be allowed to, get out now unless you are just in it for the learning/course credit but not to ultimately obtain a certification. It would be unfortunate if you paid all that money and put all that time in and in the end, you would have to take the course again elsewhere at an accredited school.



Someone always has to be in the first class if a school is being accredited. UCF has a new med school and they are being accredited, but I don't think you'll find the students worrying about it. The accreditation will take effect their senior year before they graduate.


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## JPINFV (Aug 15, 2010)

jjesusfreak01 said:


> Someone always has to be in the first class if a school is being accredited. UCF has a new med school and they are being accredited, but I don't think you'll find the students worrying about it. The accreditation will take effect their senior year before they graduate.



A quick technical explanation of this process. There are several stages of accreditation for medical schools. The last step before full accreditation is "preliminary accreditation" and this is the step where new medical schools can enroll their first class. Full accreditation isn't reached until the first class graduates. 

Here's a summary of the process for MD schools (DO schools are extremely similar, including the entire "not fully accredited until the first class graduates" process), including a list of schools at each stage of accreditation. There are currently 7 schools in the preliminary accreditation stage. 

http://www.lcme.org/newschoolprocess.htm


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## rescue99 (Aug 15, 2010)

JPINFV said:


> I'm going to disagree with this because people remember much more what they get wrong on exams than what they get right. The exam itself is very much a teaching tool in addition to a testing school. In fact, the only exam at my school we don't get easy feedback on is the OSCE patient exams, and those we can always go talk either to the course director or the standardized patient program people to find out what we did wrong. Outside of that, every point, be it quiz, exam, or final, are accounted for.



Terminal tests (exams) are not teaching tools. They are measurements of knowledge, comprehension, application, critical thinking proficiency. The instructor should tell a student how many and perhaps in what areas he/she is deficient, but at no time does a terminal measurement get handed back for review. 

Quizzes and some tests (if I don't plan on using it again) are meant to be gone over, discussed and/or reviewed....especially quizzes. Those play a key role in the learning process. If a quiz is not handed back and gone over in class I hand back the quiz, sometimes with an annotated answer key. Students are also welcome to drop in before class, sit down with thier scantrons and go over certain tests and ask questions. Homework quizzes are gone over in small groups with the annotated answer key. By doing this, students have an oportunity to dig into thier books and help each other work through the questions together. It's become a favorite class activity and a most useful learning tool.


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## JPINFV (Aug 15, 2010)

Damn, every single exam I ever took in undergrad, grad school, and now medical school apparently was done wrong. By the way, how does the school handle questions that were poorly or wrongly worded if students can't bring it to the schools attention?


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## rescue99 (Aug 15, 2010)

JPINFV said:


> Damn, every single exam I ever took in undergrad, grad school, and now medical school apparently was done wrong. By the way, how does the school handle questions that were poorly or wrongly worded if students can't bring it to the schools attention?



An item analysis will point to questions that were poorly worded. It may lead the educator to questions involving material which is poorly understood or perhaps to a question that was keyed incorrectly. It is the educators job to do an analysis of his/her quizzes and tests, not the students. 

Creating an item analysis by hand takes time when the class is large and the test is long but today, with so many generators and test scanning programs in use, it only takes the push of a button. I can see very quickly what, if any problems there are with a quiz or test just by creating an item analysis before handing back the grades. It's my job to catch problems before they become a debate and sometimes I do. Mistakes are made. The time to catch them is before they become an arguable issue. Written answers still have to be checked the good ole fashioned way....by hand.


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## JPINFV (Aug 15, 2010)

You're assuming that an item analysis will always catch poorly worded questions. This, however, is only the case if a large portion picks the non-keyed acceptable answer. Is it fair to keep points from a small number of students because you included two acceptable answers in an exam question? 

Again, I need to ask. Are you saying that the majority of professors at major universities on both sides of the country are running their programs wrong by giving students feedback on terminal exams (both midterm exams and finals since the material is rarely held accountable over multible exams past things representing foundation knowledge)?


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## Hellsbells (Aug 15, 2010)

> between 83 and 95 on a good day lol - and we're all foaming at the mouth after the test wondering which few we missed, going over our reviews and quizzes and it is not clear what we're struggling with



This is exactly the point with these type of tests. It incourages the students to go back and study ALL the material in the texts, and to make sure that you comprehend the majority of the information. If you are averaging between 83-95% on the tests, It seems like you have a good grip on the material at hand. 

If the school is attempting to achieve accreditation, perhaps they have to follow some very specific guidelines, that involve a secure testing procedure. I'm sure that if there is information you don't understand prior to testing that you can approach your instructors for help, can you not?


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## chilipepper25 (Aug 15, 2010)

Hellsbells said:


> This is exactly the point with these type of tests. It incourages the students to go back and study ALL the material in the texts, and to make sure that you comprehend the majority of the information. If you are averaging between 83-95% on the tests, It seems like you have a good grip on the material at hand.
> 
> If the school is attempting to achieve accreditation, perhaps they have to follow some very specific guidelines, that involve a secure testing procedure. I'm sure that if there is information you don't understand prior to testing that you can approach your instructors for help, can you not?



Thanks Hellsbells, I do feel that I have a pretty good grip on the material and I didn't consider that they may have to be following specific protocols for the accreditation process, nor did I consider that their method encourages us to go back and thoroughly read everything (which we all do). I still think it's a bit silly - but I don't feel as shortchanged as before.


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## gw812 (Aug 16, 2010)

chilipepper25 said:


> Thanks Hellsbells, I do feel that I have a pretty good grip on the material and I didn't consider that they may have to be following specific protocols for the accreditation process, nor did I consider that their method encourages us to go back and thoroughly read everything (which we all do). I still think it's a bit silly - but I don't feel as shortchanged as before.



You're right, it is silly. Yes, a terminal test is an assessment tool that can pass or fail overall, but any teacher worth their salt will at least review with the student the general areas of deficiency. The whole 'go back and read everything' approach only results in frustration. The reluctance of the school to explain why they utilize that policy worries me even more. My advice is to just buckle down, use your peers for help and study, and get yourself through this course, then don't go back to them for paramedic.


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## chilipepper25 (Aug 16, 2010)

gw812 said:


> You're right, it is silly. Yes, a terminal test is an assessment tool that can pass or fail overall, but any teacher worth their salt will at least review with the student the general areas of deficiency. The whole 'go back and read everything' approach only results in frustration. The reluctance of the school to explain why they utilize that policy worries me even more. My advice is to just buckle down, use your peers for help and study, and get yourself through this course, then don't go back to them for paramedic.



Come to think of it.......I think it's possible that even the instructors don't know the actual questions from the tests - they do not write the exams, it is through the official website of the AAOS book that I mentioned we work out of. Our reviews consist of general powerpoint slides - again made by the authors of the book, and there is no review nor much discussion after - we have to immediately shift focus to the next 5 chapters.

 This material is by no means unreasonably challenging, but the way it's being presented is either evidence of a poorly structured program or just the way it goes everywhere in my state? It really just grinds my gears sometimes; I really want to be the best that I can be in this field. Oh well.


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## medicRob (Aug 16, 2010)

feldy said:


> for the national, you cannot see what you got wrong or even the areas you got wrong.



However, if you fail the National Registry examination, they send out a letter listing the competency areas (OB, Trauma, Medical, Airway, etc) and one of three scores for each.

Above Average
Average
Below Average

(Might not be the exact wording, it has been so long since I've seen it).


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## rescue99 (Aug 16, 2010)

medicRob said:


> However, if you fail the National Registry examination, they send out a letter listing the competency areas (OB, Trauma, Medical, Airway, etc) and one of three scores for each.
> 
> Above Average
> Average
> ...



That's right...and it is the most any higher level educator should do. There is no worse sense of wrong in a good educator's eyes than to be obligated or forced into letting students see thier exam so the poor things can see what they did wrong.  Something like that is the extreme exception, not the rule. It's not right and it isn't helping the students do anything more than "feel" better if they can see what they got wrong. Or my favorite; argue like a child in an effort to get his/her way. It's my job to be reasonably certain no errors are made on an exam. It's my job to do an item analysis. Any educator who takes the lazy route and doesn't, burns himself and his students in the end. 

IMO, college is big-boy school. All this feel good education garbage is just that, garbage education.


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## medicRob (Aug 16, 2010)

rescue99 said:


> That's right...and it is the most any higher level educator should do. There is no worse sense of wrong in a good educator's eyes than to be obligated or forced into letting students see thier exam so the poor things can see what they did wrong.  Something like that is the extreme exception, not the rule. It's not right and it isn't helping the students do anything more than "feel" better if they can see what they got wrong. Or my favorite; argue like a child in an effort to get his/her way. It's my job to be reasonably certain no errors are made on an exam. It's my job to do an item analysis. Any educator who takes the lazy route and doesn't, burns himself and his students in the end.
> 
> IMO, college is big-boy school. All this feel good education garbage is just that, garbage education.



I would tend to agree with you, especially when you are having to prepare your students to take a Computer Adaptive Test where the line of competency is clearly drawn and you either Pass or Fail. 


Think about this Chilipepper, 

If you are attempting to initiate IV access on a patient who needs critical meds, does the fact that you got a flash but not a patent IV mean that patient has a patent IV line? It most certainly does not. In this field, some of the decisions we make can mean the difference between life and death. When you are dealing with situations such as these, "Almost" just isn't enough. You either have the IV or you dont. The patient is either intubated or they are not. The instructor coordinator's job is to ensure competency and that every EMT and medic he/she puts out there can perform to the standards of their profession. This is not the place for "Hand-Holding" and gold stars. An instructor giving you praise for doing a skill half-way is almost equivalent to excusing the fact that you did half of it wrong. 

When you get in the field, you are practicing under the license of your medical director, if you are not competent, it is not only your *** if you make a mistake, it is his. If you do not feel competent or are not sure about something, you should get with your instructor coordinator and say, "Sir, I am having trouble with this skill, I don't understand why I should do this, etc". However, you should put in the proper leg work when doing so and make the effort to read your textbooks to show your instructor that you are in fact making an effort and not just expecting him/her to do all the leg work for you. It is your responsibility in EMT / Paramedic school to get the knowledge you need to become competent and to practice the skills and the techniques to the point where you can perform them in high stress situations. The scene of a code is not the place to realize that you do not know how to intubate a patient. 

That being said, good luck on all your educational endeavors.


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