So I take it you didnt have to do 3rd rides or internships to get your license? Not an attack on you but thats how you make it sound. You have to start somewhere. You would have a licnesed medic right next to you to stop you from messing up.
Third rides.. yep Under a guided licensed Paramedic, remember that is for when you are in school not after you have completed it. In other words they are to guide and carefully watch and stop wrong procedures to be performed and make suggestions... because you are a student. In testing scenarios; one could not stop a procedure or make recommendations otherwise it would be considered skewed. This is an academic and procedure for credibility purposes. Also remember in liability you are covered under the school insurance and agreement of a EMS service. As far as I know, I know no license or certification examination performed upon real patients, nor would ever be considered. Even training on animals is under very careful scrutiny, with in depth procedures and usually a Veterinarian on the premises.
I agree it appears that it may not to be the best test, but it is the best way to validate one's knowledge. Consider that it is much more involved to develop the test, than just to develop test questions. I know, I am one of the many test writers for NREMT. Questions have to be created using recent and well documented references approved by the NREMT. They are not based upon anectodotal events or regional opinions. After initial development, they are reviewed and written by academic test writers for validity. If not, the test would be non-credible and worthless for a professional credibility. Alike
all other medical professional examinations (remember that is truly what we are.. medical) and other professional examinations (Law/Bar, Electricians, Engineers, etc). Not to be rude, but it is such tests and examinations that is supposed to separate the professional (white collar) from blue collar professions.
Protocols should only be suggested guidelines, usually for legal purposes. There is no way a protocol should or could ever be developed for everything. For example; my service protocols are only about 20 pages long, yet we perform medical diagnostics and procedures not listed, as it is expected we have a common "medical knowledge and understanding of emergency medicine". In other words actions and knowledge that is up to the local medical community standards of care... AHA/ACLS, PALS, NRP, PEPP, PHTLS, etc... Alike physician and other medical practitioners (R.T., P.T., Radiographers) we should be expected to know much more than a step by step or algorithm procedures. Suggestions or guidelines? Sure but medicine, is not a cookie recipe. It takes much more in-depth education and understanding of all the multiple possibilities at one time. Alike the hypothetical question posted, one should automatically know the most reasonable and most accurate answer would be related to a gynecological emergency. Not knowing this represents that one may not be aware of most probability causative agent.
Critical thinking skills can be increased with in-depth education and detailed and complex scenario base lab time. Such scenarios are ones that have multiple or are complex and require multiple actions. In other words multiple treatment(s) and actions should be taken and considered all at one time. In regards to protocols, there maybe three or four protocols that have to be initiated. i.e. Medical/Trauma, or respiratory depression secondary to distributive shock caused by infection. Knowing that one has to perform much more than just the ABC's and maybe very complex in treating.
Unfortunately, many in EMS assume that our role should be limited and be kept simple. EMS if done properly is
never easy and is very complex. The reason testing has to be taken very seriously and with scrutiny.
There are many that fail tests for multiple reasons. Such reasons maybe due to poor test taking skills, reading too much into the question, test anxiety and then simply poorly educated or ill trained. There are many ways and information to increase each of those areas.
R/r 911