National Registry Failures

[Guest guest]

Shamelessly stolen from another paramedic's blog (and also, bumped to the

paramedicine list as well)...

***************************************************

" So last May I started my Paramedic class, and was the *only* one who jumped

into the class halfway through as an Intermediate and went on to Paramedic.

The rest of the class had been plugging away at it since last January. The

course wrapped up in September, and we began testing in October. I took my

initial Paramedic test for the National Registry in November, got my results

in December, and was finally certified in January of this year. Needless to

say, the process takes a little time. Well, today I ran into one of my

classmates... She is* still* waiting on taking *another* re-test.

Apparently from what she told me, over half of the class of 14 people did

not pass the test in the first 3 attempts, and only 3 of us, myself included

have actually become certified. I'm truly amazed. I mean really. I'm by *

far* not the best student, but I studied like *mad* for those tests. I will

admit, the class itself was not the best. The staff tried, but they were

just not very well organized. The other students got tired, and they got

frustrated, and they just stopped trying I think. The students that failed

3 times now have to take the *entire* course over again. In essence, they

wasted 9 months of their time and $3,500 of their money. I honestly can't

place 100% of the blame on either the students *or* the instructors, I

believe it was about half of both. The instructors were very disorganized

and didn't present the material very well, and the students knew that, were

frustated, and didn't know what to study on their own. And I do have to

admit I had a slight advantage... I have been working in the EMS field for

several years, most of them have not. That means that I have practical

knowledge of the things I learned in the classroom, so it wasn't a ton of

abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

just ave to work on learning *more *stuff, and switch my mental gears up a

notch... "

***************************************************

It would seem like with the discussion about NR failures, the NR test, the

NR testing process, and NR administrative headaches, that at least some

discussion needs to focus on student participation and student/instructor

interaction. Without blaming any specific student, I can say that when I've

precepted students on EMS units that this pretty much runs the gambit - some

are very well studied and trying to learn, some are trying to do as little

as possible and skate by, some are struggling to keep their heads above

water.

Personally, I don't want an NR test with a 100% pass rate. I want a failure

rate, because I want to ensure that the test is difficult enough to merit

administration - not just a mere " check-off sheet " for paramedic course

knowledge. On the flip side, I think a 50% failure rate for first attempts

would be bad, too, indicating a problem with the test, with the curriculum,

or the training provided. I don't know what the actual NR numbers are now,

but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

for those on paramedicine group) several years ago. They do track this, and

my understanding was that they use this information to validate questions,

etc. I'm not training in test-making, analysis, or stastics, so I can't

comment on how, when, why, where, etc... but it's likely that someone on one

of these lists can.

I do, however, place fault directly on students when they fail the NR exam

three times. Not because they can't, but because they didn't. Whether this

means that they didn't know the material, didn't undertstand how to relate

the material to a question/scenario, or didn't have good test-taking skills,

the burden for passing the exam in three tries falls on noone else. After a

first failure, the student should be re-assessing their knowledge and

understanding, and assessing their performance on the exam itself (how WELL

did I TAKE the test, not necessarily how WELL did I DO). There are several

test-taking strategies - especially for " body of knowledge " multiple-choice

standardized exams - that can significantly increase the chances of

passing. While this should probably be taught in a paramedic course, I can

understand not being " able to " teach it due to budget, time, or other

pressures put on paramedic course coordinators/administrators. Not that it

excuses them from culpability for failing to properly prepare students, but

ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

a paramedic course), the burden is ultimately on the student to perform.

After a second test failure, the student should be seeking help to identify

their problem areas - be it knowledge, application or presentation

(test-taking skills). After a third failure... more re-assessment. After

(as described earlier in this thread) a FIFTH failure? At that point, I

just don't know how a student can " blame " anyone other than themselves.

NR certainly has its problems, and I question its applicability in the broad

swath it's been applied to paramedic education and testing. That said, I

tend to think that a state-based, non-NR driven test could actually be

*harder*. I also believe that the burden shouldn't be on NR to lower

testing standards, but on local EMS folks to demand from their legislature

an increase in the requirements for paramedic licensure. Want an example?

To become a barber in Texas requires a 1500 hour training course, pass a

written and skills test.

To become a paramedic in Texas requires 764-924 hours of training which

includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

EMT-Intermediate first (which, for those on paramedicine, isI/85).

Becoming a paramedic in Texas requires HALF of the hours required to become

a barber.

So, to sum up, students should be responsible for their own multiple

failures if they aren't trying to mitigate and understand each failure.

Educators essentially have their hands tied (witness: Navarro College

situation this month). EMS folks in general have an " I've got mine, what do

I care if someone else gets theirs, why raise standards " attitude. With

those things as a given, how DO you make things better?

My idea? Piss off the public. Someone needs to stand up and shame the hell

out of the EMS folks in this state - providers, personnel, fire departments,

mom-n-pop services, major EMS agencies - ALL of them. The public needs to

be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

professionalism of EMS providers (as a whole) and to DISTRUST their lives

and safety to folks in the bambulances...

Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

the legislature, beg for mercy, actually ASK for additional training

requirements, pull up their boots and get to work earning back the trust

that they've been skating along on all this time. How? By committing to

higher training standards, re-training standards, professional

requirements/standards, a stronger state-level governing body for EMS, and

true representation of the public's need for safety, health care and

prevention. Then, and only then, will the public TRUST EMS folks again -

and for the first time in a long time - righteously, because EMS folks will

have actually EARNED it.

FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

of " them " too in my email, so don't think I'm on a high horse.

Flame on.

Mike

[Guest guest]

WOW Mike...I do not believe I have ever come so close to agreeing 100% with any

of your emails...

The only issue I don't agree with is the DISTRUST piece...I don't think you

have to swing the pendelum all the way the other direction to get action...I

think just nudging it back to the middle would be enough to fix a multitude of

issues.

Coordinators I talk to wonder how far they have to go in this process...student

after student that cannot read at a high school level, cannot do basic math, and

have absolutely no skills at studying or test taking...you can't make up in 9

months for 12 years of shoddy education, lack of parent envolvment, not enough

money spent of public education...yada...yada...yada...

This person's BLOG is the answer. The students who BUY into the process, work

to get themselves through it, and take their time...stopping off at Basic or

Intermediate for a few months or years are our most successful EMS personnel.

I always " lament " about my agencies difficulties in finding quality paramedics.

The ones we do find however have some things in common. First, they can read and

write the english language at or above a high school level. Secondly, they are

motivated individuals who CHOOSE to be in EMS and desire to make their own way.

Third, all but maybe a couple (who made up for it with intelligence and hard

work) stopped in their progression to Paramedic at the Basic or Intermediate

level for some period of time (longer than a semester break).

I cannot remember the last time we hired anyone for a full-time position that

was fresh out of paramedic school which they started immediately after EMT

school...and their sum total of EMS experience, measured in years is less than

50% of their time spent in EMS education.

Now, for the NR process. Texas is behind the rest of the nation at all three

levels...but not horribly so. I do not have the information they passed out at

the May GETAC meetings, but it wasn't bad...except Texas is quite a bit higher

in people who complete the course BUT never test for NR... DSHS has stated, and

I support it, that they are going to start posting NR Exam results by

coordinator...and I think this will be beneficial.

I am a firm believer that if the institution that is teaching the course has a

high pass percentage, then they are doing something correct....either through

thorough teaching of the topic...or a thorough job of teaching how to pass the

NR...which I believe is impossible to do without thoroughly teaching the

topic...

I don't buy the " they are bad test takers " mentality. I don't see other

professions accepting that (well he flunked his physician boards...but he is a

bad test taker...maybe we can read the test to him???????) The problem is with

economics like they are, we are getting a lower calibre EMS candidate...and

facilities are being pressed to do more with much less...and we are seeing the

results.

Mike, I aaaggg....I aagggrrr....(man this is hard to say) I agggggrrre...I

concur with you...5 times and still failing??? Why keep trying?

Dudley

National Registry Failures

Shamelessly stolen from another paramedic's blog (and also, bumped to the

paramedicine list as well)...

***************************************************

" So last May I started my Paramedic class, and was the *only* one who jumped

into the class halfway through as an Intermediate and went on to Paramedic.

The rest of the class had been plugging away at it since last January. The

course wrapped up in September, and we began testing in October. I took my

initial Paramedic test for the National Registry in November, got my results

in December, and was finally certified in January of this year. Needless to

say, the process takes a little time. Well, today I ran into one of my

classmates... She is* still* waiting on taking *another* re-test.

Apparently from what she told me, over half of the class of 14 people did

not pass the test in the first 3 attempts, and only 3 of us, myself included

have actually become certified. I'm truly amazed. I mean really. I'm by *

far* not the best student, but I studied like *mad* for those tests. I will

admit, the class itself was not the best. The staff tried, but they were

just not very well organized. The other students got tired, and they got

frustrated, and they just stopped trying I think. The students that failed

3 times now have to take the *entire* course over again. In essence, they

wasted 9 months of their time and $3,500 of their money. I honestly can't

place 100% of the blame on either the students *or* the instructors, I

believe it was about half of both. The instructors were very disorganized

and didn't present the material very well, and the students knew that, were

frustated, and didn't know what to study on their own. And I do have to

admit I had a slight advantage... I have been working in the EMS field for

several years, most of them have not. That means that I have practical

knowledge of the things I learned in the classroom, so it wasn't a ton of

abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

just ave to work on learning *more *stuff, and switch my mental gears up a

notch... "

***************************************************

It would seem like with the discussion about NR failures, the NR test, the

NR testing process, and NR administrative headaches, that at least some

discussion needs to focus on student participation and student/instructor

interaction. Without blaming any specific student, I can say that when I've

precepted students on EMS units that this pretty much runs the gambit - some

are very well studied and trying to learn, some are trying to do as little

as possible and skate by, some are struggling to keep their heads above

water.

Personally, I don't want an NR test with a 100% pass rate. I want a failure

rate, because I want to ensure that the test is difficult enough to merit

administration - not just a mere " check-off sheet " for paramedic course

knowledge. On the flip side, I think a 50% failure rate for first attempts

would be bad, too, indicating a problem with the test, with the curriculum,

or the training provided. I don't know what the actual NR numbers are now,

but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

for those on paramedicine group) several years ago. They do track this, and

my understanding was that they use this information to validate questions,

etc. I'm not training in test-making, analysis, or stastics, so I can't

comment on how, when, why, where, etc... but it's likely that someone on one

of these lists can.

I do, however, place fault directly on students when they fail the NR exam

three times. Not because they can't, but because they didn't. Whether this

means that they didn't know the material, didn't undertstand how to relate

the material to a question/scenario, or didn't have good test-taking skills,

the burden for passing the exam in three tries falls on noone else. After a

first failure, the student should be re-assessing their knowledge and

understanding, and assessing their performance on the exam itself (how WELL

did I TAKE the test, not necessarily how WELL did I DO). There are several

test-taking strategies - especially for " body of knowledge " multiple-choice

standardized exams - that can significantly increase the chances of

passing. While this should probably be taught in a paramedic course, I can

understand not being " able to " teach it due to budget, time, or other

pressures put on paramedic course coordinators/administrators. Not that it

excuses them from culpability for failing to properly prepare students, but

ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

a paramedic course), the burden is ultimately on the student to perform.

After a second test failure, the student should be seeking help to identify

their problem areas - be it knowledge, application or presentation

(test-taking skills). After a third failure... more re-assessment. After

(as described earlier in this thread) a FIFTH failure? At that point, I

just don't know how a student can " blame " anyone other than themselves.

NR certainly has its problems, and I question its applicability in the broad

swath it's been applied to paramedic education and testing. That said, I

tend to think that a state-based, non-NR driven test could actually be

*harder*. I also believe that the burden shouldn't be on NR to lower

testing standards, but on local EMS folks to demand from their legislature

an increase in the requirements for paramedic licensure. Want an example?

To become a barber in Texas requires a 1500 hour training course, pass a

written and skills test.

To become a paramedic in Texas requires 764-924 hours of training which

includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

EMT-Intermediate first (which, for those on paramedicine, isI/85).

Becoming a paramedic in Texas requires HALF of the hours required to become

a barber.

So, to sum up, students should be responsible for their own multiple

failures if they aren't trying to mitigate and understand each failure.

Educators essentially have their hands tied (witness: Navarro College

situation this month). EMS folks in general have an " I've got mine, what do

I care if someone else gets theirs, why raise standards " attitude. With

those things as a given, how DO you make things better?

My idea? Piss off the public. Someone needs to stand up and shame the hell

out of the EMS folks in this state - providers, personnel, fire departments,

mom-n-pop services, major EMS agencies - ALL of them. The public needs to

be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

professionalism of EMS providers (as a whole) and to DISTRUST their lives

and safety to folks in the bambulances...

Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

the legislature, beg for mercy, actually ASK for additional training

requirements, pull up their boots and get to work earning back the trust

that they've been skating along on all this time. How? By committing to

higher training standards, re-training standards, professional

requirements/standards, a stronger state-level governing body for EMS, and

true representation of the public's need for safety, health care and

prevention. Then, and only then, will the public TRUST EMS folks again -

and for the first time in a long time - righteously, because EMS folks will

have actually EARNED it.

FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

of " them " too in my email, so don't think I'm on a high horse.

Flame on.

Mike

[Guest guest]

Perhaps this comment is too oblique to be made under this thread, but I think

it ties in with what Mike and Dudley are saying.

Tonight I had dinner with an old acquaintance who is a teacher in the public

schools, at the secondary level.

He was depressed, because school is starting, and he will once again have to

begin the struggle to help students to learn in a system that has made it

almost impossible for good teachers to function and for good students to excel.

He has taught math in high school, but gave that up because the students

taking algebra were not ready for it, didn't know basic arithmetic, and worst of

all, lacked the ability to think logically.

The ability to think logically and critically is central to medicine at every

level, yet many of the students we see today come to us without practice or

skills in either.

Because of " No Child Left Behind " (if there were truth in naming, it would be

" Every Child Left Behind " ) teachers have no choice but to teach students to

take the exams, since they are held " accountable " for their students' test

results.

As a result, kids only learn to memorize data and regurgitate it on the exam.

Add to the mix the legal constraints on disciplining students, the culture of

youth that prevails now, which shows no respect for anyone or anything, the

fact that kids learn 90% of what they know from TV and the Internet, be it good

or bad, and the lack of involvement of parents in their children's lives, and

you have a recipe for becoming an illiterate and substandard country.

I recently had the pleasure of teaching an ACLS course to a group of 1st and

2nd degree medical residents from Jordan, The ines, India, Pakistan,

and Peru. Their level of intensity surpassed any group I have ever taught.

They soaked up every bit of information, engaged in spirited debate, and

practiced their skills over and over and over so that I finally had to take the

manikin away from on the last afternoon and put it away so I could go home.

I have had paramedics behave that way, but not often.

Finally, it IS possible to construct an education program that is seamless

and still produces " street ready " medics at the end of two years. The secret

is to begin clinicals and internships at the very beginning and continue them

throughout the course. That way, the student learns the street skills as he

is learning the knowledge and skills, gets to watch the information and skills

being applied from day one, and as his level of competency increases, he

progresses to the level of street ready by the time the program ends.

In the program I was involved with that employed that method, each student

performed a total of 896 hours of clinicals and internships in their 4

semesters of training. Employers routinely told us that these students were

actually better than some of their seasoned employees. No wonder. They had

been

doing ambulance internships for two years.

So it IS possible to turn out well rounded, street ready students, but it

cannot be done in a traditional program where the course concentrates on

didactic

information first, and then adds clinicals and internship at the end. If

clinicals and internships are spread over the two years, the student has the

opportunity to learn in increments. While the student may not be ready to

perform skills during the first two weeks, they begin learning about ambulance

operations, equipment, protocols, and all the other nuts and bolts things that

are

seldom covered in many courses.

As I have commented before, when we lost the opportunity to impose course

requirements that would insure that the National Standard Curriculum--at a

minimum-- is taught, we opted for mediocrity and consigned our profession to

second

class status for years to come.

Gene G.

>

> WOW Mike...I do not believe I have ever come so close to agreeing 100% with

> any of your emails...

>

> The only issue I don't agree with is the DISTRUST piece...I don't think you

> have to swing the pendelum all the way the other direction to get action...I

> think just nudging it back to the middle would be enough to fix a multitude

> of issues.

>

> Coordinators I talk to wonder how far they have to go in this

> process...student after student that cannot read at a high school level,

cannot do basic

> math, and have absolutely no skills at studying or test taking...you can't

make

> up in 9 months for 12 years of shoddy education, lack of parent envolvment,

> not enough money spent of public education... Coordinat Coordi

>

> This person's BLOG is the answer. The students who BUY into the process,

> work to get themselves through it, and take their time...stopping off at Basic

> or Intermediate for a few months or years are our most successful EMS

> personnel.

>

> I always " lament " about my agencies difficulties in finding quality

> paramedics. The ones we do find however have some things in common. First,

they can

> read and write the english language at or above a high school level. Secondly,

> they are motivated individuals who CHOOSE to be in EMS and desire to make

> their own way. Third, all but maybe a couple (who made up for it with

> intelligence and hard work) stopped in their progression to Paramedic at the

Basic or

> Intermediate level for some period of time (longer than a semester break).

>

> I cannot remember the last time we hired anyone for a full-time position

> that was fresh out of paramedic school which they started immediately after

EMT

> school...and their sum total of EMS experience, measured in years is less

> than 50% of their time spent in EMS education.

>

> Now, for the NR process. Texas is behind the rest of the nation at all three

> levels...but not horribly so. I do not have the information they passed out

> at the May GETAC meetings, but it wasn't bad...except Texas is quite a bit

> higher in people who complete the course BUT never test for NR... DSHS has

> stated, and I support it, that they are going to start posting NR Exam results

by

> coordinator. Now, for the NR process. Texas is be

>

> I am a firm believer that if the institution that is teaching the course has

> a high pass percentage, then they are doing something correct....either

> through thorough teaching of the topic...or a thorough job of teaching how to

> pass the NR...which I believe is impossible to do without thoroughly teaching

> the topic...

>

> I don't buy the " they are bad test takers " mentality. I don't see other

> professions accepting that (well he flunked his physician boards...but he is a

> bad test taker...maybe we can read the test to him???????) The problem is with

> economics like they are, we are getting a lower calibre EMS candidate... I

> don't buy the " they are bad test takers " mentality. I don't see other

> professions acce

>

> Mike, I aaaggg....I aagggrrr.... Mike, I aaaggg....I aagggrrr....<wbr>(

> Mike, I aaaggg....I aagggrrr....<wbr>(man this is hard to say) I

>

> Dudley

>

> National Registry Failures

>

> Shamelessly stolen from another paramedic's blog (and also, bumped to the

> paramedicine list as well)...

>

> ************ ******* ******* ******* ******* *

>

> " So last May I started my Paramedic class, and was the *only* one who jumped

> into the class halfway through as an Intermediate and went on to Paramedic.

> The rest of the class had been plugging away at it since last January. The

> course wrapped up in September, and we began testing in October. I took my

> initial Paramedic test for the National Registry in November, got my results

> in December, and was finally certified in January of this year. Needless to

> say, the process takes a little time. Well, today I ran into one of my

> classmates.. classmates..<wbr>. She is* still* waiting on taking

> Apparently from what she told me, over half of the class of 14 people did

> not pass the test in the first 3 attempts, and only 3 of us, myself included

> have actually become certified. I'm truly amazed. I mean really. I'm by *

> far* not the best student, but I studied like *mad* for those tests. I will

> admit, the class itself was not the best. The staff tried, but they were

> just not very well organized. The other students got tired, and they got

> frustrated, and they just stopped trying I think. The students that failed

> 3 times now have to take the *entire* course over again. In essence, they

> wasted 9 months of their time and $3,500 of their money. I honestly can't

> place 100% of the blame on either the students *or* the instructors, I

> believe it was about half of both. The instructors were very disorganized

> and didn't present the material very well, and the students knew that, were

> frustated, and didn't know what to study on their own. And I do have to

> admit I had a slight advantage... I have been working in the EMS field for

> several years, most of them have not. That means that I have practical

> knowledge of the things I learned in the classroom, so it wasn't a ton of

> abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

> just ave to work on learning *more *stuff, and switch my mental gears up a

> notch... "

>

> ************ ******* ******* ******* ******* *

>

> It would seem like with the discussion about NR failures, the NR test, the

> NR testing process, and NR administrative headaches, that at least some

> discussion needs to focus on student participation and student/instructor

> interaction. Without blaming any specific student, I can say that when I've

> precepted students on EMS units that this pretty much runs the gambit - some

> are very well studied and trying to learn, some are trying to do as little

> as possible and skate by, some are struggling to keep their heads above

> water.

>

> Personally, I don't want an NR test with a 100% pass rate. I want a failure

> rate, because I want to ensure that the test is difficult enough to merit

> administration - not just a mere " check-off sheet " for paramedic course

> knowledge. On the flip side, I think a 50% failure rate for first attempts

> would be bad, too, indicating a problem with the test, with the curriculum,

> or the training provided. I don't know what the actual NR numbers are now,

> but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

> for those on paramedicine group) several years ago. They do track this, and

> my understanding was that they use this information to validate questions,

> etc. I'm not training in test-making, analysis, or stastics, so I can't

> comment on how, when, why, where, etc... but it's likely that someone on one

> of these lists can.

>

> I do, however, place fault directly on students when they fail the NR exam

> three times. Not because they can't, but because they didn't. Whether this

> means that they didn't know the material, didn't undertstand how to relate

> the material to a question/scenario, or didn't have good test-taking skills,

> the burden for passing the exam in three tries falls on noone else. After a

> first failure, the student should be re-assessing their knowledge and

> understanding, and assessing their performance on the exam itself (how WELL

> did I TAKE the test, not necessarily how WELL did I DO). There are several

> test-taking strategies - especially for " body of knowledge " multiple-choice

> standardized exams - that can significantly increase the chances of

> passing. While this should probably be taught in a paramedic course, I can

> understand not being " able to " teach it due to budget, time, or other

> pressures put on paramedic course coordinators/ pressures put on paramedi

> excuses them from culpability for failing to properly prepare students, but

> ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

> a paramedic course), the burden is ultimately on the student to perform.

> After a second test failure, the student should be seeking help to identify

> their problem areas - be it knowledge, application or presentation

> (test-taking skills). After a third failure... more re-assessment. After

> (as described earlier in this thread) a FIFTH failure? At that point, I

> just don't know how a student can " blame " anyone other than themselves.

>

> NR certainly has its problems, and I question its applicability in the broad

> swath it's been applied to paramedic education and testing. That said, I

> tend to think that a state-based, non-NR driven test could actually be

> *harder*. I also believe that the burden shouldn't be on NR to lower

> testing standards, but on local EMS folks to demand from their legislature

> an increase in the requirements for paramedic licensure. Want an example?

>

> To become a barber in Texas requires a 1500 hour training course, pass a

> written and skills test.

>

> To become a paramedic in Texas requires 764-924 hours of training which

> includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

> Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

> EMT-Intermediate first (which, for those on paramedicine, isI/85).

>

> Becoming a paramedic in Texas requires HALF of the hours required to become

> a barber.

>

> So, to sum up, students should be responsible for their own multiple

> failures if they aren't trying to mitigate and understand each failure.

> Educators essentially have their hands tied (witness: Navarro College

> situation this month). EMS folks in general have an " I've got mine, what do

> I care if someone else gets theirs, why raise standards " attitude. With

> those things as a given, how DO you make things better?

>

> My idea? Piss off the public. Someone needs to stand up and shame the hell

> out of the EMS folks in this state - providers, personnel, fire departments,

> mom-n-pop services, major EMS agencies - ALL of them. The public needs to

> be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

> professionalism of EMS providers (as a whole) and to DISTRUST their lives

> and safety to folks in the bambulances.

>

> Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

> the legislature, beg for mercy, actually ASK for additional training

> requirements, pull up their boots and get to work earning back the trust

> that they've been skating along on all this time. How? By committing to

> higher training standards, re-training standards, professional

> requirements/ requirements/<wbr>standards, a stronger state-level governi

> true representation of the public's need for safety, health care and

> prevention. Then, and only then, will the public TRUST EMS folks again -

> and for the first time in a long time - righteously, because EMS folks will

> have actually EARNED it.

>

> FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

> of " them " too in my email, so don't think I'm on a high horse.

>

> Flame on.

>

> Mike

>

>

[Guest guest]

Dudley,

Five times and still failing is not the point. The point is that NR is still

willing to take their money so they should deliver a better product to their

customer. At the very least a little respect and take responsibility for their

mistakes.

Henry

National Registry Failures

Shamelessly stolen from another paramedic's blog (and also, bumped to the

paramedicine list as well)...

***************************************************

" So last May I started my Paramedic class, and was the *only* one who jumped

into the class halfway through as an Intermediate and went on to Paramedic.

The rest of the class had been plugging away at it since last January. The

course wrapped up in September, and we began testing in October. I took my

initial Paramedic test for the National Registry in November, got my results

in December, and was finally certified in January of this year. Needless to

say, the process takes a little time. Well, today I ran into one of my

classmates... She is* still* waiting on taking *another* re-test.

Apparently from what she told me, over half of the class of 14 people did

not pass the test in the first 3 attempts, and only 3 of us, myself included

have actually become certified. I'm truly amazed. I mean really. I'm by *

far* not the best student, but I studied like *mad* for those tests. I will

admit, the class itself was not the best. The staff tried, but they were

just not very well organized. The other students got tired, and they got

frustrated, and they just stopped trying I think. The students that failed

3 times now have to take the *entire* course over again. In essence, they

wasted 9 months of their time and $3,500 of their money. I honestly can't

place 100% of the blame on either the students *or* the instructors, I

believe it was about half of both. The instructors were very disorganized

and didn't present the material very well, and the students knew that, were

frustated, and didn't know what to study on their own. And I do have to

admit I had a slight advantage... I have been working in the EMS field for

several years, most of them have not. That means that I have practical

knowledge of the things I learned in the classroom, so it wasn't a ton of

abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

just ave to work on learning *more *stuff, and switch my mental gears up a

notch... "

***************************************************

It would seem like with the discussion about NR failures, the NR test, the

NR testing process, and NR administrative headaches, that at least some

discussion needs to focus on student participation and student/instructor

interaction. Without blaming any specific student, I can say that when I've

precepted students on EMS units that this pretty much runs the gambit - some

are very well studied and trying to learn, some are trying to do as little

as possible and skate by, some are struggling to keep their heads above

water.

Personally, I don't want an NR test with a 100% pass rate. I want a failure

rate, because I want to ensure that the test is difficult enough to merit

administration - not just a mere " check-off sheet " for paramedic course

knowledge. On the flip side, I think a 50% failure rate for first attempts

would be bad, too, indicating a problem with the test, with the curriculum,

or the training provided. I don't know what the actual NR numbers are now,

but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

for those on paramedicine group) several years ago. They do track this, and

my understanding was that they use this information to validate questions,

etc. I'm not training in test-making, analysis, or stastics, so I can't

comment on how, when, why, where, etc... but it's likely that someone on one

of these lists can.

I do, however, place fault directly on students when they fail the NR exam

three times. Not because they can't, but because they didn't. Whether this

means that they didn't know the material, didn't undertstand how to relate

the material to a question/scenario, or didn't have good test-taking skills,

the burden for passing the exam in three tries falls on noone else. After a

first failure, the student should be re-assessing their knowledge and

understanding, and assessing their performance on the exam itself (how WELL

did I TAKE the test, not necessarily how WELL did I DO). There are several

test-taking strategies - especially for " body of knowledge " multiple-choice

standardized exams - that can significantly increase the chances of

passing. While this should probably be taught in a paramedic course, I can

understand not being " able to " teach it due to budget, time, or other

pressures put on paramedic course coordinators/administrators. Not that it

excuses them from culpability for failing to properly prepare students, but

ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

a paramedic course), the burden is ultimately on the student to perform.

After a second test failure, the student should be seeking help to identify

their problem areas - be it knowledge, application or presentation

(test-taking skills). After a third failure... more re-assessment. After

(as described earlier in this thread) a FIFTH failure? At that point, I

just don't know how a student can " blame " anyone other than themselves.

NR certainly has its problems, and I question its applicability in the broad

swath it's been applied to paramedic education and testing. That said, I

tend to think that a state-based, non-NR driven test could actually be

*harder*. I also believe that the burden shouldn't be on NR to lower

testing standards, but on local EMS folks to demand from their legislature

an increase in the requirements for paramedic licensure. Want an example?

To become a barber in Texas requires a 1500 hour training course, pass a

written and skills test.

To become a paramedic in Texas requires 764-924 hours of training which

includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

EMT-Intermediate first (which, for those on paramedicine, isI/85).

Becoming a paramedic in Texas requires HALF of the hours required to become

a barber.

So, to sum up, students should be responsible for their own multiple

failures if they aren't trying to mitigate and understand each failure.

Educators essentially have their hands tied (witness: Navarro College

situation this month). EMS folks in general have an " I've got mine, what do

I care if someone else gets theirs, why raise standards " attitude. With

those things as a given, how DO you make things better?

My idea? Piss off the public. Someone needs to stand up and shame the hell

out of the EMS folks in this state - providers, personnel, fire departments,

mom-n-pop services, major EMS agencies - ALL of them. The public needs to

be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

professionalism of EMS providers (as a whole) and to DISTRUST their lives

and safety to folks in the bambulances...

Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

the legislature, beg for mercy, actually ASK for additional training

requirements, pull up their boots and get to work earning back the trust

that they've been skating along on all this time. How? By committing to

higher training standards, re-training standards, professional

requirements/standards, a stronger state-level governing body for EMS, and

true representation of the public's need for safety, health care and

prevention. Then, and only then, will the public TRUST EMS folks again -

and for the first time in a long time - righteously, because EMS folks will

have actually EARNED it.

FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

of " them " too in my email, so don't think I'm on a high horse.

Flame on.

Mike

[Guest guest]

Mike,

Why shouldn't we be able to teach to the level of the test?

Is it because our instructors are incompetent? Coordinators are

incompetent? What?

The material is there for the asking.

On the paramedic level, the NSC is there for everyone to read, including

students and instructors. It also has a teaching outline. The same is true

of

the EMT-B curriculum. So why should anyone not be teaching to the level of

the test?

Gene G.

>

> I have to agree with Henry, but only partially.

>

> I think NR came in at a time when we partially needed help. The problem

> being is that we agreed to be tested at a level that we were not prepared to

> teach to the level that we were prepared to test at.

>

> I think that when we finally get to the point that we are able to teach to

> the level that we test, we can improve..

>

> Just my honest opinion.

>

> Me

>

> Hatfield FF/EMT-P

>

> www.canyonlakefire- www.ca

>

> www.michaelhatfield www

>

> (updated 6.15.06)

>

> Re: National Registry Failures

>

> Dudley,

>

> Five times and still failing is not the point. The point is that NR is still

> willing to take their money so they should deliver a better product to their

> customer. At the very least a little respect and take responsibility for

> their mistakes.

>

> Henry

> National Registry Failures

>

> Shamelessly stolen from another paramedic's blog (and also, bumped to the

> paramedicine list as well)...

>

> ************ ******** ******** ******** ******** **

>

> " So last May I started my Paramedic class, and was the *only* one who jumped

> into the class halfway through as an Intermediate and went on to Paramedic.

> The rest of the class had been plugging away at it since last January. The

> course wrapped up in September, and we began testing in October. I took my

> initial Paramedic test for the National Registry in November, got my results

> in December, and was finally certified in January of this year. Needless to

> say, the process takes a little time. Well, today I ran into one of my

> classmates.. classmates..<wbr>. She is* still* waiting on taking

> Apparently from what she told me, over half of the class of 14 people did

> not pass the test in the first 3 attempts, and only 3 of us, myself included

> have actually become certified. I'm truly amazed. I mean really. I'm by *

> far* not the best student, but I studied like *mad* for those tests. I will

> admit, the class itself was not the best. The staff tried, but they were

> just not very well organized. The other students got tired, and they got

> frustrated, and they just stopped trying I think. The students that failed

> 3 times now have to take the *entire* course over again. In essence, they

> wasted 9 months of their time and $3,500 of their money. I honestly can't

> place 100% of the blame on either the students *or* the instructors, I

> believe it was about half of both. The instructors were very disorganized

> and didn't present the material very well, and the students knew that, were

> frustated, and didn't know what to study on their own. And I do have to

> admit I had a slight advantage... I have been working in the EMS field for

> several years, most of them have not. That means that I have practical

> knowledge of the things I learned in the classroom, so it wasn't a ton of

> abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

> just ave to work on learning *more *stuff, and switch my mental gears up a

> notch... "

>

> ************ ******** ******** ******** ******** **

>

> It would seem like with the discussion about NR failures, the NR test, the

> NR testing process, and NR administrative headaches, that at least some

> discussion needs to focus on student participation and student/instructor

> interaction. Without blaming any specific student, I can say that when I've

> precepted students on EMS units that this pretty much runs the gambit - some

> are very well studied and trying to learn, some are trying to do as little

> as possible and skate by, some are struggling to keep their heads above

> water.

>

> Personally, I don't want an NR test with a 100% pass rate. I want a failure

> rate, because I want to ensure that the test is difficult enough to merit

> administration - not just a mere " check-off sheet " for paramedic course

> knowledge. On the flip side, I think a 50% failure rate for first attempts

> would be bad, too, indicating a problem with the test, with the curriculum,

> or the training provided. I don't know what the actual NR numbers are now,

> but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

> for those on paramedicine group) several years ago. They do track this, and

> my understanding was that they use this information to validate questions,

> etc. I'm not training in test-making, analysis, or stastics, so I can't

> comment on how, when, why, where, etc... but it's likely that someone on one

> of these lists can.

>

> I do, however, place fault directly on students when they fail the NR exam

> three times. Not because they can't, but because they didn't. Whether this

> means that they didn't know the material, didn't undertstand how to relate

> the material to a question/scenario, or didn't have good test-taking skills,

> the burden for passing the exam in three tries falls on noone else. After a

> first failure, the student should be re-assessing their knowledge and

> understanding, and assessing their performance on the exam itself (how WELL

> did I TAKE the test, not necessarily how WELL did I DO). There are several

> test-taking strategies - especially for " body of knowledge " multiple-choice

> standardized exams - that can significantly increase the chances of

> passing. While this should probably be taught in a paramedic course, I can

> understand not being " able to " teach it due to budget, time, or other

> pressures put on paramedic course coordinators/ pressures put on paramedic

> excuses them from culpability for failing to properly prepare students, but

> ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

> a paramedic course), the burden is ultimately on the student to perform.

> After a second test failure, the student should be seeking help to identify

> their problem areas - be it knowledge, application or presentation

> (test-taking skills). After a third failure... more re-assessment. After

> (as described earlier in this thread) a FIFTH failure? At that point, I

> just don't know how a student can " blame " anyone other than themselves.

>

> NR certainly has its problems, and I question its applicability in the broad

> swath it's been applied to paramedic education and testing. That said, I

> tend to think that a state-based, non-NR driven test could actually be

> *harder*. I also believe that the burden shouldn't be on NR to lower

> testing standards, but on local EMS folks to demand from their legislature

> an increase in the requirements for paramedic licensure. Want an example?

>

> To become a barber in Texas requires a 1500 hour training course, pass a

> written and skills test.

>

> To become a paramedic in Texas requires 764-924 hours of training which

> includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

> Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

> EMT-Intermediate first (which, for those on paramedicine, isI/85).

>

> Becoming a paramedic in Texas requires HALF of the hours required to become

> a barber.

>

> So, to sum up, students should be responsible for their own multiple

> failures if they aren't trying to mitigate and understand each failure.

> Educators essentially have their hands tied (witness: Navarro College

> situation this month). EMS folks in general have an " I've got mine, what do

> I care if someone else gets theirs, why raise standards " attitude. With

> those things as a given, how DO you make things better?

>

> My idea? Piss off the public. Someone needs to stand up and shame the hell

> out of the EMS folks in this state - providers, personnel, fire departments,

> mom-n-pop services, major EMS agencies - ALL of them. The public needs to

> be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

> professionalism of EMS providers (as a whole) and to DISTRUST their lives

> and safety to folks in the bambulances. a

>

> Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

> the legislature, beg for mercy, actually ASK for additional training

> requirements, pull up their boots and get to work earning back the trust

> that they've been skating along on all this time. How? By committing to

> higher training standards, re-training standards, professional

> requirements/ requirements/<wbr>standards, a stronger state-level governin

> true representation of the public's need for safety, health care and

> prevention. Then, and only then, will the public TRUST EMS folks again -

> and for the first time in a long time - righteously, because EMS folks will

> have actually EARNED it.

>

> FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

> of " them " too in my email, so don't think I'm on a high horse.

>

> Flame on.

>

> Mike

>

>

[Guest guest]

I have to agree with Henry, but only partially.

I think NR came in at a time when we partially needed help. The problem

being is that we agreed to be tested at a level that we were not prepared to

teach to the level that we were prepared to test at.

I think that when we finally get to the point that we are able to teach to

the level that we test, we can improve..

Just my honest opinion.

Me

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

www.michaelhatfield.net

(updated 6.15.06)

Re: National Registry Failures

Dudley,

Five times and still failing is not the point. The point is that NR is still

willing to take their money so they should deliver a better product to their

customer. At the very least a little respect and take responsibility for

their mistakes.

Henry

National Registry Failures

Shamelessly stolen from another paramedic's blog (and also, bumped to the

paramedicine list as well)...

***************************************************

" So last May I started my Paramedic class, and was the *only* one who jumped

into the class halfway through as an Intermediate and went on to Paramedic.

The rest of the class had been plugging away at it since last January. The

course wrapped up in September, and we began testing in October. I took my

initial Paramedic test for the National Registry in November, got my results

in December, and was finally certified in January of this year. Needless to

say, the process takes a little time. Well, today I ran into one of my

classmates... She is* still* waiting on taking *another* re-test.

Apparently from what she told me, over half of the class of 14 people did

not pass the test in the first 3 attempts, and only 3 of us, myself included

have actually become certified. I'm truly amazed. I mean really. I'm by *

far* not the best student, but I studied like *mad* for those tests. I will

admit, the class itself was not the best. The staff tried, but they were

just not very well organized. The other students got tired, and they got

frustrated, and they just stopped trying I think. The students that failed

3 times now have to take the *entire* course over again. In essence, they

wasted 9 months of their time and $3,500 of their money. I honestly can't

place 100% of the blame on either the students *or* the instructors, I

believe it was about half of both. The instructors were very disorganized

and didn't present the material very well, and the students knew that, were

frustated, and didn't know what to study on their own. And I do have to

admit I had a slight advantage... I have been working in the EMS field for

several years, most of them have not. That means that I have practical

knowledge of the things I learned in the classroom, so it wasn't a ton of

abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

just ave to work on learning *more *stuff, and switch my mental gears up a

notch... "

***************************************************

It would seem like with the discussion about NR failures, the NR test, the

NR testing process, and NR administrative headaches, that at least some

discussion needs to focus on student participation and student/instructor

interaction. Without blaming any specific student, I can say that when I've

precepted students on EMS units that this pretty much runs the gambit - some

are very well studied and trying to learn, some are trying to do as little

as possible and skate by, some are struggling to keep their heads above

water.

Personally, I don't want an NR test with a 100% pass rate. I want a failure

rate, because I want to ensure that the test is difficult enough to merit

administration - not just a mere " check-off sheet " for paramedic course

knowledge. On the flip side, I think a 50% failure rate for first attempts

would be bad, too, indicating a problem with the test, with the curriculum,

or the training provided. I don't know what the actual NR numbers are now,

but I know that NR presented a set of pass/fail numbers at GETAC (in Texas,

for those on paramedicine group) several years ago. They do track this, and

my understanding was that they use this information to validate questions,

etc. I'm not training in test-making, analysis, or stastics, so I can't

comment on how, when, why, where, etc... but it's likely that someone on one

of these lists can.

I do, however, place fault directly on students when they fail the NR exam

three times. Not because they can't, but because they didn't. Whether this

means that they didn't know the material, didn't undertstand how to relate

the material to a question/scenario, or didn't have good test-taking skills,

the burden for passing the exam in three tries falls on noone else. After a

first failure, the student should be re-assessing their knowledge and

understanding, and assessing their performance on the exam itself (how WELL

did I TAKE the test, not necessarily how WELL did I DO). There are several

test-taking strategies - especially for " body of knowledge " multiple-choice

standardized exams - that can significantly increase the chances of

passing. While this should probably be taught in a paramedic course, I can

understand not being " able to " teach it due to budget, time, or other

pressures put on paramedic course coordinators/administrators. Not that it

excuses them from culpability for failing to properly prepare students, but

ultimately, in a course where participation is VOLUNTARY (you CHOOSE to take

a paramedic course), the burden is ultimately on the student to perform.

After a second test failure, the student should be seeking help to identify

their problem areas - be it knowledge, application or presentation

(test-taking skills). After a third failure... more re-assessment. After

(as described earlier in this thread) a FIFTH failure? At that point, I

just don't know how a student can " blame " anyone other than themselves.

NR certainly has its problems, and I question its applicability in the broad

swath it's been applied to paramedic education and testing. That said, I

tend to think that a state-based, non-NR driven test could actually be

*harder*. I also believe that the burden shouldn't be on NR to lower

testing standards, but on local EMS folks to demand from their legislature

an increase in the requirements for paramedic licensure. Want an example?

To become a barber in Texas requires a 1500 hour training course, pass a

written and skills test.

To become a paramedic in Texas requires 764-924 hours of training which

includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

EMT-Intermediate first (which, for those on paramedicine, isI/85).

Becoming a paramedic in Texas requires HALF of the hours required to become

a barber.

So, to sum up, students should be responsible for their own multiple

failures if they aren't trying to mitigate and understand each failure.

Educators essentially have their hands tied (witness: Navarro College

situation this month). EMS folks in general have an " I've got mine, what do

I care if someone else gets theirs, why raise standards " attitude. With

those things as a given, how DO you make things better?

My idea? Piss off the public. Someone needs to stand up and shame the hell

out of the EMS folks in this state - providers, personnel, fire departments,

mom-n-pop services, major EMS agencies - ALL of them. The public needs to

be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST the

professionalism of EMS providers (as a whole) and to DISTRUST their lives

and safety to folks in the bambulances...

Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

the legislature, beg for mercy, actually ASK for additional training

requirements, pull up their boots and get to work earning back the trust

that they've been skating along on all this time. How? By committing to

higher training standards, re-training standards, professional

requirements/standards, a stronger state-level governing body for EMS, and

true representation of the public's need for safety, health care and

prevention. Then, and only then, will the public TRUST EMS folks again -

and for the first time in a long time - righteously, because EMS folks will

have actually EARNED it.

FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

of " them " too in my email, so don't think I'm on a high horse.

Flame on.

Mike

[Guest guest]

Wasn't it September of 2000, when the rule requiring EMS programs to teach

the NSC went into effect? In March/April 2001, the disaster about the state

exams occurred, leading to the RFP and subsequent discussions and agreement

with NR. Then, in Oct 2001 (I think) the state went to the NR Basic exam

with the EMT-I and Paramedic in Feb. 2002 (again, I think). When these

changes took place some programs either didn't catch up or didn't want to

catch up. Those programs were basically teaching " old curriculum " under the

guise of " new curriculum " . As a result their students were woefully lacking

in the knowledge to successfully pass the NR written or skills exams.

Eddie , EMT-P

Director of Clinical Services

4100 Ed Bluestein Blvd., Suite 100

Austin, TX 78721

ext. 110

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of wegandy1938@...

Sent: Monday, July 31, 2006 11:16 PM

To: hatfield@...; texasems-l

Subject: Re: National Registry Failures

Mike,

Why shouldn't we be able to teach to the level of the test?

Is it because our instructors are incompetent? Coordinators are

incompetent? What?

The material is there for the asking.

On the paramedic level, the NSC is there for everyone to read, including

students and instructors. It also has a teaching outline. The same is true

of

the EMT-B curriculum. So why should anyone not be teaching to the level of

the test?

Gene G.

In a message dated 7/31/06 10:22:38 PM, hatfield (AT) neopolis (DOT)

<mailto:hatfield%40neopolis.net> net writes:

>

> I have to agree with Henry, but only partially.

>

> I think NR came in at a time when we partially needed help. The problem

> being is that we agreed to be tested at a level that we were not prepared

to

> teach to the level that we were prepared to test at.

>

> I think that when we finally get to the point that we are able to teach to

> the level that we test, we can improve..

>

> Just my honest opinion.

>

> Me

>

> Hatfield FF/EMT-P

>

> www.canyonlakefire- www.ca

>

> www.michaelhatfield www

>

> (updated 6.15.06)

>

> Re: National Registry Failures

>

> Dudley,

>

> Five times and still failing is not the point. The point is that NR is

still

> willing to take their money so they should deliver a better product to

their

> customer. At the very least a little respect and take responsibility for

> their mistakes.

>

> Henry

> National Registry Failures

>

> Shamelessly stolen from another paramedic's blog (and also, bumped to the

> paramedicine list as well)...

>

> ************ ******** ******** ******** ******** **

>

> " So last May I started my Paramedic class, and was the *only* one who

jumped

> into the class halfway through as an Intermediate and went on to

Paramedic.

> The rest of the class had been plugging away at it since last January. The

> course wrapped up in September, and we began testing in October. I took my

> initial Paramedic test for the National Registry in November, got my

results

> in December, and was finally certified in January of this year. Needless

to

> say, the process takes a little time. Well, today I ran into one of my

> classmates.. classmates..<wbr>. She is* still* waiting on taking

> Apparently from what she told me, over half of the class of 14 people did

> not pass the test in the first 3 attempts, and only 3 of us, myself

included

> have actually become certified. I'm truly amazed. I mean really. I'm by *

> far* not the best student, but I studied like *mad* for those tests. I

will

> admit, the class itself was not the best. The staff tried, but they were

> just not very well organized. The other students got tired, and they got

> frustrated, and they just stopped trying I think. The students that failed

> 3 times now have to take the *entire* course over again. In essence, they

> wasted 9 months of their time and $3,500 of their money. I honestly can't

> place 100% of the blame on either the students *or* the instructors, I

> believe it was about half of both. The instructors were very disorganized

> and didn't present the material very well, and the students knew that,

were

> frustated, and didn't know what to study on their own. And I do have to

> admit I had a slight advantage... I have been working in the EMS field for

> several years, most of them have not. That means that I have practical

> knowledge of the things I learned in the classroom, so it wasn't a ton of

> abstract " book stuff " to learn. Oh well... I'm SO glad I passed. Now I

> just ave to work on learning *more *stuff, and switch my mental gears up a

> notch... "

>

> ************ ******** ******** ******** ******** **

>

> It would seem like with the discussion about NR failures, the NR test, the

> NR testing process, and NR administrative headaches, that at least some

> discussion needs to focus on student participation and student/instructor

> interaction. Without blaming any specific student, I can say that when

I've

> precepted students on EMS units that this pretty much runs the gambit -

some

> are very well studied and trying to learn, some are trying to do as little

> as possible and skate by, some are struggling to keep their heads above

> water.

>

> Personally, I don't want an NR test with a 100% pass rate. I want a

failure

> rate, because I want to ensure that the test is difficult enough to merit

> administration - not just a mere " check-off sheet " for paramedic course

> knowledge. On the flip side, I think a 50% failure rate for first attempts

> would be bad, too, indicating a problem with the test, with the

curriculum,

> or the training provided. I don't know what the actual NR numbers are now,

> but I know that NR presented a set of pass/fail numbers at GETAC (in

Texas,

> for those on paramedicine group) several years ago. They do track this,

and

> my understanding was that they use this information to validate questions,

> etc. I'm not training in test-making, analysis, or stastics, so I can't

> comment on how, when, why, where, etc... but it's likely that someone on

one

> of these lists can.

>

> I do, however, place fault directly on students when they fail the NR exam

> three times. Not because they can't, but because they didn't. Whether this

> means that they didn't know the material, didn't undertstand how to relate

> the material to a question/scenario, or didn't have good test-taking

skills,

> the burden for passing the exam in three tries falls on noone else. After

a

> first failure, the student should be re-assessing their knowledge and

> understanding, and assessing their performance on the exam itself (how

WELL

> did I TAKE the test, not necessarily how WELL did I DO). There are several

> test-taking strategies - especially for " body of knowledge "

multiple-choice

> standardized exams - that can significantly increase the chances of

> passing. While this should probably be taught in a paramedic course, I can

> understand not being " able to " teach it due to budget, time, or other

> pressures put on paramedic course coordinators/ pressures put on paramedic

> excuses them from culpability for failing to properly prepare students,

but

> ultimately, in a course where participation is VOLUNTARY (you CHOOSE to

take

> a paramedic course), the burden is ultimately on the student to perform.

> After a second test failure, the student should be seeking help to

identify

> their problem areas - be it knowledge, application or presentation

> (test-taking skills). After a third failure... more re-assessment. After

> (as described earlier in this thread) a FIFTH failure? At that point, I

> just don't know how a student can " blame " anyone other than themselves.

>

> NR certainly has its problems, and I question its applicability in the

broad

> swath it's been applied to paramedic education and testing. That said, I

> tend to think that a state-based, non-NR driven test could actually be

> *harder*. I also believe that the burden shouldn't be on NR to lower

> testing standards, but on local EMS folks to demand from their legislature

> an increase in the requirements for paramedic licensure. Want an example?

>

> To become a barber in Texas requires a 1500 hour training course, pass a

> written and skills test.

>

> To become a paramedic in Texas requires 764-924 hours of training which

> includes classroom AND clinicals (140 EMT, 160 EMT-Intermediate, 624

> Paramedic). 764 if you do EMT then Paramedic, 924 if you step through

> EMT-Intermediate first (which, for those on paramedicine, isI/85).

>

> Becoming a paramedic in Texas requires HALF of the hours required to

become

> a barber.

>

> So, to sum up, students should be responsible for their own multiple

> failures if they aren't trying to mitigate and understand each failure.

> Educators essentially have their hands tied (witness: Navarro College

> situation this month). EMS folks in general have an " I've got mine, what

do

> I care if someone else gets theirs, why raise standards " attitude. With

> those things as a given, how DO you make things better?

>

> My idea? Piss off the public. Someone needs to stand up and shame the hell

> out of the EMS folks in this state - providers, personnel, fire

departments,

> mom-n-pop services, major EMS agencies - ALL of them. The public needs to

> be made to DISTRUST the (lack of) training of EMS providers, to DISTRUST

the

> professionalism of EMS providers (as a whole) and to DISTRUST their lives

> and safety to folks in the bambulances. a

>

> Then, once proplerly DISTRUSTED, EMS folks need to approach the public and

> the legislature, beg for mercy, actually ASK for additional training

> requirements, pull up their boots and get to work earning back the trust

> that they've been skating along on all this time. How? By committing to

> higher training standards, re-training standards, professional

> requirements/ requirements/<wbr>standards, a stronger state-level governin

> true representation of the public's need for safety, health care and

> prevention. Then, and only then, will the public TRUST EMS folks again -

> and for the first time in a long time - righteously, because EMS folks

will

> have actually EARNED it.

>

> FYI, I'm one of those EMS folks. I'm a Texas Licensed Paramedic. I'm one

> of " them " too in my email, so don't think I'm on a high horse.

>

> Flame on.

>

> Mike

>

>