National Registry vs Competency was Re: National Registry question

[Guest guest]

Gene;

I understand what you are saying. I have seen on this list many times and

have spoken to students from across the state where the content that is supposed

to be taught is somehow missing the target audience. That tells me that even

though the classes should be adhering to the National DOT they may not be.

Although there may not be any data to show that competency levels increase if

one has NR status I believe it brings closer than not everyone at least knowing

where the same page is.

Can you remember how far that was only 5 years ago? I can.

I am not saying that the NR exam is by far a cure all. I can see problems with

the process.

The questions I keep asking are : Do we need better testing?, or Do we need to

start on the same page?

I would have to ask why the other states are turning away. Is it a competency

issue or is it a failure issue. By that I mean are the medics somehow not as

competent in doing their job after the exam?, or are so many failing that we

need to change so we can be kinder to those who have difficulty in passing?

Issuing exams are the only ability we have to determine competency. OJT is

less likely a good choice these days (lawsuits happen).

As far as your last comment on the board. Is that not what is supposed to

happen during initial classroom instruction? Although not given by a board are

students not supposed to know what is happening to the patient and how to treat

them? In the classes I have seen taught and have assisted in teaching more than

one instructor is there to train, teach, instrtuct, and test all students. If

the process is not being done, Find better instructors.

I have always been opposed to passing students who cannot or will not

demonstrate that they will take care of me or my loved onesproperly when they

hit the field. Passing the tests are ok. Classroom is, or should I say, should

be designed for the purpose of determing competency.

Like it or not the only thing we have at this time is the NR exam and being

able to pass that, even though it be an entry exam; should not be taken lightly.

wegandy1938@... wrote:

Danny,

I have to respectfully disagree with you on a some of your points.

The fact that some people see the NR exam as being more difficult than the

last Texas exams were, is not the reason that the NR is in Texas. The reason

is that the state stopped giving adequate funding to what was then the TDH to

develop, evaluate and administer the exams. In fact, back in the '90s Texas

had a GREAT paramedic exam that separated the colts from the dolts. I took

it, and it was not easy. It was far more difficult than the NR currently is.

In a subsequent post I'll pose one of the questions that was on that exam and

see just how many medics can solve it quickly (and it can easily be done in

your head).

Second, the NR has nothing to do with course content as taught in Texas.

Texas adheres to the DOT National Standard Curriculum for each level, and that's

where both the Texas exam questions and the National Registry exam questions

are based. Every question must be based upon a DOT learning objective. So

if a course is teaching the curriculum, the graduate should be well qualified

for the NR.

Third, many Texas programs, including the last two I was affiliated with,

taught far in excess of the minimum requirements, and there is nothing in NR

that was not taught in those courses.

Fourth, there is no data whatsoever, anywhere, in any form or fashion that

correlates how one does on the National Registry examination with competency

to perform as a medic, nor does it predict in any way the performance of any

person.

The NR is a gate keeper, nothing more. You have to pay the toll to pass

through the gate, but there's no guarantee that it makes anyone a better medic.

I have never taken the NR even though I have written questions for it. I

believe that it is completely irrelevant to medical practice other than as a

device to control entry into the system.

It is not the NR that should be driving EMS education. What should be

driving EMS education is professionalism and a desire to include in the

curriculum

more than the minimum stuff in the NSC.

Several states have now recognized that NR is not the thing for them and they

are moving away from it into other testing organizations. Illinois is the

latest state that I know of that has done that.

Don't get me wrong. I believe in comprehensive medical education for each

level and have always provided much higher levels than many other programs. I

challenge anyone to take one of my Paramedic final exams, and compare it to

the NR exam. I think they would find that the medical knowledge required was

much higher and much more in depth than that required on the NR.

However, I would be the first to say that passing that exam would tell me

nothing about how a medic would practice in the field.

When I took the bar exams in Colorado and Texas, they consisted entirely of

essay questions, comprehensive and mind-boggling scenarios that required the

highest level of knowledge, mental functioning and critical thinking. They

were right up at the top of Bloom's scale.

Sadly, the myth of multiple choice testing has caused that to change, for the

worse, I think.

I believe that every candidate for paramedic certification or licensure in

Texas should face an exam board composed of at least 6 EMS educators,

paramedics, nurses, and physicians and they should have to demonstrate knowledge

of

history taking, assessment, critical thinking, identification of differential

diagnoses, and a treatment plan, including drug administration and doses, and

this

should be a half-day process for each candidate at minimum.

That will never happen, but it should.

And if it did, there would be Paramedic Death Squads after me! LOL.

Gene Gandy, JD, LP

>

> Andy;

> There was no dig intended. We all want more knowledge and all want to be

> able to show it.

>

> I find that the NR test was more strenuous than the Texas certification

> test. Different things the NR wanted a person to know than what I was taught.

>

> I speak of " You'll never use this outside of class' " We don't do that here "

> " I have never seen this done/used in my time "

>

> rachfoote@... wrote:

> Yeap, I kinda felt a dig there with Danny's last sentence.? I am not, nor

> shall I ever be.

>

> Andy Foote

>

> National Registry question

> >

> >

> >

> > I am a currently certified Texas Paramedic... I am a currently cer

> has

> > been well over 2 years ago. I am looking to obtain NREMT-P

> > certification however, the NREMTP site is clear as mud and talking

> to

> > them is even mudier.

> > I know that I will need to have a formal refresher of 48 hrs in the

> > appropriate categories.. appropriate categories..<wbr>.but what if

> Can

> > I use the hours from that course as my " refresher " ?

> > Any suggestions about what is the most painless (ha,ha) way of

> going

> > about getting NREMT-P certification for a paramedic who has been

> > certified for a while?

> >

> > Thanks,

> >

> > Leach EMT-P, CCEMTP

> >

> >

> >

> >

> >