EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: https://emsworld.epubxp.com/i/1032353

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Page 80 of 87

80 OCTOBER 2018 | EMSWORLD.com S P O T L I G H T: of students who did not pass the affective domain evaluation on cognitive and noncognitive (psychomotor and capstone field internship) student outcomes. Methods—A retrospective records analysis of graduated para- medic students in Fisdap, an online database for EMS and health- care education, was conducted. Completed affective domain (professional behavior) evaluations were reviewed to determine association with cognitive performance (results on the PRE3 or PRE4 exam) and noncognitive performance (team leader perfor- mance score on lab and field daily evaluations). The evaluations consisted of 11 criteria on the Fisdap professional behavior evalu- ation and were dichotomized by preceptors as "competent" or "not yet competent," with an overall rating of pass or fail. Results—Data were collected from 25,534 professional behav- ior student evaluations. Failing scores on the affective domain were assessed in 151 (0.6%) assessments for 93 students. Data for individual questions (n=282,051) were extracted, with 1,661 (0.6%) items scored as "not yet competent." Item competency failures ranged between 74%–89%. Self-motivation, self-con- fidence, communication, time management, and careful deliv- ery of service were items that were most often reported as "not yet competent." Due to the extremely low number of failures, no association between affective domain and cognitive or noncogni- tive performance was discovered. Conclusion—The results of the study were unable to demon- strate any association between affective scores and cognitive or noncognitive performance. Results did, however, indicate nearly all students passed their professional behavioral evaluations. The findings suggest several possibilities, including a flaw in the affective domain evaluation tool, evaluators not accurately evalu- ating the affective domain, evaluator reluctance to issue failing affective scores, or EMS students naturally having an underly- ing good affect. Further study of affective domain evaluation is recommended to determine the reason or reasons for the nearly 100% pass rate. An Exploration of Program Director Leadership Practices in Nationally Accredited Paramedic Education Programs Author: Gordon Kokx, PhD, NRP Introduction—The number of paramedic education programs participating in the national accreditation process has nearly tri- pled in the past several years. Although accreditation standards describe program director roles and responsibilities, nothing has been formally studied regarding their leadership practices. Purpose—The purpose of this study was to explore leadership practices of program directors in nationally accredited paramedic education programs. Methods—The study was designed with an a posteriori episte- mological stance, incorporated a constructivist perspective, and was conducted using qualitative methodology. It explored the perceptions and observations of uniquely qualified, elite subject matter experts (SMEs) to determine the leadership practices of nationally accredited paramedic education program directors. Twelve SMEs were selected based on the inclusive criteria of EMS educator, program director, and accreditation board mem- ber experiences. A series of in-depth, semistructured interviews using interpretive inquiry were conducted to explore the context, challenges, and best practices of program director leadership. Results—EMS educator experience totaled 379 years (range: 10–40 years/SME). Program director experience totaled 223 years (range: 4–36 years/SME). Accreditation board experience totaled 87 years (range: 1–16 years/SME). Site visitor experience totaled 149 years (range: 1–32 years/SME). Participants ranked the specific positive leadership theories of "authentic, servant, ethical" as most important; whereas "charismatic, spiritual, and transformational," although recognized, were less significant. The leadership skills theory (including human, technical, and conceptual skills) was also important to the sphere of leader- ship responsibilities of program directors. Findings revealed con- text and best practice themes which included a critical need for understanding and establishing a culture of quality. Significant challenge themes included the existence of an EMS identity crisis and generational dissonance. Conclusions—Program director leadership is responsible for 75.44% of a program's success, yet no formalized leadership cur- riculum or training exists. Subsequently, there is both a need for the development of a program director leadership curriculum as well as program director leadership training. This study added to the research literature and identifies leadership practices that may improve paramedic education programs. Further study in the field of paramedic education program director leadership practice is recommended. Characteristics Associated with Examination Persistence After an Unsuccessful First Attempt at the National EMT Cognitive Examination Author: Kim McKenna, PhD, RN, EMT-P Associate authors: Elliot Carhart, EdD, FAEMS, E. Paulette Isaac- Savage, EdD, Remle Crowe, MS, NREMT Introduction—Recruiting EMS professionals is essential to meet increasing demands for emergency care. EMT certification is often the entry point for EMS as well as firefighting careers. A prerequisite for obtaining licensure to practice in most states is successful completion of the National EMT certification (National Registry) cognitive examination (NREMT-C). Candidates who are unsuccessful at their first NREMT-C attempt and never return for

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