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.

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Page 82 of 87

82 OCTOBER 2018 | EMSWORLD.com S P O T L I G H T: Methods—This paper is part of a larger project which con- sisted of three cycles of action research. Data were collected via an online survey questionnaire and by conducting a series of semistructured interviews with participants in the reflective discussion forum. These included all three clinical levels of pre- hospital emergency care practitioners and the three hierarchical levels within the organization. Findings—The collaborative reflective discussion forum was found to be beneficial. Among the benefits cited were: the opportunity to draw on the experience of more experienced colleagues; the development of critical thinking skills; and the potential for use as part of a mentoring process. It was also felt that the collaborative nature of the forum had the potential to improve workplace relationships through empowerment of the staff. Concerns were raised regarding the potential for abuse and misuse, particularly in relation to the areas of patient con- fidentiality and a lack of trust within organizations. Recommendations—The establishment of a regular reflective discussion forum within organizations is a key learning strategy. Any collaborative forum must be chaired by a trusted, experi- enced, and highly skilled facilitator. A learning contract for all par- ticipants and faculty, including a confidentiality agreement, must be in place before the establishment of any collaborative forum. The Answer to the Big Flippin' Question Author: Mark Malonzo, EdD(c), NRP, NCEE Associate authors: Leah Tilden, MA, AEMT, Felix Marquez, BA, NRP, Sara Walker, MS, EMT-P, Jonathan Willoughby, PhD(c), NRP, Nancy Hoffmann, MSW, Tiffany Sliter, BS, Michael Shoulders, AS, NRP, Jose Palma, PhD(c) Introduction—A flipped classroom model is based on out-of- class learning (e.g., via the Internet) for core content followed by in-class application-level activities. Flipped classrooms are thought to enhance learning through interactive activities among instructors and peers. Data from a 2016 pilot study found a mar- ginal increase in NREMT cognitive exam scores in a flipped OB module. Research question—Is there a difference in NREMT cognitive pass rates between traditional and flipped classrooms within the institution? Is there a difference in NREMT cognitive pass rates between national and individual programs? Is there a difference in exam scores between flipped classrooms and the national Fisdap scores in 2017? Hypothesis—Flipped-classroom students will score higher on cognitive exams than traditional EMT students. Methods—Four geographically different EMT programs self- identified to use a flipped-classroom delivery for the entire EMT class. Students took the unit exams and ERE2. On completion of the course, students also took the NREMT cognitive exam. Nonparametric bootstrap tests were used to determine differ- ences in the mean achievement scores between students from flipped and traditional classrooms using different measures. For each measure, a Monte Carlo p-value was computed using 4,999 bootstrap duplicates from the data. Each p-value com- puted is a corrected p-value using the suggestion by Davison Hinkley (1997). Results—Data from 51 students were included in the study. Nonparametric bootstrap tests found p-values were statistically significant in all unit exams and the ERE2. For each of the mea- sures, this is evidence against the null hypothesis of no mean differences and suggests students from flipped and nonflipped classrooms may differ in each measure. EMT students in the flipped classroom also had higher cognitive scores than national averages on the NREMT cognitive exam. Conclusion—Flipped-classroom students had higher scores than the national NREMT cognitive exam average. These flipped- classroom students also had significantly higher scores on all six unit exams and the ERE2. While further research with a larger geographic distribution and number of participants is needed to generalize these findings, these results align with evidence from other disciplines suggesting that EMT students have higher cognitive competency in a flipped-classroom setting. Dierences in Paramedic Education by Student Demographics Author: Rebecca Valentine, BS, Paramedic, MA I/C, NCEE Associate authors: Pakou Her, BS, Robert Gurliacci, BPS, EMT-P, Rebecca Brun, NRP, Daniel W. Murdock, BT, FP-C, NRP, CIC, Daniel Armstrong, DPT, MS, EMT, James E. Gretz, NRP, CCP-C, Ryan Huser, BS, NRP, CCEMTP, Daniel Haugen, BA, BS, Adisack Nhouyvanis- vong, PhD, Sahaj Khalsa, BS, NRP Introduction—During paramedic training, students encounter multiple opportunities to perform psychomotor skills on actual patients under realistic conditions. In some cases, however, the student does not perform the skill, but rather simply observes a preceptor do so. This investigation examines whether student demographic variables influence psychomotor skill engagement during paramedic training. Hypothesis—Demographic variables influence the perfor- mance of psychomotor skills during paramedic training. Methods—This retrospective analysis utilized a 2x2x3 facto- rial design. We abstracted data from Fisdap, an online database for EMS and healthcare education, for student-patient encoun- ters that occurred during a 39-month interval from November 2014 through January 2018. All students consented to the use of their data, and instructors verified accuracy. The dependent

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