Medication dosing errors in pediatric patients treated by emergency medical services.

Competence encompasses knowledge skills abilities and traits It is gained in the healthcare professions through pre-service education in-service training and work experience Competence is a major determinant of provider performance as represented by conformance with various clinical non-clinical and interpersonal standards Measuring competence is essential for determining the ability and readiness of health workers to provide quality services Although competence is a precursor to doing the job right measuring performance periodically is also crucial to determine whether providers are using their competence on the job A provider can have the knowledge and skill but use it poorly because of individual factors (abilities traits goals values inertia etc) or external factors (unavailability of drugs equipment organizational support etc) This paper provides a framework for understanding the key factors that affect provider competence Different methods for measuring competence are discussed as are criteria for selecting measurement methods Also evidence from various research studies on measuring the effectiveness of different assessment techniques is presented (authors)

Measuring the competence of healthcare providers.

Background. Emergency medical services (EMS) providers infrequently encounter seriously ill and injured pediatric patients. Clinical simulations are useful for assessing skill level, especially for low-frequency, high-risk problems. Objective. To identify the most common performance deficiencies in paramedics’ management of three simulated pediatric emergencies. Methods. Paramedics from five EMS agencies in Michigan were eligible subjects for this prospective, observational study. Three clinical assessment modules (CAMs) were designed and validated using pediatric simulators with varying technologic complexity. Scenarios included an infant cardiopulmonary arrest, sepsis/seizure, and child asthma/respiratory arrest. Each scenario required paramedics to perform an assessment and provide appropriate pediatric patient care within a 12-minute time limit. Trained instructors conducted the simulations by following strict guidelines for sequences of events and responses. Videos of CAMs were reviewed by an independent evaluator to verify scoring accuracy. Percentage of steps completed for each of the three scenarios and specific performance deficiencies were recorded. Results. Two hundred twelve paramedics completed the CAMs. The average percentages of steps completed were as follows: arrest CAM, 45.3%; asthma CAM, 51.6%; and sepsis CAM, 47.1%. Performance deficiencies included lack of airway support or protection; lack of support of ventilations or cardiac function; inappropriate use of length-based treatment tapes; and inaccurate calculation and administration of medications and fluids. Conclusion. Multiple deficiencies in paramedics’ performance of pediatric resuscitation skills were objectively identified using three manikin-based simulations. EMS educators and EMS medical directors should target these Received August 14, 2008, from the Department of Emergency Medicine (RLL, MJB, WDF, RAH), Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, Michigan. Revision received November 26, 2008; accepted for publication De-

Simulation-based Assessment of Paramedic Pediatric Resuscitation Skills

This represents one of a series of studies of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) being undertaken by the National Registry of Emergency Medical Technicians and the National Highway Traffic Safety Administration (NHTSA). This secondary analysis of the LEADS database, which provides a representative sampling of EMTs throughout the United States, examines the effects of instructor quality on the level of preparedness of emergency medical technicians (EMTs). Results showed significant differences, based on instructor quality, in the ratings on ten dimensions of EMT preparedness for both EMT Basics and EMT Paramedics. Implications for HRD practitioners, adult educators and researchers are discussed.

Instructor quality affecting emergency medical technician (EMT) preparedness: a LEADS project

The Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) provides a representative sampling of EMTs throughout the United States. The present study adds to the transfer of training literature by examining the relationship between instructor quality and National Registry of Emergency Medical Technicians certification examination outcomes. The effective sample size included 513 EMT-basics and 406 EMT-paramedics. The survey sample responded to questions concerning their experiences and ratings of the quality of the certification education and training. Survey respondents were matched with their certification test results, using the initial score on that exam as well as the number of test attempts. Results showed significant correlations, based on instructor quality on initial exam scores, as well as on the number of tries to obtain a passing score. Implications for HRD practitioners, adult and continuing professional educators, and researchers are discussed.

Taking the pulse of training transfer: Instructor quality and EMT certification examination results

PREFACE The National Highway Traffic Safety Administration (NHTSA) has assumed responsibility for the development of training courses that are responsive to the standards established by the Highway Safety Act of 1966 (amended). Since these courses are designed to provide national guidelines for training, it is NHTSA's intention that they be of the highest quality and be maintained in a current and up-to-date status from the point of view of both technical content and instructional strategy. Paramedic Practice Analysis, and the EMS Agenda for the Future. These continuing education guidelines are part of a series of courses making up a national EMS training program for prehospital care.

/pdf/emt-paramedic-and-emt-intermediate-continuing-education-5ovpfc1ear.pdf

EMT-Paramedic and EMT-Intermediate Continuing Education. National Guidelines.

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EMT-Paramedic and EMT-Intermediate Continuing Education. National Guidelines.