Beyond the Skill Sheet: Assessment Practice That Matters

Part 3 in a 3-part series about preparing EMT students for the new NREMT exam. Read part 1 and part 2.

We want our students to think and apply. We want them to do well on our exams and the NREMT. More and more, we realize that practice and application are the keys to getting there. Not lecture.

Patient Assessment OB Scenario

Consider the following as a scenario to give your students near the end of their EMT class:

How does this link to patient assessment and the NREMT exam? This scenario is ideal preparation for the questions that end in “You should,” “You should suspect,” and “You should first.” It is the prime case demonstrating how a scenario can teach skills, differential diagnosis, and key cognitive elements in a true “nook and cranny” area.

How should your students perform? What will they get from this experience?

• Students should consider three broad stroke causes: trauma from the crash, supine hypotensive syndrome, and placental abruption. This is differential diagnosis under fire. Will your students consider and assess for these causes?

• Will they develop a management plan and use available treatments for these causes (e.g. positioning for supine hypotensive syndrome and prompt transport to an appropriate facility)?

• Can they differentiate the anxiety caused by “Is my baby going to be OK?” from the anxiety caused by shock? Or at least realize that both exist?

• Will they recognize the differences that pregnancy causes in the body (e.g. blood volume and distribution)?

• What will students get from this scenario? They’ll get application practice and cement the core cognitive elements regarding pregnancy (above).

We think of debriefings when we do a formal “simulation” using a manikin. Let’s be sure we do appropriate debriefings during lab sessions every day. What would you debrief? Most importantly, debriefing links the experience and assessment findings and the patient's condition and outcome. These are key elements of the NREMT exam.

Debriefing links the experience and assessment findings and the patient's condition and outcome. These are key elements of the NREMT exam.

Use Labs to Improve Student Understanding and NREMT Readiness

Go deeper in labs. Consider adding some of the following concepts into your labs to increase depth, understanding, and new tasks from the NREMT’s exam blueprint.

EMT Lab Idea: Stopwatch

Have one student use their watch’s stopwatch feature to time a scenario involving a code. Have a second student mark time only when compressions are being performed. This will:

• Engage students more deeply in the scenario as observers while others are practicing.

• Help students truly understand compression fraction in a code and ways to maintain it.

• Predict patient outcomes based on EMS actions.

EMT Lab Idea: Two Patients

Have students enter a scenario and find two patients, not one. This will:

• Highlight important elements of the scene size-up, such as calling for additional assistance and triage.

• Help use the initial parts of the size-up and primary assessment to determine criticality and make priority decisions.

• Require teamwork as far as delegating and resource management.

• Note: The patients don’t both have to be critical. This is a simple yet effective learning experience about elements of the new NREMT tasks: size-up, priorities, and triage.

EMT Lab Idea: Combination Scenarios

Use “combination” scenarios like the trauma in pregnancy example above. This will:

• Foster differential diagnostic skills.

• Lead to more in-depth learning as you start using more narrow scenarios as the class progresses. For example, after the respiratory and cardiology lessons, present a patient who has chest discomfort but from pneumonia (cough, gradual onset, malaise), not MI.

More Downloadable Assessment Resources

Assessment Exercises

Download our Rapid Patient Assessment exercise and Secondary Assessment Body System exercise to use in your classroom and lab sessions. These exercises highlight the secondary assessment’s history and physical exam.

Pattern Recognition and Critical Thinking PowerPoint

The NREMT exam’s focus on assessment makes pattern recognition and critical thinking more important than ever. Can your students identify common patterns and presentations? They will after you use this Pattern Recognition and Critical Thinking PowerPoint deck. This contains 17 brief patient presentations, each on an individual slide, for your students to read, interpret, and make a diagnosis. The slides use key diagnostic hallmarks as clues. Each slide has detailed built-in slide notes to help guide the presentation.

Patient Assessment Classroom Posters

Don’t forget our patient assessment posters! We have a two-poster set that provides a detailed guide to primary and secondary assessment. We also have a guidelines poster that covers patient assessment more conceptually for greater application and understanding.

Don’t get stuck in the lecture trap – but make sure the scenarios you run give you and your students high-yield results in core assessment concepts. This helps your students in practice and on the NREMT cognitive exam!