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Clinical Judgment Item Development for Emergency Medical Service Clinicians
Paul Rosenberger1, Kenneth W Navarro1, Christopher B Gage1,2,3
1National Registry of Emergency Medical Technicians, Columbus, Ohio.
Prehospital Emergency Care
|September 27, 2024
Summary
A new template standardizes clinical judgment assessment in emergency medical services (EMS) education. This tool aids in developing consistent evaluations of prehospital care providers, improving overall quality of care.
Area of Science:
- Medical Education
- Emergency Medical Services (EMS)
- Clinical Judgment Assessment
Background:
- Clinical judgment is crucial for healthcare providers but lacks clear assessment methods in emergency medical services (EMS) education.
- Existing definitions of clinical judgment are ambiguous, hindering consistent evaluation in initial and continuing EMS training.
- A recent theoretical framework offers clarity on clinical judgment within the dynamic context of prehospital care.
Purpose of the Study:
- To present a template for developing clinical judgment assessment items in EMS education.
- To leverage a new theoretical framework for clinical judgment to standardize assessment methods.
- To facilitate reproducible and transparent item generation for evaluating EMS providers' cognitive skills.
Main Methods:
- Developed an item development template with input from EMS clinicians, educators, and nursing subject matter experts.
- The template incorporates the six core cognitive steps of clinical judgment: recognizing cues, analyzing cues, forming hypotheses, generating solutions, taking action, and evaluating outcomes.
- Expert collaboration ensured the template's relevance to clinical judgment item development.
Main Results:
- A transparent and reproducible template for generating clinical judgment assessment items is provided.
- The template evaluates the six fundamental cognitive reasoning steps essential for EMS practice.
- A practical example using a hypoglycemic patient case demonstrates the template's application across different prehospital care phases (en route, scene, post-scene).
Conclusions:
- The developed template enables the creation of standardized assessment items for clinical judgment in EMS.
- Items can be generated for each phase of an EMS event, allowing for serial and flexible application.
- This tool supports consistent evaluation of prehospital care providers across diverse clinical scenarios.
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