Understanding higher-order constructs of leadership and communication in EMS clinical judgment.

Background: For emergency medical services (EMS) clinicians, clinical judgment is a higher-order construct that encompasses the initial thought process (clinical reasoning) that assists clinicians in reaching conclusions (clinical decision making). Current theoretical frameworks of clinical judgment contain other higher order constructs (e.g.

Clinical Judgment Item Development for Emergency Medical Service Clinicians.

Objectives: While clinical judgment is vital for all clinicians, it is not clearly assessed in initial or continuing emergency medical services (EMS) education due to unclear definitions. Recently, clarity of this concept has been provided through the development of a theoretical framework for clinical judgment in EMS that considers the broad and evolving nature of prehospital care delivery. To facilitate standardization of clinical judgment assessments, in this educational practice review we present a template for item development leveraging the new framework.

Examining the Reliability and Validity of the ALS Certification Examinations with the Inclusion of Clinical Judgment: An Update on the ALS Examination Redesign.

Objectives: Clinical judgment describes the process an emergency medical service clinician uses to evaluate problems and make decisions in the out-of-hospital setting. As part of the redesign of the Advanced Life Support (ALS) certification examinations, the National Registry of Emergency Medical Technicians is developing and evaluating items that measure clinical judgment, with the intention of assessing these as a new domain in the ALS certification examinations. In this study, we provide evidence around the redesign by evaluating the reliability and validity of the advanced emergency medical technician (AEMT) and paramedic certification examinations when clinical judgment is included as a sixth domain along with the five current domains.

Impact of COVID-19 on initial emergency medical services certification in the United States.

Objective: As the COVID-19 pandemic began, there were significant concerns for the strength and stability of the emergency medical services (EMS) workforce. These concerns were heightened with the closure of examination centers and the cessation of certification examinations. The impact of this interruption on the EMS workforce is unclear.

A Proposed Theoretical Framework for Clinical Judgment in EMS.

In the prehospital setting, EMS clinicians are challenged by the need to assess and treat patients who are clinically undifferentiated with a large constellation of possible medical problems. In addition to possessing a large and diverse set of knowledge, skills, and abilities, EMS clinicians must integrate a plethora of environmental, patient, and event specific cues in their clinical decision-making processes. To date, there is no theoretical framework to capture the complex process that characterizes the prehospital experience from dispatch to handoff, the interface between cues and on-scene information and assessments, while incorporating the importance of leadership and communication.