The following abstract was developed during the 2010 Research Summit and presented at the 2010 NAEMSE Symposium in Chicago.

The Effect of Clinical and Field Experience on Critical-Thinking Performance for Emergency Medical Technician Students Taking the EMT Readiness Exam

Kathi Ricketts, RN, EM T-P, FP-C; Rob Gurliacci, BPS, EMT-P; Sara Houston, BS, AS, NREMT-P; Tim Howey, BA, NREMT-P; Barry Jensen, NREMT-P, NCEE; Liz Neerland, BA; Ian Young, BA

Introduction: Clinical experience has been proven to enhance classroom learning in medical professions. No literature was found that examines the relationship between clinical experiences and critical-thinking performance on cognitive examinations by the emergency medical technician (EMT) student. Past research has shown a positive correlation between clinical experience and paramedic student criticalthinking performance.

Hypothesis: Clinical exposure will increase scores on critical-thinking items in the EMT Readiness Exam.

Methods: Data were collected from March 2007 to February 2010 from EMT students participating in FISDAP, a national, online EMS student tracking system. Inclusion criteria were FISDAP EMT accounts, clinical experience preceding the EMT Readiness Exam, first-attempt examination only, and taking the examination within three months after finishing clinical rotations. Students prospectively reported their clinical and field experiences. A multiple regression model was used to determine whether field hours, number of field contacts, hospital clinical hours, or hospital clinical contacts were predictive of increased overall examination scores. Also compared were the same variables with only the criticalthinking items on the examination.

Results: Data from 1,038 students met the inclusion criteria. Field contacts (p < 0.001), clinical hours (p < 0.001), and clinical contacts (p =0.047) were predictive of higher overall examination scores. Field contacts (p < 0.001) and clinical hours (p< 0.001) were predictive of higher scores on critical thinking items in the examination. Clinical contacts (p = 0.078) were not predictive of higher scores on the critical-thinking items on the examination.

Conclusion: The new education standards for EMTs recommend clinical and field experience with a minimum of 10 patient contacts overall. Based on the above findings, patient contacts are more useful when obtained in the field, and clinical time is best spent in observation of the care continuum.