Emergency Medical Services (EMS) refers to the medical unit that deals with the treatment and transport of patients experiencing critical life-threatening conditions. Medical teams that work in the EMS sectors deal with emergencies such as drowning, fire burns, heart attacks and car accidents among others. The emergency medical technicians (EMT) provide the relevant provide support services to aid in the provision of EMS to patients. The study examines the evaluation tools that will be applied by the program director when testing the competence levels of students in the sector. The tools will encompass those that relate to the psychomotor, cognitive and affective domain.
Cognitive domain
The cognitive domain involves checking the level of knowledge and mental skills of an individual in evaluating whether they can handle a particular task. Cognitive testing is one of the basic levels of competence that students must pass to be admitted to the entry-level of the EMT program (Harun & Noorazman, 2018) . Every candidate must pass the cognitive domain test to be licensed as a competent practitioner.
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The first recommendation of the tool that can be used to evaluate the cognitive competency of an individual involves Manikin-based simulation. Manikin-based simulation is a tool that is used to evaluate the abilities of a potential EMS provider. The tool is used to measure the level of skills that EMS providers possess in providing the required attention to the patient (National Association of State EMS Officials, 2015) . A significant contribution of the simulation tool is that it would aid in increasing the level of safety of the patients through the timely response by the EMT team. The tool also aids in filling the gaps of knowledge to students who may undertake the EMT programs.
The second tool for recommendation involves mandatory continuing education (CE). The CE tool involves updating paramedics and other health professionals with the latest knowledge in their field to help them perform their healthcare duties. A huge benefit of the tool is that it aids the practitioners to identify problems and the easiest solutions to solve them to prevent further problems (National Association of State EMS Officials, 2015) . The tool is highly reliable as since it emphasizes on the employment of the most accurate measures of solving a health issue that may face the affected parties. The tool is also most effective in handling cases involving contemporary issues that have not been experienced in the past. A combination of the tools mentioned above ensures that the EMS practitioners have the required competence based on the cognitive domain.
Psychomotor domain
Psychomotor domain involves a combination of the mental and the physical strength to perform a particular task. The evaluation of the competency levels of a medical practitioner through checking the domain entails ensures that the student can utilize their mental and physical prowess concurrently to achieve the desired results. The National Registry of Emergency Medical Technicians (NREMT) requires every student to pass the psychomotor competency test to become a qualified medical practitioner. According to the National Registry of Emergency Medical Technicians (2015) , psychomotor skills aid in the promotion of safety and effective care to patients when they are out of the hospital.
A significant tool used in examining the psychomotor domain competence of a student entails Capstone Field Internship among the paramedics and other health technicians. The tool is a form of competence model package that involves checking the skills of paramedics and the ability to apply them in a practical situation. (National Registry of Emergency Medical Technicians, 2015) The relevance of the tool is that it enables paramedics to develop confidence when handling their tasks which improve their competence. The tool is reliable since it involves the practical application of the knowledge that paramedics have learnt in class to the field. The tool is effective in providing a vast experience to the paramedics through involving them in the daily tasks that they will undertake in the field. The tool also promotes teamwork since the health practitioners work in groups to execute tasks to achieve common results.
The second tool for measuring psychomotor competency of health practitioners involve evaluation. Evaluation involves checking the level of success that a health practitioner meets through assessments. Evaluation enables students to showcase the accuracy of the skills learnt in class and laboratory (National Registry of Emergency Medical Technicians, 2015) . The assessments used during the evaluation period are reliable since they assure that successful students have completed the competency test. The evaluation tool also aids in testing a student’s Clinical Experience on the types of patients to expect which aids in validating the competency of the candidate (Harun & Noorazman, 2018) . Evaluation is effective in bridging between the mental knowledge and the practical application of the skills that one has honed throughout the training sessions.
Affective Domain
Affective domain entails the growth in emotional areas of an individual. In paramedic education, affective domain addresses the learned behaviors which relate to the performance of clinical and other healthcare duties. Some of the practices involved in affective domain include teamwork, critical thinking, and creation of awareness among others.
A significance tool that can aid in the evaluation of the affective domain among practitioners is debriefing. Debriefing involves reviewing the events that have taken place, exploring and analysing actions to improve future performance. Debriefing tool aids medical practitioners to provide feedback on the experience that all parties gained while in the field (Batt, 2015) . The tool is reliable since it helps the practitioners to improve their previous experience through expressing areas where they were competent and those that need improvement. The tool is also valid since it involves all members of the team which enhances combined efforts among all members. The tool is most effective in situations where medical practitioners work as teams for long periods.
Another tool for evaluating the competency of medical practitioners involve reflection. The tool involves self-reflection of the aspects involved during the performance of one’s professional duties. The tool enables practitioners to reflect on the learning experiences at work and hence connecting between the theory and practice (Batt, 2015) . The tool is also reliable since it involves a continuous process of self-evaluation to improve productivity and efficiency at work. Also, the tool promotes validity through the provision of an avenue that one can use to reflect on their strengths and weaknesses. The reflection tool is effective for the achievement of the continuous improvement of an individual. The improvement increases the efficiency at work and hence a high level of productivity at work.
Conclusion
The study has revealed that the EMS education is a delicate one and requires continuous evaluation to ensure that health practitioners display the highest level of competence when handling their tasks. The paper has also proposed six recommendations that the program director should consider when evaluating the competency of students at the entry-level in the field. The implementation of the recommendations would aid in the selection of the most competent paramedics and health practitioners to carry out respective roles.
References
Batt, A. (2015). Teaching and evaluating the affective domain in Paramedic education. Retrieved from http://prehospitalresearch.eu/?p=5397
Harun, H., & Noorazman, A. (2018). The Effectiveness of Cognitive and Psychomotor Domain of Culinary Art Students’ Performance after Internship in Private Colleges. MATEC Web of Conferences , 150 , 1-4. Retrieved from https://doi.org/10.1051/matecconf/201815005021
National Association of State EMS Officials. (2015). Assessing Continuing Competence in Emergency Medical Services: A Reference for State EMS Offices. Retrieved from https://nasemso.org/wp-content/uploads/Continuing-Competence-White-Paper-Apr2015.pdf
National Registry of Emergency Medical Technicians. (2015). 201 5 Paramedic Psychomotor Competency Portfolio (PPCP). Retrieved from https://content.nremt.org/static/documents/Paramedic_Psychomotor_Competency_Portfolio_Manual_v4.pdf
