2002 National Guidelines

For Educating EMS Instructors

National Association of EMS Educators
U.S. Department of Transportation
U.S. Department of Health and Human Services

Table of Contents for Appendices

1. Action Verbs Useful for Writing Objectives
2. Academic Honesty College Procedure
3. Classroom Behavior, "A Practical Guide for Faculty"
4. Student Counseling Report (Sample)
5. Affective Domain Evaluation Tools (excerpt from 1998 EMT-P: NSC)
6. Rubric Affective Domain Tool
7. Guidelines for Activities and Classroom Exercises on Ethical Issues
8. Classroom Arrangement Strategies
9. Bloom’sTaxonomy of the Domains of Learning
10. Maslow’s Hierarchy of Needs
11. Lesson Plan Outline
12. Unit #1 - Pathophysiology and Management of Anaphylaxis
13. Daily Lesson Plan - Anaphylaxis Unit (sample lesson plan)
14. Confined Space Rescue – Awareness (sample lesson plan)
15. Use of Safety Gear Inside a Fire Scene (sample lesson plan)
16. EMS Student Handbook Sample (EMT-Basic)
17. Emergency Medical Health Services Program – Student Handbook
18. Budget Considerations
19. Glossary of Terms

Dear Colleagues:

In January 2001, The National Association of EMS Educators (NAEMSE) entered into a cooperative agreement with the National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration (HRSA). The goal of this partnership was to design an instructor preparation curriculum for guiding EMS educators to effectively teach adult learners who populate the EMS classroom.

Drafted by representatives of the National Association of EMS Educators along with representatives from professional organizations, regulatory groups, accreditation agencies and state education agencies, this curriculum represents a common core of teaching knowledge and skills which will help all EMS educators to assist the adult learner acquire 21st century knowledge and skills.

Organizations participating with NAEMSE in the task force included:

The National Association of EMTs

The National Association of State EMS Directors

The National Council of State EMS Training Coordinators

The International Association of Fire Chiefs

The International Association of Firefighters

The Committee on Accreditation of EMS Programs

The National Registry of EMTs

The National Association of EMS Physicians

Emergency Medical Services for Children – National Resource Center

The efforts of the task force constitute the initial step towards a coherent approach to the preparation and certification of the professional educator in the EMS setting. The curriculum is based upon the shared view within the EMS education community of what constitutes professional teaching.

The task force acknowledges the variety of settings that EMS education takes place, ranging from the instruction of citizens (CPR, first aid, etc.) to graduate programs in EMS management. The task force also acknowledges the wide variance in the educational preparation of persons who chose to teach in the EMS setting. This document addresses the knowledge, standards, and performance expectations deemed essential for all professional educators, regardless of topic area or level of instruction. This document will assist with the implementation of the vision prescribed in the EMS Education Agenda for the Future: A Systems Approach (2000). The Education Agenda will create an EMS education system that "emphasizes high-level cognition, problem solving, and the ability to deal with ambiguity and conflicting priorities"

One intended outcome of this curriculum is to stimulate dialogue among the stakeholders of the EMS education profession regarding the best thinking of their colleagues as to what constitutes competent entry-level EMS instruction. Our work is offered to state and local EMS agencies and educational institutions concerned with the professional development of EMS educators. The curriculum may serve as a resource to revisit State standards for training and licensing of new EMS educators; as a step towards national certification; and, as a part of the process for national accreditation of EMS education programs. It is only with consensus among EMS educators that a shared vision of future EMS education will be forged.

We encourage all EMS educators to consider ways that this curriculum might enhance their EMS teaching skills and improve the outcomes of the EMS student in the education system. Our ultimate shared goal is to provide the highest level of quality patient care.

Sincerely,

Judith A. Ruple, PhD, RN, NREMT-P
Project Director
Task force Co-Chair

Angel Clark Burba, MS, NREMT-P
Project Director
Task force Co-Chair

 

INSTRUCTOR TASK FORCE MEMBERS AND REPRESENTATIVES

The EMS Education Agenda for the Future clearly articulates a vision for an educational system where national program accreditation and national EMS certification are explicitly tied to one another. The current EMS education system in the United States has such wide variability in its approach to the education and certification of its EMS providers that there is no clear, consistent description of the "typical" EMS provider, regardless of level. A result of this situation is the inability of a well-qualified and educated EMS provider to readily move from one part of the country to another without exerting significant efforts to re-establish the ability to function as an EMS provider. Efforts to achieve national consensus on educational issues such as national standard curricula have also been limited by these inconsistencies.

Critics of national certification and program accreditation argue that EMS practice should be determined at the regional or local level. National certification and program accreditation does not restrict the ability of an EMS system or authority to define what may or may not be included in the scope of practice for emergency medical technicians. Rather, these concepts support an educational system that better prepares the EMS student to function within the local environment. There may be additional benefits that will be realized as cross-region barriers are reduced, such as a larger potential employee pool for EMS employers to draw from.

Efforts to restructure EMS education, as it is envisioned in the EMS Education Agenda for the Future, are redefining the mission of EMS education programs and the scope of work for EMS Educators. Rather than merely delivering a prescribed curriculum, EMS educators will be expected to ensure that all adult learners learn and perform at high levels of competency. EMS educators will be expected to find ways to support and connect with the needs of all the adult learners in their classrooms. This new mission requires substantially more knowledge and skill on the part of EMS educators and the implementation of a more student-centered approach to providing EMS education. These changes occurring in the delivery and content of EMS education and in EMS program structure require supportive policies for preparing educators and for accrediting EMS education programs.

A major initiative to strengthen the EMS education profession was the establishment in 1995 of the National Association of EMS Educators (NAEMSE). The mission of NAEMSE is, "to promote EMS education, develop and deliver educational resources, and advocate research and life long learning for the professional EMS educator". NAEMSE is dedicated to assisting in the development, preparation, and induction into the EMS education profession of those persons interested in teaching in the EMS setting. The National Association of EMS Educators believes that the complex art of teaching requires the development of performance-based standards and assessment strategies that are capable of capturing EMS educators' reasoned judgments and that evaluate what they can actually do in authentic teaching situations.

The National Association of EMS Educators (NAEMSE) entered into a cooperative agreement with NHTSA and HRSA in January 2001, to revise the EMS Instructor Training Program (1995). A task force was convened to consider what changes were needed in the document to create standards for entry into the EMS educator profession. These are standards that embody the kinds of knowledge, skills, and performances that entry-level EMS educators need to practice responsibly when they enter the field of EMS teaching. The standards are also designed to be built upon and prepare entry-level EMS educators for eventual success as master level EMS educators later in their careers.

The goal of the task force was to create a curriculum based on sound educational standards designed to prepare entry-level instructors as well as enhance the teaching skills of experienced instructors. Professional organizations, State agencies, and other stakeholders in the project reviewed the standards and the content of the curriculum.

The foundation of any educational system is the preparation and experience of its teachers. The EMS educational system is no different. However, the current approach still relies heavily upon the concept of a "good clinician" is a "good teacher." This may have served the EMS education system satisfactorily when it was in its infancy, however, as the EMS profession continues to develop and mature, so must its educators. As the EMS profession does not believe that providers of emergency medical care should learn their craft by trial and error; it should not expect that from its teachers. EMS educators should be educated in the practice of teaching, and should be able to demonstrate their competency in doing so. The development of national standards for the credentialing of EMS educators will be a critical step toward the development of consistent, effective educational practices and successful student outcomes.

The task force began its work by articulating standards for a common body of teaching knowledge and skills that should be acquired by all entry-level instructors. These initial standards will be followed by additional distinct standards for specific areas and levels of EMS education. Like the first tier of assessment for licensing or certification in virtually all other professions, this body of knowledge is intended to outline the common principles and foundations of practice that cut across specialty areas in EMS education. It includes the knowledge of adult learning and motivation theories, curriculum design and teaching methods that all fields of education share.

The initial development of this shared body of knowledge was viewed by the task force as important for two reasons. First, it is the common commitment to ethical practice and foundational knowledge that provides the philosophy that holds members of the profession together. A common language and shared body of knowledge enables educators to better communicate with each other. Second, the development of the common body of knowledge becomes the essential foundation for designing assessment methods for the evaluation of instructional skills.

The educational community recognizes that application of this common body of EMS education knowledge will occur in specific contexts. The adult learner, level of instruction, and instructional setting will define these contexts. We emphasize the dynamic nature of this set of professional understandings, abilities, and commitment standards.

An important attribute of this curriculum is that it is outcome-based. The curriculum describes what EMS educators should know and should be able to do in an educational setting rather than prescribing what specific course of action should be taken. This shift toward outcome-based standard setting is in line with the EMS Education Agenda for the Future. This curriculum will clarify the criteria required for successful completion of the instructor-training course. The flexibility of this document comes into play as the end user (jurisdiction, state, training program, etc.) determines to what level (depth and breadth) assessment will take place. The task force placed emphasis on the abilities EMS educators should develop rather than the hours they spend taking classes. Ultimately, performance-based certification standards should enable states and other interested parties to permit greater innovation and diversity in how EMS educator programs are designed and delivered by assessing their outcomes rather than their inputs or procedures.

The curriculum was developed from six major consensus points reached by the task force during the initial development of the curriculum. The task force agreed that the EMS educator (whether entry level or experienced) has the following professional attributes and skills:

EMS educators are committed to the needs of the adult learner and their learning preferences.

EMS educators know the subjects they teach and how to teach those subjects using different methods to a diversity of adult learners.

EMS educators are responsible for managing the learning environment and assessing learning outcomes.

EMS educators think systematically about their practice and learn from their classroom experience.

EMS educators are members of the larger EMS and educational communities and are committed to continual improvement in the EMS education system

EMS educators are aware of the content and implications of the EMS Education Agenda for the Future.

In our work, the task force used historical documents from the Federal government, numerous seminal adult education texts, excerpts from previous National Standard Curricula, and survey information gathered from the States and members of professional organizations as the basis for exploring what entry-level EMS educators should know and be able to do. We drew on the work of a number of States who have developed certification standards for EMS educators, the valued input of instructional designers, and early versions of professional development courses (Bourn, Dalton and Smith, 1994)

The Professional Attributes and Skills Set Criteria (Module 2) was the reference point in the development process and it permeates throughout the curriculum. The curriculum is not organized within each of the criteria since so many abilities are interdependent. An instructional matrix (figure 1.1) is provided to assist those implementing the curriculum with the selection of topics for inclusion in their individual program. The matrix is based on performance outcomes, matching the education objective level (breadth) to the performance expectations (depth) of what the educator is expected to do in a particular classroom setting.

The task force spent a great deal of time considering the question, "How do we distinguish between beginning and advanced levels of performance by the EMS educator?" The requirements for entry into the EMS education profession have become more sophisticated. Many States require probationary periods prior to issuing a certification to teach and an increasing number require an internship as part of their preparation. Questions arise about what the EMS educator should be expected to know and be able to do at various points in their professional development. The task force debated the question of what level of preparation and depth of knowledge would be needed to enable EMS educators to succeed at the entry-level. The task force accepted the fact that variation will continue to exist nationally, but successful completion of the instructor course should prepare participants to practice responsibly as an entry-level EMS instructor.

The adult learners’ need for well grounded and adaptive teaching techniques are what must ultimately define the standards for EMS educators. The entry-level EMS educator must have the ability to engage in learner-centered, outcome-based practices articulated by the curriculum. Successful completion of the curriculum should provide the opportunity for building and developing teaching skills on a solid foundation that will lead to higher levels of instructional and administrative expertise.

While revising the course, the task force discussed whether or not the level of knowledge, understanding, commitment, and ability differed between entry-level educators and more expert educators. The group concluded that the appropriate distinctions between beginning and advanced practice are in the degree of sophistication the EMS educator exhibits in the application of knowledge rather than in the kind of knowledge needed to perform effectively in the classroom setting.

Advanced level EMS educators, having greater flexibility and adaptability, are expected to develop their abilities to deal simultaneously with more complex facets of the teaching environment. They should have greater capacity to integrate understanding and performance based upon the adult learners' individual needs. To that end, to eventually become an expert practitioner the entry-level instructor must have, at the very least, an awareness of the kinds of knowledge and understandings needed -- as well as resources available -- to develop their skills. In addition, entry-level instructors must have the capacity to address the facets of the curriculum, classroom presentation, and adult learning styles. The curriculum not only aims to develop entry-level instructors, but it also is designed to improve the performance of expert educators.

The curriculum was distributed in draft form to members of the task force for review on July 15, 2001. The task force members were asked to review the curriculum based upon the accuracy of theoretical content, presentation quality, and appropriateness of content for entry-level instructors. We asked the task force to identify the curriculum’s strengths and weaknesses and suggest strategies for revising it.

After incorporating task force comments, we posted the draft curriculum on the NAEMSE web site on July 30, 2001, for further national peer review. In addition, we e-mailed NAEMSE members and published requests to review the draft in the organization’s bimonthly newsletter. The EMS community and other interested parties were asked to evaluate the quality of the information provided, to examine the curriculum for strengths and weaknesses, and to critique the design and content of the curriculum.

In September 2001, two modules of the draft curriculum were presented to members attending the NAEMSE annual educational symposium. Attendees were invited to comment on the modules and encouraged to visit the web site to review and comment on the entire draft curriculum. In November 2001, all additional modifications and revisions were incorporated into the draft prior to the pilot test.

The pilot program was successfully conducted on April 6-9, 2002, in Portland, Oregon. More than one hundred and thirty persons attended the four-day program. Twenty-one task force members and faculty presented a compressed version of the curriculum. The participants evaluated the content, design, and evaluation methods used during the program. The design of the pilot was based on the constructivist model of education as students were active participants in the learning process.

Quality assurance activities included focus groups, daily evaluations, and final program evaluations. All quality assurance activities were developed, conducted and supervised by professional EMS educators who were not involved in the design and development of the curriculum. The task force reviewed and incorporated many of the suggestions from the pilot participants into the final curriculum.

The curriculum emphasizes an academic specialization, specifically, adult learning theory and teaching skills. Prerequisites for attending the program will vary according to the particular program, the local and state requirements and the area of specialization the participant is interested in pursuing.

Ideally, the entry-level EMS educator should have successfully completed a course of academic study and gained clinical experience as an EMS provider, registered nurse, physician, or other allied health practitioner prior to entering the educator program. The entry-level instructor should also be educated to a level that is at least one level higher than the level of provider they intend to instruct. For example, an experienced EMT-Intermediate could become an appropriate entry-level instructor for an EMT-Basic course. Professional knowledge is the foundation of teaching practice.

The intent of the curriculum designers is to assist in the preparation of educators who are proven EMS practitioners and enthusiastic role models for lifelong learning and professional standards. Participants who attend the entry-level EMS educator program should be teacher candidates who have proven their commitment to the profession through self-initiated field experiences and academic performance. Previous teaching experience is preferred.

Another recommendation is that the entry-level EMS educator participates in a supervised teaching internship in an EMS program, working and learning under the shared guidance and expertise of experienced educators. During this internship it is recommended that the participant document their learning and professional growth through the development of a portfolio that should be reviewed by the experienced program educators.

It is envisioned that the entry-level EMS educator programs, offered at the State and local levels, will evolve in the future and be part of a national instructor credentialing process and the envisioned national accreditation process. A national instructor credentialing process will help pave the way for reciprocal credentialing in other states.

The instructor course curriculum is designed to facilitate the use of Professional Attributes and Skills Set Criteria as outlined in Module 2.

A needs assessment of the intended student population should be conducted prior to the delivery of the course. Performance outcomes expected of the participants following completion of the course should be clearly identified and articulated in writing. The question to ask is, "What should the participants be able to do as a result of taking this course?" The answer to this question can come from many sources, including discussions with course participants, faculty, employers, advisory groups, certifying bodies, and EMS community representatives.

The first step in presenting this curriculum is to identify the intended learning outcomes for the program. Intended learning outcomes answer the following questions:

1. What will participants know or understand once they have successfully completed this course?
2. What will they be able to do with their knowledge or understanding when they have successfully completed the course?

Once the outcomes are in place, discussions should take place about how the intended learning outcomes will be assessed at the completion of the course or program. In outcome-based educational processes, assessment is not an academic exercise unlike anything the student will encounter elsewhere in life. Evaluation methods must parallel what the participant will be expected to as an EMS educator. Additional questions to be addressed are:

1. What assessment tasks will the participants have to complete (and to what degree) to assure that the outcomes have been met?
2. In what ways do these assessment tasks reflect the context in which the participants will be expected to use the knowledge, skills and attitudes learned in this course?

When the assessment process has been delineated, determine the necessary content and appropriate learning processes. Questions to address are:

1. What facts and information do the participants need to have in order to meet the outcomes?
2. What skills and abilities are essential to the outcomes?
3. What themes, issues or concepts do participants need to explore and understand?
4. What experiences will best help the participants to gain the knowledge, skills, abilities and values needed to meet the outcomes?

As an outcome based education program, the course must include instructional methods that emulate the modeling, coaching and facilitating concepts integral to the cognitive knowledge base of the EMS instructor. The course should include group activities that encourage participants to link their experiences to conceptual knowledge and learning activities that challenge the participants to use their problem-solving skills and demonstrate their theoretical knowledge. Emphasis should be placed on instruction and teaching processes rather than the administrative and managerial functions of EMS instruction.

Some areas may be best covered in non-traditional methods, such as pre-requisite directed readings. This approach would prove particularly appropriate for those modules that are largely aimed at presenting an introduction to the topic. There is no intent for the modules of this curriculum to be presented in a formalized lecture format.

Presenters of this curriculum must be prepared to move back and forth between outcomes, assessment, content and learning processes; to continually learn from the participants; and to constantly question how to better prepare participants for their work in the field of EMS education.

Acknowledging the diversity of EMS educational settings and the individual needs of local, State, and regional governments, the task force developed a matrix (curriculum map) for the implementation of a modular approach to the contents of the curriculum. The matrix outlines the recommendations of the task force for the level of performance the participant should master. This level of mastery is based upon the entry-level instructor’s responsibility in the program setting. Built around the levels of learning that are described in Modules 8 and 16, the matrix further defines process, skills, and content topics.

The task force was charged with articulating standards for entry into the EMS educator profession and to develop a curriculum that would assist persons in meeting those standards. The first section of this module presented the philosophical consensus points reached by the task force regarding the professional attributes and skills of the entry-level EMS educator. The professional attributes were expanded to describe a common body of teaching knowledge and skills that should be acquired by all entry-level instructors.

The task force realizes the positive impact that the EMS Education Agenda for the Future will have on the EMS education environment. This environment is characterized by increasing knowledge, complexity, and uncertainty. The task force proposes that the knowledge of adult learning, curriculum design, and teaching methods described in the curriculum are requisite for EMS educators, regardless of their level of instruction, their years of experience, or the specific content area they specialize in.

In the second part of this first section, the task force acknowledges the diversity of the environments in which the curriculum will be used and the diversity of the persons who will participate in the course. Suggestions are included for designing program offerings at two levels of instructor responsibility: primary and secondary. A description of professional attributes and skills sets, with suggestions for outcomes and assessment, is included.

The effort of the task force constitutes the initial step towards a coherent approach to the preparation and certification of the professional educator in the EMS setting. This curriculum is based upon the EMS education community’s shared opinion of what constitutes professional teaching. The curriculum serves as the framework for preparing EMS entry-level educators to work comfortably in a classroom environment.

The task force believes that to be effective, the entry-level EMS educator must be able to integrate content knowledge with pedagogical understanding to assure that all adult learners learn and perform at high levels in their chosen field.

The task force would like to acknowledge the contributions of the following people to the successful development, refinement and production of the final curriculum.

Ms. Joann Freel, Executive Director of the National Association of EMS Educators (NAEMSE). Ms Freel served as the project administrator and oversaw all aspects of the project, specifically in the financial and planning areas. Her knowledge of the grant process and dedication to the vision of the task force was key to the success of the project.

The expert writers who captured the essence of the task force discussions and deliberations and distilled the information into draft form for review by the national EMS community. After the draft was reviewed, the expert writers incorporated all of the suggestions and modifications into the final product. Thank you to Ms. Heather Davis, Mr. Sandy Hunter, and Ms. Linda Honeycutt for your personal commitment and dedication to this important project.

Mr. David Bryson, NHTSA EMS Specialist. Mr. Bryson served as our Federal government contact and liaison. His experience and guidance during the development of the project was invaluable.

The National Association of State EMS Directors, The National Council of State EMS Training Coordinators and the National Association of EMT’s for providing access to survey information and supporting the initial surveys of EMS teaching professionals on a national level.

Ms. Jean Miller, Director, Interstate New Teacher Assessment and Support Consortium (INTASC) for her input and direction in the process of developing entry-level educator standards. The design models used by the Consortium were most helpful.

Our colleagues in EMS education who participated in the pilot program held in Portland, Oregon, in April 2002. Your thoughtful and thorough evaluation of the curriculum content was essential to the successful completion of this project. Thank you for your time and your talent.

Thanks to the staff of NAEMSE who provided administrative support throughout this project.

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At the completion of this module, the student-instructor should be able to:

1. Use their own words to provide a descriptive definition of the Primary and Secondary EMS Instructor
2. Describe the differences between the Primary and Secondary Instructor
3. Describe the duties of a Primary Instructor providing the majority of instruction during the entirety of an EMS course
4. Describe the duties of a Secondary Instructor assisting a Primary Instructor
5. Describe the importance of professional development through continuing education, conference offerings and formal academic coursework for the EMS instructor
6. Describe sources for locating relevant educational and research materials
7. Describe the relationship between the instructor and the student, assistant instructor, program director and medical director
8. Describe the role of the course syllabus and lesson plan in course management
9. Describe the major components of the syllabus and lesson plan

There are no psychomotor objectives for this section

At the completion of this module, the student-instructor should be able to:

1. Defend the importance of continuing professional development for the professional educator
2. Value the role of the instructor in the EMS classroom
3. Serve as a role model for other educators in the EMS setting
4. Assess personal attitudes and demeanor that may distract from professionalism
5. Value the variety of the classroom culture
6. Appreciate the importance of the teacher-student relationship
7. Value the need to provide fair, timely and constructive feedback to students
8. Exhibit professional behaviors in the following areas: integrity, empathy, self-motivation, appearance and personal hygiene, self-confidence, communications, time management, teamwork, diplomacy, and respect
9. Explain the value of serving as a mentor
10. Value the importance of mentoring in the development of a professional EMS instructor

1. Why this module is important
1. EMS instructors do more than teach students in the classroom setting so it is important to have an understanding of the scope of duties and responsibilities
2. EMS instructors should value the team approach to teaching and know those individuals included on the instructional team
3. EMS instructors should know the desirable character traits of an educator and the commonalties that exist between the characteristics of an EMS provider and an EMS educator
4. EMS instructors should understand the value of mentoring in the professional development of an instructor
2. Module terms
1. The following terms are used in this module
2. See the appendix for a complete listing of terminology for this curriculum
3. Primary instructor:
1. An individual who possesses the appropriate academic and/or allied health credentials, an understanding in education principles and theories, and the required teaching experience to provide quality instruction to a cohort of EMS students
4. Secondary instructor:
1. An individual who possesses the appropriate academic and/or allied health credentials and an understanding in education principles and theories that may have limited teaching experience. This individual is responsible for providing instruction to students and in assisting a primary instructor.
5. Cohort:
1. A defined group of students who are attending a class together
6. Class:
1. Two definitions are used for class and the context will determine the definition
2. Class: A single block of instruction provided at a single point in time, like when a class meets for 3 hours and the topic is the ABCs of CPR
3. Class: Refers to a cohort of students who are attending an ongoing program of study (with multiple meeting sessions) that will lead to certification or licensure, like EMT-basic training
7. Program:
1. Two definitions are used for program and the context will determine the definition
2. Program: Another term for a class of students attending training with multiple blocks of instruction, like first responder training
3. Program: Term for an organized body that designs, develops and/or delivers a variety of EMS education products including primary instruction, refresher and continuing education. This body may be found within a training academy, hospital, industrial setting, business or academic setting. In this use of the term, programs organize and administrate classes and events.
8. Event: Refers to a single educational product like a daylong workshop or a refresher course. Event generally does not refer to education products that continue to have classroom sessions for an extended period of time like an EMT-Intermediate or Paramedic course
3. Overview of EMS education practice
1. The primary source for information concerning EMS instructor education is derived from the following sources:
1. National EMS Education and Practice Blue Print
2. EMS Agenda for the Future
3. EMS Education Agenda for the Future
4. Revisions of BLS and ALS National Standard Curricula (NSC)
5. DOT EMS Instructor NSC (Revised 2002)
2. Secondary sources of information on education
1. Education professional groups
2. Academic settings
3. Internet sites on education
4. Collected bodies of knowledge recognized for their expertise in educational theories and best practices
5. Others
4. Professional attributes and skill sets of EMS instructors
1. Ten professional attributes and skills sets are identified for EMS instructors
2. Professional Attributes and Skills Set Criteria #1: The EMS educator understands the central concepts, tools of inquiry, and structures of the EMS discipline(s) they teach and can create learning experiences that make these aspects of subject matter meaningful for the adult learner
1. Cognitive Goals
1. Understands major concepts, assumptions, debates, processes of inquiry, and ways of knowing that are central to the discipline(s) they teach.
2. Understands how the adult learners’ conceptual frameworks and their misconceptions for an area of knowledge can influence their learning
3. Can relate knowledge of the discipline to other specific subject areas
2. Affective Goals
1. Realizes that EMS subject matter knowledge is not a fixed body of facts but is complex and ever evolving; they seek to keep abreast of new ideas and understandings in the EMS field
2. Appreciates multiple perspectives and conveys to adult learners how knowledge is developed from the vantage point of the learner
3. Has enthusiasm for the discipline(s) they teach and is able to relate the subject matter to clinical practice
4. Is committed to continuous learning and engages in professional discourse about subject matter knowledge
3. Performance Outcomes
1. Effectively uses multiple representations and explanations of concepts that capture key ideas and link them to the adult learners’ prior understandings
2. Can represent and use differing viewpoints, theories, "ways of knowing" and methods of inquiry in the teaching of subject matter concepts
3. Can evaluate teaching resources and curriculum materials for their comprehensiveness, accuracy, and usefulness for representing particular subject matter and concepts
4. Develops and uses curricula that encourage the adult learner to see, question, and interpret ideas and subject matter from diverse perspectives
5. The EMS educator can create interdisciplinary learning experiences that allow the adult learner to integrate knowledge and skills from several subject areas
3. Professional Attributes and Skills Set Criteria #2: The EMS educator understands how the adult student learns, and can provide learning opportunities that support their intellectual, professional and personal development
1. Cognitive Goals
1. Understands how learning occurs--how the adult learner constructs knowledge, acquires skills, and develops values--and knows how to use instructional strategies that promote student learning
2. Understands that the adult learners' physical, social, emotional, moral and cognitive attributes influence learning and knows how to address these factors in the instructional environment
3. Is aware of the domains of learning (cognitive, affective and psychomotor), can identify levels of readiness in learning, and understands how development in any one domain may affect performance in others
2. Affective Goals
1. Appreciates individual variations within each domain of learning, shows respect for the diverse talents of all learners, and is committed to helping them develop self-confidence and competence
2. Uses the adult learners’ strengths as a basis for growth, and their errors as an opportunity for learning
3. Performances Outcomes
1. Considers the level of individual and group performance in order to deliver instruction that meets learners' current needs in each domain (cognitive, affective and psychomotor)
2. Stimulates student reflection on prior knowledge and links new ideas to already familiar ideas, making connections to the adult learners’ experiences, providing opportunities for active engagement, manipulation, and testing of ideas and materials, and encouraging the adult learner to assume responsibility for learning and performance outcomes
3. Considers the adult learners' experiences as a basis for instructional activities by, encouraging discussion, listening and responding to group interaction, and eliciting samples of student thinking orally and in writing
4. Professional Attributes and Skills Set Criteria #3: The EMS educator understands how the adult learner differs in their approaches to learning and creates instructional opportunities that can be adapted to diverse learning styles and situations.
1. Cognitive Goals
1. Understands and can identify differences in approaches to learning and performance, including different learning styles and performance levels, and can provide instruction that helps use the adult learners' strengths as the basis for growth
2. Knows about areas of exceptionality in learning--including learning disabilities, visual and perceptual difficulties, and special physical or mental challenges
3. Understands how individual experiences, talents, and prior learning experience influence adult learning
4. Has a well-grounded framework for understanding cultural diversity and knows how to learn about and draw upon the adult learners’ experiences and cultures in the instructional setting
2. Affective Goals
1. Believes that all adult learners can learn at high levels and persists in helping all students to achieve success
2. Appreciates and values human diversity, shows respect for the adult learners’ varied talents and perspectives, and is committed to the pursuit of individual excellence for all students
3. Respects adult learners as individuals with differing personal and family backgrounds and various skills, talents, and interests
4. Is sensitive to community and cultural norms
5. Makes the adult learner feel valued for their potential as EMS provider
3. Performance Outcomes
1. Selects instructional techniques and methods appropriate to the adult learners' learning styles, strengths, and needs
2. Recognizes and seeks assistance in making appropriate provisions (in terms of time and circumstances for work, tasks assigned, communication) for the adult learner who has particular learning differences or needs
3. Can identify when and how to access appropriate services or resources to meet exceptional learning needs
4. Seeks to understand the adult learners' culture, and uses this information as a basis for connecting instruction to the adult learners' experiences (e.g. drawing explicit connections between subject matter and clinical practice, making assignments that can be related to the adult learners’ experiences)
5. Creates a learning community within the classroom setting in which individual differences are respected
5. Professional Attributes and Skills Set Criteria #4: The EMS educator understands and uses a variety of instructional strategies to encourage the adult learners’ development of high level thinking skills, problem solving skills, and psychomotor performance skills
1. Cognitive Goals
1. Understands the cognitive processes associated with various kinds of learning (e.g. high level, critical and creative thinking, problem solving, memorization and recall) and how these processes can be stimulated
2. Understands principles and techniques, along with advantages and limitations, associated with various instructional strategies (e.g. lecture format, demonstration, scenario based, participatory learning, etc.)
3. Knows how to enhance learning through the use of a wide variety of materials as well as human and technological resources (e.g. computers, audio-visual technologies, videotapes and discs, local experts, texts, reference books)
2. Affective Goals
1. Values the development of the adult learners’ critical thinking, independent problem solving, and skill performance capabilities
2. Values flexibility and reciprocity in the teaching process as it relates to student responses, ideas, and needs
3. Performance Outcomes
1. Uses learning goals to assist in choosing teaching strategies and materials to achieve instructional purposes and to meet student needs
2. Uses teaching and learning strategies to engage the adult learner in active learning opportunities that promote the development of critical thinking, problem solving, and skill performance capabilities and that help the student assume responsibility for identifying and using learning resources
3. Varies their role in the instructional process (e.g. instructor, role modeling, coach,) in relation to the content and purposes of instruction and the needs of the adult learner
4. Utilizes a variety of clear, accurate presentations of EMS concepts, using alternative explanations to assist the adult learners’ understanding
6. Professional Attributes and Skills Set Criteria #5: The EMS educator uses an understanding of individual and group motivation and behavior to create a learning environment that encourages positive group interaction, active engagement in learning, and self-motivation
1. Cognitive Goals
1. Understands how groups function and how to influence people in the educational environment
2. Knows how to assist the adult learner to work productively and cooperatively with others in the educational environment
3. Understands the principles of effective classroom management and uses the knowledge to promote positive relationships, cooperation, and purposeful learning in the classroom
4. Recognizes factors and situations that are likely to promote or diminish intrinsic motivation, and knows how to help the adult learner become self-motivated
2. Affective Goals
1. Takes responsibility for establishing a positive climate in the classroom and participates in maintaining such a climate
2. Values the role of the adult learner in promoting each other's learning and recognizes the importance of peer relationships in establishing a climate of learning
3. Recognizes the value of intrinsic motivation to the adult learners’ life-long growth and learning
3. Performance Outcomes
1. Creates a learning setting in which the adult learners assume responsibility for themselves and one another, participate in decision making, work collaboratively and independently, and engage in purposeful learning activities
2. Engages the adult learner in individual and cooperative learning activities that help them develop the motivation to achieve by, for example, relating didactic lessons to clinical experiences, encouraging the adult learner to ask questions and pursue problems that are meaningful to them
3. Maximizes the amount of class time spent in learning by creating expectations and processes for communication and behavior along with a physical setting conducive to education goals
4. Helps the group to develop shared values and expectations for student interactions, academic discussions, and individual and group responsibility that create a positive classroom climate of openness, mutual respect, support, and inquiry
7. Professional Attributes and Skills Set Criteria #6: The EMS educator uses knowledge of effective verbal, nonverbal, and media communication techniques to foster active inquiry, collaboration, and supportive interaction in the classroom.
1. Cognitive Goals
1. Understands how cultural and gender differences can affect communication in the classroom
2. Recognizes the importance of nonverbal as well as verbal communication
3. Knows about and can use effective verbal, nonverbal, and media communication techniques
2. Affective Goals
1. Values many ways in which people seek to communicate and encourage many modes of communication in the classroom
2. Is a thoughtful and responsive listener to students concerns and questions
3. Appreciates the cultural dimensions of communication, responds appropriately, and seeks to foster culturally sensitive communication by and among all the adult learners in the class
3. Performance Outcomes
1. Models effective communication strategies in conveying ideas and information and in asking questions (e.g. monitoring the effects of messages, restating ideas and drawing connections, being sensitive to nonverbal cues)
2. Knows how to ask questions and stimulate discussion in different ways for particular purposes, for example, probing for learner understanding, helping the adult learner articulate their ideas and thinking processes, promoting risk-taking and problem-solving, facilitating factual recall, stimulating curiosity, helping the adult learner to question
3. Communicates in ways that demonstrate sensitivity to cultural and gender differences (e.g. appropriate use of eye contact, interpretation of body language and verbal statements, acknowledgment of and responsiveness to different modes of communication and participation)
4. Knows how to use a variety of media communication tools, including audio-visual aids and computers, to enrich learning opportunities
8. Professional Attributes and Skills Set Criteria #7 The EMS educator plans instruction based upon knowledge of subject matter, the attributes of the adult learner, and curriculum goals
1. Cognitive Goals
1. Understands the basics of learning theory, and is competent in the subject matter, is aware of the process of curriculum development, and knows how to use this knowledge in the instructional setting to meet instructional goals
2. Knows when and how to adjust instructional delivery methods based on student responses and performances
2. Affective Goals
1. Values both long term and short term planning to ensure a productive classroom setting
2. Believes that plans must always be open to adjustment and revision based on student needs and changing performance outcomes
3. Values planning as a collegial activity and includes other instructors and students in the process
3. Performance Goals
1. Provides learning experiences that are appropriate for curriculum goals, relevant to learners, and based upon principles of effective instruction (e.g. that activate the adult learners’ prior knowledge, encourages exploration and problem-solving, and builds new skills on those previously acquired)
2. Plans for learning opportunities that recognize and address variations in learning styles and performance modes
3. Respond to unanticipated sources of input, evaluates plans in relation to short- and long-range goals, and systematically adjusts plans to meet student needs and enhance learning
9. Professional Attributes and Skills Set Criteria #8: The EMS Educator understands and uses formative and summative strategies with both formal and informal techniques to evaluate and ensure the continuous cognitive, affective and psychomotor development of the learner
1. Cognitive goals
1. Is aware of the characteristics, uses, advantages, and limitations of different types of assessments (e.g. criterion-referenced and norm-referenced instruments, traditional standardized and performance-based tests) for evaluating the adult learner
2. Knows how to select and use assessment strategies and instruments appropriate to the learning outcomes being evaluated
2. Affective Goals
1. Values ongoing assessment as essential to the instructional process and recognizes that many different assessment strategies, accurately and systematically used, are necessary for monitoring and promoting student learning
2. Is committed to using assessment to identify student strengths and promote student growth rather than to deny the adult learner access to learning opportunities
3. Performance Outcomes
1. Appropriately uses a variety of formal and informal assessment techniques (e.g. observation, portfolios of student work, teacher-made tests, performance tasks, projects, student self-assessments, peer assessment, and standardized tests) to evaluate the adult learners’ progress and performances, and modify teaching and learning strategies
2. Uses assessment strategies to involve learners in self-assessment activities, to help them become aware of their strengths and needs, and to encourage them to set personal goals for learning
3. Evaluates the effect of class activities on both individuals and the class as a whole, collecting information through observation of classroom interactions, questioning, and analysis of student work
4. Monitors his or her own teaching strategies and behavior in relation to student success, modifying plans and instructional approaches accordingly
5. Maintains useful records of student work and performance and can communicate student progress knowledgeably and responsibly to the adult learner
10. Professional Attributes and Skills Set Criteria #9: The EMS educator is a reflective practitioner who continually evaluates the effects of their choices and actions on others (the adult learner and other professionals in the learning community) and who actively seeks out opportunities to grow professionally
1. Cognitive Goals
1. Understands methods of inquiry that provide them with a variety of self- assessment and problem-solving strategies for reflecting on their practice and its influences on the adult learner
2. Is aware of major areas of research on teaching and of resources available for professional learning (e.g. professional literature, colleagues, professional associations, and professional development activities)
2. Affective Goals
1. Values high level thinking and self-directed learning
2. Is committed to reflection, assessment, and learning as an ongoing process
3. Is willing to give and receive help
4. Is committed to seeking out, developing, and continually refining practices that address the individual needs of the adult learner
5. The EMS educator recognizes their professional responsibility for engaging in and supporting appropriate professional practices for self and colleagues
3. Performance Outcomes
1. Uses classroom observation, information about the adult learner, and research as sources for evaluating the outcomes of teaching and learning and as a basis for experimenting with, reflecting on, and revising practice
2. Seeks out professional literature, colleagues, and other resources to support their own development as a learner and a teacher
3. The EMS educator draws upon professional colleagues as supports for reflection, problem-solving and new ideas, actively sharing experiences and seeking and giving feedback
11. Professional Attributes and Skills Set Criteria #10: The EMS educator fosters relationships with EMS colleagues and EMS agencies in the larger community to support the students learning and well-being
1. Cognitive Goals
1. Understands the EMS educational program is an organization within the larger EMS community and understands the operations of the relevant aspects of the EMS system within which they work
2. Understands how factors in the adult learners’ environment outside of school (e.g. family circumstances, community environments, health and economic conditions) may influence the adult learners’ life and learning
3. Understands and implements laws related to the adult learners’ rights and teacher responsibilities (e.g. for confidentiality, privacy, and appropriate treatment of the adult learner)
2. Affective Goals
1. Values and appreciates the importance of all aspects of the adult learner’s classroom experience
2. Respects the privacy of the adult learner and confidentiality of information
3. Is willing to work with other professionals to improve the overall learning environment for the adult learner
3. Performance Outcomes
1. Participates in collegial activities designed to make the EMS program and educational setting a productive learning environment
2. Makes links with the adult learners' other environments on behalf of the adult learner, by consulting with other EMS educators and professionals in other EMS agencies
3. Can identify and use EMS community resources to foster student learning
4. Talks with and listens to the student, are sensitive and responsive to clues of distress, investigates situations, and seeks outside help as needed and appropriate to remedy problems
5. Acts as an advocate for the adult learner
5. General professional educator characteristics
1. The following listing of characteristics are considered appropriate for educators in most settings:
1. Possessing integrity and honesty
2. Empathetic and compassionate
3. Highly self-motivated
4. Maintains a professional appearance with good personal hygiene
5. Self-confident
6. Possesses clear verbal and written communication skills
7. Exhibits effective time management
8. Advocates the teamwork approach for teaching and for student interaction
9. Diplomatic and respectful when dealing with others
10. Has a desire to continue improving, growing professionally and intellectually (valuing "life-long learning")
11. Possesses knowledge of the subject and content areas
12. Is a student advocate
6. EMS provider professional behaviors and characteristics
1. The DOT NSC for the EMT-paramedic identifies the following eleven professional behaviors for paramedics
2. These characteristics apply to all levels of EMS provider, including instructors
1. Integrity
2. Empathy
3. Self-motivation
4. Appearance / personal hygiene
5. Self-confidence
6. Communications
7. Time management
8. Teamwork and diplomacy
9. Respect
10. Patient advocacy
11. Careful delivery of services
7. Definition of primary instructor
1. The "primary instructor" is defined by the scope of responsibility more so than by seniority or time spent in direct instruction of students
1. The primary instructor is often the individual held responsible for a course
2. The primary instructor has experience in teaching and may be moving into a role with greater program responsibilities in addition to classroom responsibilities
1. Some classification strategies for EMS educators call the primary instructor the "lead" or "instructor of record" and instructors who assist this individual in the classroom are sometimes called "support" or "adjunct" instructors
1. For purposes of consistency in this curricula, the terms primary and secondary instructor will be used
1. The content of this curriculum applies to both the primary and secondary instructor
2. The individual user of this curriculum will determine how to best implement this curriculum to meet their unique needs and obligations. See Module 1 for a discussion of recommended implementation strategies.
2. In addition to using "primary" and "secondary" to describe EMS instructors, another method classifies instructors into distinct levels based upon education credentials and/or teaching experience
1. Depending upon the classification strategy used the most senior instructor may have a higher or lower number designation
1. Example one: Level I: most senior instructor, Level II: assistant instructor, Level III: clinical instructor, Level IV: field preceptor, etc.
2. Example two: Level 1: classroom presenter and/or probationary new instructor, Level 2: experienced educator with X # of hours teaching, Level 3: course coordinator, Level 4: instructor trainer, etc.
8. The primary instructor may be called upon to provide leadership or oversight of the course in the following areas:
1. Program responsibilities: the primary instructor may also serve at a program level to assist in coordinating operations of the training program and other courses
2. Course administration: completing documentation and paperwork and providing timely feedback to the stakeholders in the course
1. Stakeholders are those individuals who have a financial stake or interest in the successful completion of the course and its students
2. Examples of some types of stakeholders: employer, employee union, course sponsor etc.
3. Course coordination: including coordinating visiting faculty and guest lecturers, secondary instructors, clinical rotations, fieldtrips, etc.
4. Interface with the Medical Director and course stakeholders on a regular basis
5. Guidance on policies and procedures for the courses or program
1. Selecting and screening students
2. Evaluating the students and program
6. Student discipline and feedback
1. Assess the student and situation to identify the problem and the cause of the problem
2. Work with medical director, program administration, faculty, and the student to correct problem behaviors
7. Student remediation
1. Assess the student and situation to identify the cause of the problem
2. Develop a workable strategy to assist the student in succeeding on reevaluation
8. Classroom instruction: deliver curriculum, mentor junior and support instructors, and ensure that the class maintains a high standard of quality
9. Perform all of the additional duties listed as secondary instructor duties
9. Definition of a secondary instructor
1. Like the primary instructor, the secondary instructor is often defined by the scope of responsibility
1. The main responsibilities of the secondary instructor are to provide instruction to the student and to support the primary instructor
2. Because the primary instructor often sets the tone for the class the secondary instructor must be aware of the expectations of the primary instructor regarding:
1. Content to be covered
2. Presentations styles expected for content delivery
3. Rules and regulations pertinent to the class
3. The secondary instructor generally possesses an entry level competency and is not expected to behave or perform with the same proficiency as an "experienced" teacher
1. The optimal relationship between the primary instructor and secondary instructor is one where mentoring and professional growth is taking place for both individuals
10. Common EMS instructor roles & responsibilities
1. Manage daily class activities
2. Manage the learning environment
3. Monitor student attendance
4. Provide evaluations and feedback to students, course coordinator, medical director, and appropriate stakeholders as appropriate
5. Manage discipline and grievance issues
6. Manage course paperwork
7. Maintain course and student records
8. Teach: deliver didactic content, direct and control classroom discussions, conduct practical skills development sessions, evaluate student performance on cognitive, affective and psychomotor skills
9. Design/develop (as required) and effectively use testing instruments
10. Mentor students and faculty
11. Adhere to the course syllabus
12. Design/develop (if required) and effectively use lesson plans
11. Managing daily class activities
1. Additional information on this topic is interspersed through this curriculum in several modules
2. Maintain schedule as posted in syllabus
3. Set the tone for the classroom environment by modeling desired affective behaviors
12. Managing the learning environment
1. See Module 6: The Learning Environment for more information
2. Assure classes are held in an adequate learning environment
1. Adequate room size, lighting, ventilation, and temperature are all considerations
3. Start and end class sessions on time
1. Breaks are important
4. Vary the pace of delivery and content of material as appropriate to keep class interesting and the learners engaged
13. Manage student attendance
1. Create and review student attendance rosters
2. Comply with reporting requirements regarding attendance
3. Provide feedback to students and appropriate stakeholders throughout class
14. Provide evaluations and feedback
1. Refer to Module 12: Evaluation Techniques for more information on feedback and evaluations
2. To be most effective, feedback should be continuous and timely
3. Provide students, course administration, the medical director and appropriate stakeholders with regular progress reports
1. Grade tests and papers quickly
4. Process and report course grades by the specified deadline
15. Manage discipline and grievance issues
1. Refer to Module 19: Discipline, and Module 14: Communication and Feedback for additional information
2. Each student should be aware of their right to an environment free of violence, threats, harassment, demeaning comments and other negative conduct
3. Students must have access to a process for reporting problems
1. Determine if your agency has a formal policy already in place
2. Provide students with copies of policies and procedures
3. Consider designing a student handbook if one does not exist
1. Involve your medical director, program coordinator and advisory group in the development of any policies or procedures
4. Problems must be investigated and resolved by the instructor
1. Determine if it can be resolved at your level or it needs to be taken further up the chain of command
1. You may need to consult with your supervisor or employer
2. Remember to maintain confidentiality of all parties involved
5. Students who fail to adhere to appropriate conduct rules may be removed from the classroom and or reported to other authorities
1. Ensure students have knowledge of the appeals process
2. Issues of insensitivity may require outside intervention and or counseling (e.g., racial slurs, inappropriate gender remarks, etc.)
3. If the incident involves illegal activity, domestic violence or abuse you MUST report it to the proper authorities
16. Manage course paperwork
1. Understand and comply with all laws and regulations regarding the maintenance and storage of confidential files and information
2. Maintain accuracy and confidentiality of:
1. Attendance roster
2. Course grade report
3. Disciplinary action report
4. Student conference and counseling report
5. Course correspondence
17. Maintain course and student records
1. Verify with the state EMS office, accrediting body, and academic host of the course the amount of time required to maintain student and course records
1. When in doubt – don’t throw it out!
2. Records may be maintained in writing, on computer file, or via other media (example: microfiche) as approved
3. Records must be kept in a secure area (e.g., locked file cabinet, secured computer with password, etc.)
4. Confidentiality of information is very important
1. Students must not be identified by personal information if grades and or progress reports are distributed publicly
5. Student and course information and records may not be accessible by stakeholders unless:
1. The student has given written permission to release documents and information
2. The document or information has been demanded through a legal summons
18. Teach
1. Modules 11 through 18 contain additional information on the following topics; 11: Presentation Skills, 12: Evaluation Techniques, 13: Facilitation Techniques, 14: Communication and Feedback, 15: Motivation, 16: Teaching Thinking Skills, 17: Teaching Psychomotor Skills, and 18: Affective Domain
2. Deliver didactic content
1. Use a variety of methods including lecture to deliver didactic content
2. Vary the pace and content to keep students engaged
3. Include material for every learning style (auditory, visual and kinesthetic learners)
3. Direct and control classroom discussions
1. Provide equal access to all students and encourage participation, monitoring and controlling students who monopolize conversations
1. Advocate for introverted students by encouraging them to participate
2. Encourage open discussion
3. Do not allow discussions to become lengthy without direction or purpose
4. Conduct instruction in practical skills development
1. Included in the appendix of this document is a practical skill sample lesson plan
2. Meet with all secondary instructors to ensure consistency in procedures and expectations
5. Evaluate practical skills competence
1. Practical skills competence should be measured on multiple occasions at various levels of mastery
2. Mastery of skills must be thoroughly documented and reviewed
6. Observe student classroom and laboratory performance
1. Demonstrate skills objectives during classroom / laboratory setting
7. Allow students to practice the skill under direct observation, for example, by performing the skill in a simulated patient encounter or scenario
1. Direct the practice of the skill with close supervision and feedback
2. Evaluate the skill
3. Remediate as needed to achieve successful performance
4. Reevaluate to document when mastery level performance occurs
5. Review periodically to ensure mastery is maintained
19. Design/develop (as required) and effectively use testing instruments
1. Module 8: Domains of Learning and Module 9: Goals and Objectives has useful information necessary to understand the evaluation process
2. Module 12: Evaluation Techniques lists specific types of evaluation instruments
3. Testing may be through written, oral or skills demonstrations and should be conducted in each Domain of Learning
4. Test design may not be required of entry level instructors
1. It is important for an entry level instructor to understand the goal of the testing and what level of proficiency is required for the student to be successful
1. This is critical when psychomotor skills are being evaluated
2. Question items should always be designed based upon the objectives of the presented material
3. It is always important to review "test banks" or "canned" testing items for accuracy and relevancy
5. Provide students with timely feedback following an evaluation (report grades and give suggestions for improvement when appropriate)
6. Many written test formats are available
1. Multiple choice
2. Short answer / essay
3. True false
4. Fill in the blank
5. Matching
7. Test item formats are explored in detail in Module 12: Evaluation Techniques
1. Multiple choice questions are extremely common in EMS tests
1. National and state licensing examinations usually contain only multiple choice items
2. Multiple choice questions may be purchased through vendors in test banks (textbook publishers, websites, colleagues) or written by the instructor
2. Regardless of the format used, all test items should be evaluated for validity and reliability
1. Validity - does the test item test the knowledge intended
2. Reliability - does the test item reproduce similar results when administered over a period of time
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