Clinical Judgment Item Development for Emergency Medical Service Clinicians.

ABSTRACT

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. METHODS: To facilitate standardization of clinical judgment assessments, in this educational practice review we present a template for item development leveraging the new framework. Developed with input from EMS clinicians, educators, and expertise from the nursing field with experience in clinical judgment item development, this template can be used to support item generation for a specific event phase (e.g., en route, scene, and post scene) in a clinical scenario. RESULTS: We provide a transparent and reproducible template for item generation for clinical judgment assessments evaluating the six basic cognitive reasoning steps of recognizing cues, analyzing cues, defining a hypothesis, generating solutions, taking action, and evaluating the outcomes of those actions. CONCLUSIONS: This template allows for generation of items for each EMS event phase that can be repeated serially for any combination of prehospital clinical situations.