Unfit for duty? Evaluation of 4 years of paramedic preemployment fitness screening test results.

ABSTRACT

BACKGROUND: Preemployment testing is utilized by many ambulance services. Surprisingly, there is limited published research on the efficacy of this testing in determining an employee's ability to complete the requirements of this physically demanding occupation. OBJECTIVES: The purpose of this study was to analyze the preemployment fitness test results from a 4-year cohort of paramedic students from an Australian university. To date, no published studies have reported on the fitness test scores for paramedic students or on whether overall test score is biased toward any particular test components. Similarly, no data have been presented on whether there are gender differences in scores for individual test components or overall test score. METHODS: Retrospective cohort study of de-identified data from 4 years of data from Paramedic Science students (n = 251) (mean age = 24.9 years). Data were recorded from the Queensland Ambulance Service (QAS) Health Related Fitness Test (HRFT), a preemployment fitness test used by an Australian state ambulance service. HRFT score is calculated out of a possible 100 points and is based on performance scores in nine component fitness tests. Raw test scores for each of these component tests are ranked on a 0-4 scale prior to these data being scaled and summed to generate the overall HRFT score. An overall score >24.99 is awarded a "Pass." Results. Five individuals failed to "Pass" the HRFT. Overall HRFT scores were influenced significantly by performance in the strength tests, with males also recording significantly (p < 0.005) higher scores in all of the strength tests than females. Similarly, approximately 40% of the female participants, compared to 6% of males, achieved an overall test "Pass" and yet gained a ranked score of 0 in at least three of the component tests. CONCLUSIONS: It was concluded that the scoring system did not exclude participants with poor fitness levels, as many participants recorded low scores in several test components yet still passed the test. We recommend that before redesigning the HRFT, studies should be first conducted on the occupational demands and physical standards required for this important profession.