OEC 5th Edition: The Exam

Our patrol's OEC exam is Dec. 8.

Is the exam a major departure from past exams?

I am taking the OEC course at the local hill.  The 5th edition of the manual is a beast.  Seems like the breadth and depth of the material we are studying doesn't match the on snow mission or the allowable protocols.

There are two high schoolers in AP classes in my household and it seems that I do more studying than they do.  I took my daughter to a swim meet yesterday and was studying from the 5th edition during the downtime.  I would leave the book open on the table as I went in to watch my daughter swim each of her five events.  As the day progressed three people came up to me and said they had a  look at the book while I was gone and asked if I was a doctor doing some kind of review.

I am in this for the long haul and intend to graduate to full patroller status, but the gap between the on hill allowable protocols and the level of 5th edition training is huge.

My training class is a great group of people who all are dedicated to getting this done and our instructor is exceptional.  We will be well prepared.  Our first on snow training is Monday nite if there is any snow. 

It won't be long until we all end up taking EMT-B.  That will be the end of the road for me.  It's not that I couldn't pass it, just simply for the time involvement and commitment for the 6 hours a week I patrol.  As a volunteer, it will no longer be worth the hassle or additional expense.

It is not a great curriculuum.

It incudes a lot of information that is not helpful for patrolling.  Every minute spent on childbirth, or antidotes for use in chemichal warfare,or memorizing trauma center designations, is a minute not spent on the emergency care and tansportation of the sick and injured skier.

It includes some poor information like diagnosing and reducing a posterior sternoclavicular dislocation.  This is extremely rare, and is a diagnosis often missed by ED docs.  Other than NSP, nobody seems to think this is a good idea.

The curriculuum is also misunderstood by many.  So much so that some patrols are actually adopting a policy on patient restraint.  To make it worse, people are being taught to essentially use slipknots to restrain a pt.  This idea is bad on so many levels I m not sure where to start.

Back to your original question:

The new curriculuumisi similar in scope to an EMT- B, yet is frequently taught in 50-70% of the time.  No surprise that people are having trouble mastering the material.  It's possible that some instructors are focusing on real first aid, rather than preparing students for the test.  Simply not enough hours to cover all that material as well as teach first aid.

Re reading your post, it appears your instructors tried to teach the course in 40 hours.  Not realistic.

Also- clearly the test is not great.  NSP is changing some answers so some questions will have more than one right answer.  This is a sign of a less than stellar test.

On the plus side, it may result in some fails changing to pass.

Good luck.

Quote:

Originally Posted by Skiism 

Why would this 40 hours of instruction not be enough? This didn't include the practical side of it, we did that separately. When i went through our training after five hours on a sunday afternoon for two months i was ready to be done with it as well. How much time are other patrols spending on this?

Our current course is scheduled at 90 hours on the syllabus, including practicals, not counting study time.  NSP recommends to be prepared to spend 80 to 100 hours. 

Our classroom and scenario work is 54 hours and the on snow and toboggan work adds another 32 hours.

The scope of the course is now similar to an EMT course.  An EMT is 110-120 classroom hours.  Trying to cover a similar volume of material in 40-60 hours is not realistic.  Toboggan work, scenarios, and other things relevant to patrolling, won't help much in passing the test.  The hours spent on practical work will help you patrol, but that's a diffferent issue.

Out of curiosity, regarding the entire class that failed:  Did you actually use the Fifth edition?

The fact that they are starting to revise the answers would be an indication that the test has problems.  In my experience when this happens, the test has problems that go beond the changes that are retroactively made.

From your experience taking the test, why did so many fail? 

Legitimate quesitons, for wich you were ill prepared?

Questions that seemed trcky, rather than designed to test your knowledge?

I am interested in your perspective, having taken the test.

Have any of you contacted National about these concerns - they may be legitimate, if so National can possibly help. Just wondering why you guy's are posting on this forum instead of NSP pages?

I was thinking the same thing.

Quote:

Originally Posted by Steve2ski 

Have any of you contacted National about these concerns - they may be legitimate, if so National can possibly help. Just wondering why you guy's are posting on this forum instead of NSP pages?

when did the class start?  there was a cutoff that mandated use of the 5th edition for courses starting after XX date,  this answer sounds like the course was not run using the 5th edition as its base, although I could be misinterpreting and if I am ---oops!.

Steve2ski makes a good observation tho, you should take this to the NSP forum, no one here can do much other than make comments, over on the national forum you might get results.
 

Quote:

Originally Posted by Skiism 

 

Yup we did, although some were just by a few questions. We also implemented all of the new 5th edition stuff into our refresher for the current patrollers.
 

 

edited

40 hours is way too short and did the candidates an injustice.  The EMT course is 120 hrs. plus ER clinical and also ambulance ride alongs. I have seen many go upwards to 130-140 hrs. total.

The NREMT test is not a test of your knowledge of EMT. If you have ever taken the exam, it is an exam of your test taking skills. The correct answer may be the 3rd or 4th thing down on a procedure or protocol. They left out the perfect answer. Therefore it is not the correct answer that jumps out at you it is the the second or third correct answer that is actually right.

Terrible exam. Hopefully NSP didn't move in this direction.

I suspect it is lack of didactic hours and not enough instructor prep that caused a bunch of the problem.

I would agree with the comments on the 5th edition.  I am not very impressed with it.  I think it was written by doctors to impress other doctors and doesn't reflect what we do on the hill.  I also think a 0% pass rate reflects more on the instructors in this case than the text.  That course is supposed to be around 100hrs of class room.  If you're doing it in 40, you are shorting your students.  We do a bit less than the 100 and those who pass then go on to do additional on hill training before becoming patrollers.  A lot of the "100 hour" OEC component is hands on and is done outside in the dark.  All of the on-hill candidates have to do the whole scenario list again with loaded sleds and radios on hill after they pass the sled handling training.  I don't know the hours involved to do the on hill training, but would estimate that it goes about an additional 40-50 hours after passing OEC.

Quote:

Originally Posted by tetonpwdrjunkie 

I would agree with the comments on the 5th edition.  I am not very impressed with it.  I think it was written by doctors to impress other doctors and doesn't reflect what we do on the hill.  I also think a 0% pass rate reflects more on the instructors in this case than the text.  That course is supposed to be around 100hrs of class room.  If you're doing it in 40, you are shorting your students.  We do a bit less than the 100 and those who pass then go on to do additional on hill training before becoming patrollers.  A lot of the "100 hour" OEC component is hands on and is done outside in the dark.  All of the on-hill candidates have to do the whole scenario list again with loaded sleds and radios on hill after they pass the sled handling training.  I don't know the hours involved to do the on hill training, but would estimate that it goes about an additional 40-50 hours after passing OEC.

Was it written by doctors?  Or does the style/verbiage just make you assume it was?

There is usually a doc or two hanging around the committee for any medically related board/exam (we are like that...big buttinskis), but outside of our own boards, I don't know that docs have a large role, let alone final say in the exams.

I believe that there were a few doctors directly involved.  The book is out in the car and it's REAL cold out there so I'm not going to go look right now to get their names for you.  As far as the exams go...  I didn't have to take it, so I don't know directly.  All but one of our candidates passed and I was told that the one that didn't hadn't put in the effort required.  I ran a station at this years refresher and didn't love the "required" content.  I felt like it didn't reflect what we see and do.  For example...  All of the paramedics and EMTs associated with our patrol had real issues with the emphasis on posterior sternoclavicular dislocation that is in the book and "featured" in this years refresher.  After talking with them and with my brother in law, who is an ER Doc, there is no way that I am comfortable with what they are telling us to do.  Our protocol will be to not automatically do the thing unless the airway is extremely compromised and the patient is dieing right in front of us.  My brother in law was stunned that we being trained in that way as it is an extremely rare injury and the chances of screwing it up are pretty high, he told me if I ever see one to stabilize as presented and to not try to reduce it.
 

Quote:

Originally Posted by Alveolus 

Quote:

Was it written by doctors?  Or does the style/verbiage just make you assume it was?

 

There is usually a doc or two hanging around the committee for any medically related board/exam (we are like that...big buttinskis), but outside of our own boards, I don't know that docs have a large role, let alone final say in the exams.

Tetonpowderjunkie,

"All of the paramedics and EMTs associated with our patrol had real issues with the emphasis on posterior sternoclavicular dislocation that is in the book and "featured" in this years refresher."

The 5th edition OEC says this is a controversial procedure (page 652), I do not understand the mentality of making this procedure a high point of a station in the annual OEC refresher.

I have never knowingly seen this injury in 28 yrs of patrolling. With this injury it would seem to me there would be many other injury's to consider (extreme facial and/or internal bleeding) first. With major vessels in that area possibly being compromised the chances of farther damage seems quite great. Screwing around with something that might increase the likeliness of traumatic shock and/or major internal bleeding seems to be a self defeating procedure.

Possibly, the point is to get the airway consideration first - but to what outcome..................

I have an OEC 5th edition downloaded on my computer.  An electronic search of the OEC 5th edition for the the medication Coumadin shows up 10 times in 6 different chapters.  Coumadin search in EMT Brady book shows up ONCE.  This indicates each chapter in the OEC 5th edition had a different author and they did not communicate well between authors. 

Let's not forget, the role of a patroller is that of a "first responder" not a Doctor, Nurse, Paramedic, or EMT. The OEC 5th edition seems to overlooked that fact.

I am not saying more training and knowledge is wrong or bad, but the "first responder" role should not be overlooked.

The OEC course has dual purpose.  The first and most obvious one is to train first responders in outdoor/alpine environments, and the second one is to provide the DoD with a large number of well-trained, mountain-ready first responders in the event of a war or large scale disaster.  See bottom of page 4 of the book, or http://en.wikipedia.org/wiki/10th_Mountain_Division_%28United_States%29 for more information on that.

As such, some information contained in the book is over the top for the medical conditions commonly found on the hill, in the cafeteria or parking lot of the ski resorts we patrol.  Still, I am grateful that such a great book exists, even as imperfect as it might be.

As for the exam itself, it should be refocused to cover the cases a patroller is most likely to encounter on the line of duty.  In my humble opinion, knowing how to assist during child birth is interesting, but should not be a criterion to evaluate whether someone is fit for ski patrol or not.

Quote:

Originally Posted by Skiism 

Am i ignorant... or am i missing the link between the 10th Mountain Div. and Ski patrol?

It's Historical Fact, but doesn't apply to current operation's.