The Effect of Affect on Paramedic Student Performance

Introduction—The affective domain of learning is recognized as a vital component of paramedic education as described in the National EMS Education Standards and national accreditation standards. This study explored the potential relationship of students who did not pass the affective domain evaluation on cognitive and noncognitive (psychomotor and capstone field internship) student outcomes.

Methods—A retrospective records analysis of graduated paramedic students in Fisdap, an online database for EMS and healthcare education, was conducted. Completed affective domain (professional behavior) evaluations were reviewed to determine association with cognitive performance (results on the PRE3 or PRE4 exam) and noncognitive performance (team leader performance score on lab and field daily evaluations). The evaluations consisted of 11 criteria on the Fisdap professional behavior evaluation and were dichotomized by preceptors as “competent” or “not yet competent,” with an overall rating of pass or fail.

Results—Data were collected from 25,534 professional behavior student evaluations. Failing scores on the affective domain were assessed in 151 (0.6%) assessments for 93 students. Data for individual questions (n=282,051) were extracted, with 1,661 (0.6%) items scored as “not yet competent.” Item competency failures ranged between 74%–89%. Self-motivation, self-confidence, communication, time management, and careful delivery of service were items that were most often reported as “not yet competent.” Due to the extremely low number of failures, no association between affective domain and cognitive or noncognitive performance was discovered.

Conclusion—The results of the study were unable to demonstrate any association between affective scores and cognitive or noncognitive performance. Results did, however, indicate nearly all students passed their professional behavioral evaluations. The findings suggest several possibilities, including a flaw in the affective domain evaluation tool, evaluators not accurately evaluating the affective domain, evaluator reluctance to issue failing affective scores, or EMS students naturally having an underlying good affect. Further study of affective domain evaluation is recommended to determine the reason or reasons for the nearly 100% pass rate.