Sub-Section 3-350-92 - EMT Academy Terminal Competency Form

CMH EMS Education Manual

Citizens Memorial Hospital - Emergency Medical Services Education Department hereby certifies that the candidate listed below has successfully completed all the terminal competencies required for graduation from the EMT education program as a minimally competent, entry-level EMT and as such is eligible for State and National Certification written and practical examination in accordance with our published policies and procedures.

Name of graduate:

• Overall score: % (80% minimum overall score). [PROOF ATTACHED (OzarksEMS Transcript)]
• Practical skill sheets (includes all required skill sheets). [PROOF ATTACHED (Platinum)]
• Clinical tracking records (includes required hours, areas, procedures, patient contacts, etc.):
• All clinical and experience hours meet minimum requirements. [PROOF ATTACHED (OzarksEMS)]
• Laboratory and clinical skill meet minimum requirements. [PROOF ATTACHED (Platinum)].
• Final exams:
• Cognitive: Platinum timed comprehensive adaptive test, or cumulative summary results with "Good" in all categories.[PROOF ATTACHED (Platinum)]
• Affective: Final comprehensive eval with "PASS" status. [PROOF ATTACHED (Google Drive)]
• Psychomotor: Final psychomotor "PASS" results [PROOF ATTACHED (Eval Form)].
• Student counseling (as applicable). Notes:
• Required course certifications:
• AHA BLS. [PROOF ATTACHED]
• NAEMT PHTLS. [PROOF ATTACHED]
• BEMS skills verification form completed (https://health.mo.gov/safety/ems/pdf/TrainingEntityEMT-BSkillsVerification.pdf)

Program requirements successfully and fully completed on:

Medical Director signature (optional):

Program Director signature:

CMH EMS Education Mission: "Provide state-of-the-art education to develop and support a team of exceptional emergency medical professionals."

CMH EMS Education Manual is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Based on a work at http://ozarksems.com/edman-4-240.php.