Paramedic Student Ability to Determine Glasgow Coma Scale

Posted by Patrick Lickiss on May 31, 2012 in Assessment, General, Research | 6 comments

As we talked about last week, the Glasgow Coma Scale is a useful assessment and triage tool in patients presenting with illness and injury. An article in the Emergency Medicine Journal looks at the ability of Australian paramedic students to correctly determine the GCS of several patients on a video test.

Here’s the abstract from PubMed:

Emerg Med J. 2012 Apr 13. [Epub ahead of print]

Should an alternative to the Glasgow Coma Scale be taught to paramedic students?

Winship C, Williams B, Boyle MJ.

Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia.

Abstract

Background The accurate assessment of a patient’s conscious state using the Glasgow Coma Scale (GCS) is an important skill for paramedics as it may determine the patient’s initial and ongoing management. The objective of this study was to determine if undergraduate paramedic students from a large Australian University were able to accurately interpret a variety of conscious states.

Methods A prospective double-blinded observational pilot study requiring students to interpret the conscious state of four adult patients using the GCS by viewing a simulation DVD package.

Results There were 137 students who participated in the study, of whom 65% (n=87) were female students. The results demonstrated that undergraduate paramedic students were unable to accurately interpret a number of patient conscious states with only 20% and 37% of students able to accurately identify the GCS of patients 2 (GCS=12) and 3 (GCS=7). The motor component of the GCS appeared to be the component where the least accurate interpretation occurred, with only 47% of students being able to accurately identify the criteria that patient 3 displayed. Participants were however able to accurately interpret the GCS of both patient 1 (GCS=14) (86%) and patient 4 (GCS=15) (92%).

Conclusion This pilot study demonstrates that undergraduate paramedic students from an Australian university were unable to accurately interpret a patient’s conscious state if their GCS score was <14. These findings have provided academic staff with important information for considering alternative teaching and learning strategies and approaches in conscious state assessment in current paramedic curricula.

Obviously there are some short falls in the performance of the students.  I find it interesting, however, that the title of the article discusses finding an alternative to GCS. For better or worse, the Glasgow Coma Scale is a standard measurement.  If the students aren’t able to utilize it properly, perhaps a different method of teaching is warranted.  If an entirely different assessment technique is taught, those students would just have to learn GCS after getting into the field.

What do you think?