NCCT-TSC NCCT Technician in Surgery test prep |

NCCT-TSC test prep - NCCT Technician in Surgery Updated: 2023

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NCCT Technician in Surgery
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NCCT Technician in Surgery
Question: 83
Which of the following nursing interventions is appropriate for the patient with
sickle cell crisis?
A. Moving and stretching swollen extremities.
B. Educating male patients to try and hold urine in the bladder to avoid
developing priapism.
C. Providing rest in a quiet environment as much as possible.
D. Both A and B
Answer: C
The tech who is caring for a patient in sickle cell crisis should provide rest in a
quiet environment as much as possible. The patient is typically in severe pain and
may be in need of fluids to help with hydration. Depending on the type of
procedure schedule, the patient with uncontrolled pain who is in acute sickle cell
crisis may need to have surgery postponed to reduce the risk of infection and
further complications.
Question: 84
A patient is being admitted for a surgical procedure to place an abdominal
catheter for continuous ambulatory peritoneal dialysis. Which of the following
complications should the tech educate the patient about as they prepare for the
A. Diarrhea
B. Abdominal hernia
C. Chest pain
D. Syncope
Answer: B
The tech should educate the patient about the potential complication for an
abdominal hernia to develop after placement of a catheter for continuous
ambulatory peritoneal dialysis. The fluid exchange that takes place may increase
pressure in the abdomen. The most common types of hernias that occur in this
situation include inguinal, diaphragmatic and umbilical hernias.
Question: 85
To prepare the patient for transfer to the post-anesthesia care unit (PACU), the
tech must move the patient to a stretcher and secure their body. What other
interventions should the perioperative tech do to prepare the patient for transfer?
A. Elevate the head of the bed 90 degrees.
B. Gather the patient"s belongings and place them at the foot of the bed.
C. Raise the side rails on the stretcher.
D. Swaddle the patient"s body with a dry, heavy blanket.
Answer: C
The tech should raise the side rails on the stretcher before transferring a patient to
the PACU. This promotes patient safety and prevents injury if the patient were to
roll over or fall from the bed. Side rails should be up any time a patient is in bed,
even if they are alert and oriented. Lower the side rails when the patient is ready
to be transferred to the next bed.
Question: 86
A patient is transferred to the PACU and presents with snoring respirations and
little chest expansion while breathing. The tech notes that their oxygen saturations
are at 94% and starting to decrease. What is the tech"s first action?
A. Perform a jaw thrust to open the airway.
B. Notify the physician immediately.
C. Stimulate the patient to take deeper breaths.
D. Turn the patient prone.
Answer: C
The tech should stimulate the patient to take deeper breaths. The patient may be in
a relaxed state following anesthesia and the tongue muscle may slip backward,
partially occluding the airway. By stimulating the patient, they may awaken
slightly and take several deep breaths, reducing snoring and increasing respiratory
effort and oxygen saturations. If depressed respirations continue, the tech should
consider repositioning the patient and administering oxygen.
Question: 87
Which of the following is the most common reason for agitation and confusion
during the time period when the patient is transferred from the operating room?
A. Pain
B. Hypothermia
C. Hypoxemia
D. A history of depression
Answer: C
Hypoxemia is the most common reason for agitation and confusion during the
time period when the patient is transferred from the operating room. Hypoxemia
results in decreased blood flow throughout the body, including to the brain, which
may cause the confusion. The tech should assess the patient"s levels of
oxygenation and provide supplemental oxygen if necessary.
Question: 88
Which of the following is an essential element of planning for the patient"s
postoperative care?
A. Involving family members in the patient"s care
B. Eliminating the causes of pain before discharge
C. Progressing the diet to return to normal
D. Both A and C
Answer: A
An essential element of planning for the patient"s postoperative care is involving
family members in the patient"s care. Family members or significant others are
extremely important for providing support and help with a patient after surgery
and should be taught the best methods of care alongside the patient. The patient
may be free from pain before discharge, but pain may not be eliminated entirely;
it should, however, be under control. The patient may or may not return to a
normal diet right away, depending on the surgical procedure.
Question: 89
Which of the following subjects are appropriate teaching subjects for the patient"s
A. The physician"s cell number in case of emergency
B. The reasons, side effects, dosage, and timing for every medication the patient
will be taking
C. Instructions about what to do if the patient decides to ambulate to use the
D. Both B and C
Answer: B
The family should be taught the reasons, side effects, dosage and timing for every
medication the patient will be taking. Medications have a large impact on the
patient"s ability to heal as well as providing pain control. The family should have
knowledge of medications, as well as why they are used and where to obtain
them, in order to support the patient"s healing process.
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Wed, 24 May 2023 04:00:00 -0500 en text/html
5 Best At-Home Herpes Tests for 2023

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Several companies produce at-home kits that test for herpes. These may benefit those who suspect they have herpes but are reluctant or unable to visit a doctor’s clinic.

This article discusses the different types of at-home herpes tests available and some advantages and disadvantages. It also lists a selection of at-home herpes tests that people can consider.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

All quotes are provided by a Medical News Today Editor, Lois Zoppi, who received a free herpes test from LetsGetChecked to review.

Medical News Today follows a strict product selection and vetting process. Learn more here.

Best subscription for herpes test: LetsGetChecked

  • Price: $119
  • Collection method: finger prick blood sample
  • Results: within 2–5 days
  • Follow-up care: nurses available through LetsGetChecked to discuss positive results
  • Pro: tests for both HSV-1 and HSV-2
  • Con: does not accept insurance

The LetsGetChecked home kits can test for both HSV-1 and HSV-2. This test kit may be best for people who require regular testing as the company’s subscription options can offer significant discounts.

A person receives a collection kit with all the tools they need to collect their samples at home. This includes needles, a prepaid envelope, alcohol swabs, and a tube. The tests come in discreet packaging so that other people will not know what the person has received.

The person also has access to an instruction video on the company website that explains how they should take their test. LetsGetChecked suggests that people take a blood sample before 9 a.m. and return it to the laboratory on the same day.

“I would recommend this product to MNT readers. It’s an easily-accessible way to access tests that allow you to gain insight into your health. The ordering and testing process is very easy and relatively pain-free, and results come quickly.” — Lois Zoppi, MNT Editor

The company states that it issues the results within 2–5 days.

Individuals who receive a positive result can contact a nurse through the company, and they may suggest a treatment plan.

LetsGetChecked offers a one-time purchase for $119. Anyone who requires regular testing can purchase a LetsGetChecked subscription and get discounts on its tests. For instance, a 3-monthly subscription will supply a person a 30% saving on the cost of the kits.

Learn more about LetsGetChecked here.

Best convenient herpes test: MyLAB Box

  • Price: $89
  • Collection method: finger prick blood sample
  • Results: within 2–5 days
  • Follow-up care: free consultation with a doctor if test results are positive
  • Pro: the doctor may prescribe treatment if test results are positive
  • Con: only tests for HSV-2

People can order at-home herpes tests from MyLAB Box. These kits contain instructions, a specimen bag, and a prepaid return envelope. Users may find this test convenient because of its quick turnaround for results and the option to book a free consultation and get treatment.

It is also one of the more affordable tests available online.

Once a person receives their collection kit, they can collect their sample using the instructions. They can then use the prepaid envelope to send it to the laboratory.

People should receive their results within 2–5 days. If the test is positive, they can book a free consultation with a doctor to discuss their results and treatment options. The doctor may then prescribe treatment.

This at-home test only works for people who wish to test for genital herpes. The company does not offer test kits for oral herpes.

The kit costs $89 as a stand-alone test, but the company also markets other kits that test for different infections. For example, if a person also wishes to test for other STIs, they can purchase the Total Box – 14 Panel option or the Uber Box – 8 Panel option.

Best for quick results: STDcheck

  • Price: $45 for HSV-1 or HSV-2
  • Collection method: blood test
  • Results: within 1–2 days
  • Follow-up care: consultation with a doctor and a written prescription for $95
  • Pro: rapid results
  • Con: requires a visit to a laboratory

STDcheck offers tests for both HSV-1 and HSV-2. A person can order an HSV-2 test for $45. There is also an option to order a test package that tests for 10 different STIs.

This option is best for people who need their results quickly.

To order a test, a person must enter their ZIP code on the company website to find their nearest testing center. The company claims it has over 4,500 test centers nationwide, making them a convenient option for most people.

A person needs to attend their local Test Center for a blood test. They should then receive their online results within 1–2 days. Anyone who receives a positive result is eligible for a phone consultation with a STDcheck doctor. The doctor may prescribe treatments at their discretion.

Best affordable herpes test: HealthLabs

  • Price: $45 (HSV-1/HSV-2) or $79 (both HSV-1 and HSV-2)
  • Collection method: blood sample
  • Results: within 1-3 days
  • Follow-up care: no information available at time of publishing
  • Pro: does not require appointments and accepts walk-ins
  • Con: requires a visit to a laboratory for a healthcare professional to collect the sample

HealthLabs offers laboratory-based herpes tests. These may be the best option for people who do not have health insurance and those working with small budgets.

After placing an order, the person receives a laboratory requisition form, which they need to print out and present at a laboratory. The company claims it has 4,500 laboratory locations, and individuals should receive their test results within 2–3 business days.

HealthLabs has three herpes tests available for purchase:

  • a test for HSV-1, which costs $45
  • a test for HSV-2, which costs $45
  • a test for HSV-1 and HSV-2, which costs $79

People may also order at-home tests for other STIs, including gonorrhea, chlamydia, and HIV.

Learn more about HealthLabs here.

Best for early detection: Priority STD

  • Price: $99 for standard herpes testing and $189 for early-detection testing
  • Collection method: blood test or urine sample
  • Results: within 1–3 days
  • Follow-up care: phone consultation with a partner physician who may prescribe treatment for $65
  • Pro: offers tests for early detection of herpes
  • Con: requires a visit to a laboratory

Priority STD offers three lab-based herpes detection tests: A standard herpes test, costing $99, and a herpes early detection test, costing $189. The latter can detect the presence of the herpes simplex virus as early as 10 days after exposure.

This may be suitable for people who would prefer to quickly seek diagnosis and treatment for herpes.

To order either herpes test, a person must access the company website and enter their ZIP code to find their nearest testing center.

The company claims it has over 4,000 private test centers across the United States.

After ordering the herpes test, a person can walk into their local center to receive the testing. An appointment is not necessary.

The test procedure involves a simple blood test and urine sample, which typically takes a matter of minutes. A person can expect to receive their online test results within 1–3 days.

In the event of a positive result, a person can have a phone consultation with a partner physician, who may prescribe treatment at an additional cost of $65.

The table below compares the six at-home herpes tests for cost, follow-up care, and more.

People considering buying a home test may seek advice from a pharmacist on which test is likely to be best for them. The pharmacist may also be able to show them how to collect the sample at home to prevent inaccuracies.

People who are looking for an at-home herpes test should consider the following before making a purchase:

  • Clear information: The company should offer all the information that a person needs for testing, including clear and complete instructions.
  • Consultations: Some companies offer consultations for people who wish to discuss their sexual health concerns, particularly if they receive a positive result.
  • Treatment plan: Online providers may suggest further testing or treatment depending on the individual’s results and concerns.
  • Certified laboratories: Some companies work with laboratories with Clinical Laboratory Improvement Amendments (CLIA) certification. The Centers for Disease Control and Prevention (CDC) claims that the CLIA regulations “establish quality standards for laboratory testing.”

At-home and in-person tests screen for the herpes simplex virus and will return either a positive, negative, or inconclusive result.

At-home tests require a person to collect the sample themselves. These samples may include urine, mouth or genital swab, or a blood sample.

While at-home tests may be more convenient for those who are uncomfortable discussing their sexual history with others, or those who cannot easily access healthcare, there are some risks. If a person does not collect the sample correctly, they run the risk of receiving an inconclusive or incorrect test result.

Some at-home tests involve ordering a test online and visiting a lab so that a technician can collect the sample. This may be a good middle ground between true at-home tests and tests from a clinic for those who prefer not to discuss their sexual health with their doctor.

Samples taken by lab technicians and healthcare professionals are more likely to be valid. These professionals have had training and are more likely to take the sample correctly.

Another difference between at-home and in-person tests is that companies offering at-home testing may not offer follow-up advice. On the other hand, healthcare professionals from a clinic can provide people with resources, treatment, and prevention tips.

Herpes is an infection with the herpes simplex virus (HSV). The virus spreads through contact with moist areas of the skin, such as the mouth and genitals.

Tests can make people aware that they have the virus, encouraging them to take steps to reduce the likelihood of passing it to others.

The World Health Organization (WHO) categorizes HSV into two types: HSV-1 and HSV-2.

HSV-1 causes oral herpes, which may develop after exposure to the virus in saliva or on skin surfaces. Many people do not experience symptoms; some develop the virus from nonsexual contact during childhood. Sometimes, HSV-1 can also cause genital herpes through oral sex.

Learn more about what herpes looks like.

HSV-2 causes genital herpes, which is a sexually transmitted infection (STI) that affects more than 1 in 6 people aged 14–49 years in the United States.

Some at-home tests may check for just one type of HSV, whereas others may test for both types.

The CDC states that more than 1 in 6 people in the U.S. ages 14–49 years have genital herpes.

Herpes spreads through oral, anal, and vaginal sex. People can reduce the risk of transmitting herpes to another person by using condoms or dental dams during sex and avoiding having sex when they are experiencing an outbreak of herpes.

The CDC recommends herpes testing only for people who experience symptoms. Herpes can produce blisters on and around the genitals, mouth, or rectum. One reason for this is that false-positive results are possible.

Learn more about how long it takes for herpes symptoms to show.

People who have active herpes lesions can undergo a swab test. However, if the lesion is small or has started healing, there might not be enough of the virus for the test to detect. Due to this, there is also a risk of a false-negative result.

Healthcare professionals may be able to diagnose a person with herpes if they present with blisters and sores. Doctors may also swab sores or blisters that have not yet healed and send the samples to a lab for tests.

Anyone who thinks they might have had exposure to HSV and wants to take a test for reassurance despite a lack of symptoms will need to test for antibodies in the blood instead.

According to the American Sexual Health Association, people should wait 12–16 weeks from the time of sexual contact before taking a test. The test checks whether or not the body has developed antibodies for HSV-1 or HSV-2, which may take some time to become detectable after exposure.

People who are sexually active or share needles with others may require regular testing.

Individuals with partners with herpes and who do not use barrier methods such as condoms each time they engage in sexual activity should also test for herpes regularly.

Some people may prefer to order their at-home tests from online providers since this does not require them to leave their homes.

A 2020 study notes that at-home kits may also benefit those who may not access routine healthcare.

There are two types of home tests: self-collection and laboratory-based.

Self-collection tests

After purchasing a test collection kit from an online provider, individuals receive all the tools they need to perform the test at home. They collect a sample by following the instructions in the kit and then return it to the company or its laboratory for analysis.

Laboratory-based tests

After purchasing the test from an online provider, the person receives a laboratory requisition form, which they present at a testing site. A healthcare professional takes the required sample, and the individual receives their result within a few days.

HSV-1 or HSV-2 test results may be negative or positive. These results depend on the type of test people take.

False results can occur with many diagnostic herpes tests. This is because herpes tests are not as exact as tests for other STIs, such as chlamydia and gonorrhea.

A research review on the diagnosis of HSV-1 and HSV-2 concludes that using blood tests to diagnose genital herpes may be inappropriate because positive results may be due to chronic infection, whereas negative results may overlook accurate infection.

According to the American Sexual Health Association, other viruses carried by the person in their blood may cross-react with the herpes virus, causing a false positive herpes result. These viruses include the varicella-zoster virus (VZV) which causes chickenpox or cytomegalovirus (CMV).

Other factors which may determine the correct outcome of a herpes test result include sample preparation and the stage of infection of the sample.

Four types of tests can confirm the presence of the HSV-1 or HSV-2 infection. These are:

Polymerase chain reaction (PCR)

This is also known as a viral DNA test or HSV DNA test. The healthcare practitioner examines the sore sample to look for the DNA of HSV-1 and HSV-2 to determine which virus is causing the person’s infection.

These tests are 99% accurate and are regarded as the gold standard of testing by healthcare practitioners in advanced HIV infections.

Viral culture

A healthcare practitioner collects a sample from the person’s skin sore and sends it to a laboratory to see if the virus grows. This type of test is useful early in an outbreak when the sore is open.

A positive result indicates that the person has an HSV infection. This may be an initial outbreak or a recurring one.

A negative result indicates that the test sample did not contain HSV. A negative result does not always mean that the person is free from the herpes virus. For example, a false negative may occur if the lesion is small or has started to heal.

Tzanck smear

A healthcare practitioner scrapes cells from the person’s sore to look for characteristics of herpes infection. A clinician examines the cells at the doctor’s office. There is no need to send the sample to a laboratory.

A positive result indicates the person has an infection. A negative result indicates that they do not have a herpes infection.

Antibody tests

Herpes simplex antibody tests determine the presence of the HSV-1 or HSV-2 virus. A clinician detects these antibodies in the person’s blood or sore sample.

A positive result means that the person has HSV antibodies or had an outbreak or past infection. A negative result indicates that the person does not have the virus.

Before ordering a sample collection kit, people should consider the advantages and disadvantages of using at-home herpes tests. These include:

Anyone who has sexual contact with someone who has received a herpes diagnosis should contact a doctor as soon as possible.

People who have received a positive test result may also wish to consider seeking medical advice.

Currently, herpes is not curable, but doctors can prescribe medications to reduce the frequency and severity of the symptoms. This may help lower the chance of the infection spreading to other individuals.

Below are some common questions about at-home herpes tests.

What can herpes be mistaken for?

Many people who have herpes do not have any symptoms at all. Additionally, if a person has herpes symptoms they can still be mistaken for something else. For example, herpes sores may look like pimples or ingrown hairs. Since herpes sores can look like blisters, they can also be mistaken for skin condition symptoms, such as dermatitis.

Learn more about what herpes sores look like here.

When and how should a person test for herpes?

The CDC recommends that only people who have symptoms of herpes undergo testing. Possible symptoms include blisters around the anus, genitals, or mouth that burst and leave painful sores. The CDC also recommends testing if a person experiences what could be a herpes outbreak.

A person can ask for a herpes test at any sexual health clinic or a doctor’s office. A healthcare professional will either swab a blister or draw a blood sample. A person can opt for at-home herpes tests, which typically require a blood sample through a finger prick.

Once a person receives their test results, they should contact a doctor to discuss treatment options, if necessary.

Learn more about medications for herpes here.

What is the fastest and easiest way to test for herpes?

Most at-home tests deliver results in as little as a few days after the lab receives the sample.

Some clinics may offer rapid testing with results available in as few as 10 minutes. However, rapid testing may not be available at all clinics.

Using an at-home herpes test could be one of the fastest ways for a person to test for herpes. Since at-home herpes tests allow people to skip going to a clinic for a blood draw and testing, they could also be one of the easiest ways to test for herpes.

If someone is uncomfortable collecting their blood samples, they should go to a clinic for a test.

Will I have to pay for herpes testing out of pocket?

The Affordable Care Act means insurance providers must cover HIV testing for most adults. However, testing for certain STIs may vary depending on a person’s age, gender, and risk factor.

People should contact their insurance providers to check whether herpes testing is under their preventive care benefits. If it is not, they will have to pay out-of-pocket costs.

What should I do if my herpes test is positive?

A positive test result means that the virus is present in a person’s blood sample.

While there is no cure for herpes, healthcare providers can prescribe medication to reduce the severity of herpes outbreaks. Some people may not experience any symptoms after the initial outbreak, whereas others may have recurrent herpes symptoms.

At-home herpes tests may be the preferred option for people who feel uncomfortable discussing their sexual health with a doctor and those who are unable to visit a healthcare facility.

Many companies sell at-home tests. Before purchasing a test, an individual may wish to compare the costs, how long it takes the companies to issue the results and their instructions for collecting the sample.

Some people may have difficulty collecting their samples at home and interpreting the test results. Some companies may only offer consultations to individuals who receive a positive test.

There are different types of herpes tests a person may wish to take. People should take into consideration that any test has room for error and those who receive a positive herpes test result should contact a doctor to discuss treatment options or a follow-up test.

Mon, 29 May 2023 12:00:00 -0500 en text/html
Indiana punishes Muncie EMTs for exam cheating scandal

Update: Muncie Fire, EMS exam cheating investigation

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An investigation into exam cheating inside the Muncie Fire Department has resulted in punishment against at least nine EMTs and could end the career of a longtime Muncie firefighter.

Six weeks after 13 Investigates broke news of the cheating scandal, Indiana’s Department of Homeland Security sent letters to inform MFD staff of discipline stemming from what State Fire Marshal Steve Jones called a “very thorough investigation.”

“There were test answers that were passed out to students so that they could cheat on tests,” Jones told 13News. “They broke the rules of the National Registry and they broke Indiana state law when it comes to our ability to supply a test. We cannot tolerate it.”

13 Investigates obtained an investigation report and order issued by state homeland security. The report states MFD Capt. Troy Dulaney coordinated a “cheating scheme” in which he sent a group text to all eight students in the January 2023 basic EMT certification course offered at the MFD training center. According to the state investigation, which included interviews with more than 30 MFD staff members, Dulaney’s unsolicited text included test Questions and Answers to help Muncie EMT recruits pass their National Registry EMT exam.

The document also says Dulaney texted the students after they completed their certification test, “indicating that they should supply him test Questions and Answers from their own NREMT examination.” State investigators said the follow-up text from Dulaney “indicated that since he had ‘invested’ in the students… they should ‘invest back in him.’”

IDHS’s investigation report claims Dulaney’s actions in his capacity as an emergency medical services professional to organize and involve others in a cheating scheme constitute “fraud and material deception” and “lewd and immoral conduct” in violation of state law.

As a result, the state EMS director has issued an order revoking all five of Dulaney’s EMS-related certifications for the next seven years. According to IDHS, the revocation essentially means Dulaney cannot be an EMT in Indiana during that time -- the harshest penalty state regulators can take against an EMT.

Jones said that discipline was chosen for a reason.

“We had never had a case that saw such blatant disregard for giving test answers out for students to cheat,” the state fire marshal said. “This was pretty big and broad in scope, way beyond what we’ve seen in the past.”

According to the city’s human resources department, MFD hired Dulaney as a firefighter in 2004. Since then, city records show he completed 37 training courses and earned 42 firefighter and EMS certifications, including passing his basic EMT certification exam in 2020 and earning an advanced EMT certification in 2022. Both of the EMT certification tests include a non-disclosure agreement in which exam takers agree not to share information about exam Questions and Answers with anyone else. MFD promoted Dulaney to lieutenant in 2020 and captain in 2021.

The MFD captain has not responded to any of 13News’ attempts to contact him.

EMT recruits avoid harsher penalties

While state officials allege Dulaney was at the center of the cheating scheme, IDHS is also taking action against the eight EMT recruits that received test Questions and Answers from him.

The state’s investigation report involving the recruits acknowledges “students were put in a challenging situation when Dulaney, a high-ranking officer in their fire department, involved the students in a cheating scheme.” It goes on to say that even though “the students did not ask to be involved in it… the students still cooperated by not reporting the misconduct and by offering return information to Captain Dulaney.”

Because of their silence, IDHS issued a censure to all eight EMTs, placed them on two years of probation and voided the results of the national EMT exam they passed in February. While the state did not officially suspend or revoke their EMT certifications, all eight of the EMTs must re-take their National Registry exam within 90 days and pay a $100 civil penalty.

13News is not naming the censured EMTs because IDHS told 13 Investigates some of the EMT recruits insisted they did not want and deleted the test information Dulaney texted to them. The state’s administrative orders against Dulaney and the other EMTs were issued May 18, 2023, but the effective date is Monday, June 5 to supply the EMTs time to appeal.     

Asked about possible penalties that his department’s EMTs could face as a result of several cheating investigations, Muncie Fire Chief Robert Mead told 13News last month that he feared multiple EMT certification revocations could be devastating to MFD’s ability to staff its EMS service.

The state fire marshal said he believes a more mild punishment was warranted for most of the EMTs identified in the state’s cheating investigation.

“We don’t want to penalize the department if we don’t have to,” Jones said. “We want Muncie to be able to provide good [EMS] service… and so putting some of them on probation for a couple years and allowing them to continue to work after re-testing, we’re confident that they can still deliver good service to the community.”

IDHS told 13 Investigates it is not taking disciplinary action against the Muncie Fire Department’s EMS provider certification or its EMS training institution status due to insufficient evidence that MFD’s official EMS instructors were involved in the cheating. While Dulaney assisted with exam preparation, IDHS says he was not a full-time instructor.

Geo Henderson, an industry expert who’s held an EMT certification for nearly 30 years and who now serves as a battalion chief at a New York fire department, agrees with IDHS’s disciplinary decisions. He said if exam cheating is suspected, requiring EMTs to re-take their certification exams is a wise choice.

“If those exams are in question, if there’s a chance you’re not truly qualified to hold your position and you’re not on your game, people’s lives hang in the balance,” he told 13News.

Henderson said the type of cheating identified in Muncie tarnishes the reputation of all first responders, and he believes MFD leaders now need to do some soul searching.

“We absolutely should not be sweeping this under the carpet. We should be looking at this with a very harsh spotlight to say, ‘How did this happen? How can we prevent this from happening? And how can we build that culture where this will never be tolerated again?’

Whistleblower complaints prompt new federal lawsuit

The state’s discipline announcement comes just weeks after 13 Investigates first reported on a cheating scandal that had grown large enough to prompt whistleblowers to come forward.

“I know what’s going on is wrong. I can’t sit back and watch it happen any longer,” an MFD insider told 13News, saying that they had seen the cheating happen firsthand.

The whistleblowers, who spoke on the condition of anonymity, provided 13News with pages and pages of test questions and answers they say Dulaney and other MFD staff harvested directly from EMT and firefighter certification exams. 13 Investigates also obtained a copy of a text message, allegedly sent by Dulaney along with test questions and answers, that said “Do not tell anyone I shared with you … The more you KNOW the material, the better recall you will have afterwards to remember questions.” 

Collected and sharing test Questions and Answers with students prior to their EMT exam is a serious violation of exam rules.

Those rules from the National Registry of Emergency Medical Technicians state:

“Candidates are not permitted to disclose or discuss with anyone, including instructors, information about the exam questions or answers seen in your examination” and “Reconstructing exam items using your memory of your exam or the memory of others is prohibited.”

Asked about its own investigation into cheating allegations at the Muncie Fire Department, an NREMT spokesman sent 13 Investigates the following statement:

“The National Registry of EMTs is continuing its investigation involving the Muncie (Indiana) Fire Department. At this time, we can confirm that some actions have been taken, including certification revocations and examination nullifications. These actions were based on the information made available to the National Registry during its investigation. Because this is an ongoing investigation, we will not provide any further information until the investigation is completed.”

While the organization has not yet completed its investigation, it has already taken dramatic action to prevent MFD staff from disseminating further test questions.

13News has learned NREMT has filed a lawsuit in federal court, seeking damages against Dulaney and two other Muncie EMTs for what it calls a “years-long scheme” to reveal “confidential and proprietary materials” before students take their EMT exams. 

The lawsuit alleges Dulaney sought help from Muncie EMTs Jacob Sutton and Adam Burk, and that the two EMT recruits “memorized questions on NREMT examinations they took and then disclosed those questions to Dulaney, knowing that Dulaney intended to share those questions with other prospective test takers.”

In doing so, NREMT says the MFD staff violated the non-disclosure agreement they signed while taking their National Registry exams, resulting in test takers getting “an improper advantage on the test and endangering the public whom these prospective emergency medical technicians were to serve.” It’s 21-page lawsuit states the Muncie Fire Department’s eight-member EMT recruit class assisted by Dulaney in 2023 had a 100% pass rate – dramatically higher than the national pass rate of 68% and Indiana pass rate of 56% for all of 2022.

Because of the cheating, NREMT claims it now has to retire and replace all of the compromised test questions and conduct a much wider investigation - a process that is “very time-consuming and expensive” and that has required the reassignment of eight full-time staff members. The organization is requesting the federal court to prohibit the defendants from obtaining and sharing their copyrighted trade-secret questions and answers, to return all collected Questions and Answers in their possession, and to award compensatory damages in an amount to be determined at trial.

While Dulaney has not responded to requests for comment from 13News, he did reply to NREMT to address the allegations levied against him. 

"While I continue to deny the veracity of the allegations presented and do therefore disagree with the findings... I do hereby apologize for even the semblance of wrongdoing," he wrote in late April.

What happens next

It’s not just Muncie EMTs who are facing punishment.

The state fire marshal has also been investigating allegations that Muncie firefighters also cheated on their certification tests, which often bring pay increases and promotions for successfully passing the exams.

IDHS tells 13News it is already preparing disciplinary recommendations involving Muncie firefighter certifications, which will be presented next week to the Indiana Board of Firefighting Personnel Standards and Education.

NREMT is also expected to release its investigation report in the coming weeks.

The focus then shifts to what actions, if any, the Muncie Fire Department will take against its own staff that state investigators cited for engaging in the cheating scheme.

While Fire Chief Robert Mead originally told 13News last month that his department was conducting its own investigation, he later seemed to suggest that MFD was not proactively investigating the allegations, but instead waiting to see what IDHS and NREMT investigators would find during their probes. It leaves many unanswered questions:

  • Will MFD take further disciplinary action against Dulaney – perhaps even firing him in the aftermath of the state’s investigation -- or allow the captain to remain with the department?
  • Will the department take additional actions against other EMTs who participated in the cheating or consider the state’s sanctions sufficient?
  • Will the two EMTs named in NREMT’s federal lawsuit face MFD punishment for allegedly providing test information to Dulaney? 

13 Investigates contacted Mead and the city’s human resources department for answers to those questions. So far, neither has responded with comment. Monday afternoon, Muncie’s EMS director and deputy fire chief referred phone calls back to the fire chief.

13News will update this story with more information as it becomes available.

The office of Muncie Mayor Dan Ridenour released the following statement:

After reviewing results from the Department of Homeland Security and the National Registry of Emergency Medical Technicians, the City of Muncie and the Muncie Fire Department have not been implicated in the investigation of potential cheating on the National Registry EMT exam. One firefighter has clearly been implicated in offering to facilitate EMT trainees in violating ethical test taking standards. 

I, Mayor Dan Ridenour, have conferred with the Fire Chief and concur wholeheartedly that this behavior is completely unacceptable. We are pursuing disciplinary action, up to and including termination. Maintaining the integrity of our Fire Department and EMT program is paramount to the safety of our citizens, and my administration will not tolerate corrupt or dishonest conduct.

The president of Muncie's fire merit commission told 13 Investigates, he has asked for an emergency executive session with the fire chief Wednesday night to learn more details. Andrew Dale claims the administration has not kept the commission informed.

Mon, 22 May 2023 15:20:08 -0500 en-US text/html
Educating within: How Baylor Scott & White is using training to confront staffing issues Kristopher Knoop in front the Midtown Clinic in College Station, Texas. © Baylor Scott & White Health/TNS Kristopher Knoop in front the Midtown Clinic in College Station, Texas.

DALLAS — Belinda Ellison, 50, always wanted to go to college. Life kept getting in the way.

The oldest daughter in her family, Ellison cared for her brothers and mother while also serving as a caretaker for her then-boyfriend’s diabetic mother. She raised her three children on her own while working as an X-ray technician and later a pulmonary tech at Baylor Scott & White Health, the state’s largest not-for-profit hospital system.

Spending money on a bachelor’s degree felt frivolous.

“Financially, the money just wasn’t there,” said Ellison, who has lived in Dallas for most of her life. “It was just my paycheck. No help, no assistance from anyone, no government assistance.”

After more than 30 years of taking care of everyone else, Ellison is finally focusing on herself. She’ll begin classes at the University of Arizona for a bachelor’s degree in business management in August, paid for through Baylor’s new workforce education program.

The program through Guild Education, a platform that manages companies’ education benefits, pays directly for employees’ college-level classes instead of requiring them to front the cost and later get reimbursed. Paying out-of-pocket for expensive courses, even with the promise of repayment, was a significant barrier to many Baylor workers such as Ellison.

Baylor rolled out the program in March as health care companies across the nation grapple with chronic staffing shortages and provider burnout. Compensation remains the top concern of employees today, but professional development remains a key concern. About half of workers do not see a career advancement path at their current company, according to the 2023 Total Talent Guide by recruitment and staffing company Tandym Group.

Matching the trends seen across the health care industry, job vacancy rates at Baylor jumped about 400% at the height of COVID-19, said Baylor chief human resources officer Nakesha Lopez. Getting that number down — and keeping it down – required a multi-pronged approach including short and long-term solutions.

The Guild Education program, part of Baylor’s broader workforce development strategy, is a win-win for both the hospital system and its employees, said Baylor CEO Pete McCanna. Workers can pursue free or discounted training and schooling that can progress their careers, while Baylor can train employees for high-need positions.

“It’s one of the best investments we make as an organization,” McCanna said. “In the current workforce, they’re going to change jobs a lot throughout the course of their working career. It’s even better if they can do that within one organization.”

Baylor has committed more than $8 million per year on the new professional development efforts.

Full-time employees and part-time employees who work over a certain number of hours per week qualify to access the Guild Education benefit program. Already, more than 10,000 Baylor staff members have started the process of choosing a continuing education program.

External degree and certificate opportunities aren’t the only professional development options for Baylor employees. The health system also offers on-the-job training programs for certified medical assistant and sterile processing technician positions.

The CMA Academy and Sterile Processing Technician Academy serve as entry points into the health care industry that requires only a high school diploma. Each academy is 12 weeks long and offers trainees full benefits from their first day of classes.

Alex Suarez, 25, knew he wanted to work in health care since he was a student at Coppell High School in Coppell, Texas. He initially pursued a nursing degree, but stepped away from classwork before moving to Pennsylvania, where he worked as a dental assistant.

When Suarez decided to move back to North Texas, a family friend alerted him to Baylor’s certified medical assistant program as an opportunity to get closer to becoming a nurse. Suarez started classes in September and learned skills like giving injections, drawing blood and administering electrocardiogram tests.

Once Suarez graduated with his cohort of 12 CMA students, he was placed at the Baylor Scott & White Primary Care at The Star in Frisco. The program requires a two-year work commitment from academy graduates.

Suarez plans to finish his nursing degree after completing his two years at the practice. He knows now more than ever that nursing is the career he wants.

“I didn’t really go to the doctor’s normally until I started this, so this was all very foreign to me,” Suarez said. “But the academy kind of brought me up to speed on how things work and the basics of what I need to know.”

That’s exactly how Baylor wants these programs to function, Lopez said. Entry-level positions, like medical assistant and sterile processing technician jobs, help guide North Texans into an industry where they can continue to learn. A technician can become a licensed practical nurse, or a nurse who provides basic patient care. A licensed practical nurse can study to become a registered nurse.

“The pathways are there, the educational opportunities are there, and it’s all about the appetite of the employee to grab hold of that and engage in those programs that are available to them,” Lopez said.

Ellison is only months away from beginning her online classes, which she’ll take while continuing her full-time job. She’s told a handful of patients about her plans.

“I told a few of them and they’re very happy for me. One of my patients … he just told me to keep going. I told him I will and he said, ‘Let me know when you’re finished,’” Ellison said.

Ellison expects to graduate in December 2024, although graduating with her bachelor’s degree won’t be the end of her educational endeavors. Ellison plans to pursue a master’s degree in legal studies so she can transition to the legal field to support people who have been wrongly incarcerated.

“It’s going to be a new chapter in my life and I’m going to be helping someone else. So there’s not going to be a patient, there’ll be a client,” Ellison said. “It’s the same thing to me, though. Everybody needs help at some point in their life.”

©2023 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

Tue, 30 May 2023 04:13:00 -0500 en-US text/html
34 cadets graduate from Allan Hancock EMS academy

Nearly three dozen cadets are now trained to provide basic life-saving skills after graduating from Allan Hancock College’s Emergency Medical Services Academy.

The 34 cadets took part in 16 weeks of field and classroom instruction prior to Thursday’s graduation ceremony at the college’s Public Safety Training Complex in Lompoc.

They’ve also passed a national registry test to become emergency medical technicians EMTs.

“During their time at the academy, the cadets learned critical skills such as patient handling and moving, emergency vehicle driving and more. Much of the training was hands-on and utilized the state-of-the-art equipment and technology available at the PSTC,” according to a press release from the college. They also trained in an EMS simulation lab at Hancock, giving the student an opportunity to practice treating a patient while in a moving vehicle. 

The accurate graduates are:
Zachary Adam
Ethan Arebalo
Jerry Barajas Reynoso
Colin Campbell
Brendan Cavaletto
Gerardo Colores
Steven Cruz
Jesse De Bone
Adrian De Luna
Christian Garcia
Armando Gomez
Andres Gonzalez
Alan Gudino
Noah Harber-Alarcon
Erza Horvath
Annika Jensen
Aidan Lange
Jovany Lucatero
Daniel McKinley
Giselle Mendez
Micah Moore
Raymond Ochoa
Francisco Ojeda
Jonathan Ordonez
Dennis Perea
Luke Potter
Jordan Raffanello
Dulce Ramirez,-Suarez
Daniel Ramos
Crystal Raposo
Wesley Van Der Linden
Gustavo Vasquez
Eric Vera
Ean Weaver

Allan Hancock’s commencement ceremony takes place Friday at 10:30 a.m. on the football field at the Santa Maria campus.

Copyright 2023 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Thu, 25 May 2023 09:06:00 -0500 en text/html
Grant helps purchase IV hand models

IV Hand Models

Submitted photo

Edison State Receives Grant to Purchase Intravenous Hand Models

PIQUA — The Edison Foundation received a $2,792 grant from the Piqua Community Foundation on behalf of Edison State Community College. The funds were used to purchase seven IV hand models, which are being used by students in the Emergency Medical Technician (EMT), Paramedic, and Nursing programs at the College.

To best prepare students interested in entering the health care industry and create a strong workforce in the community, Edison State incorporates hands-on learning into the EMT, Paramedic, and Nursing program curricula. This ensures students have the skills needed to succeed in these fast-paced, in-demand careers.

With the new IV hand models, students practice using an important tool so they can provide proper patient care in the future. The models were implemented into the programs this past fall semester and will continue benefiting students pursuing these degrees and certificates.

“The models are used to help students in a laboratory setting practice IV insertion skills and how to administer IV fluids to either a pre-hospital or hospitalized patient,” said Jill Bobb, Associate Dean of Nursing & Emergency Medical Services at Edison State. “This is an essential skill that must be mastered before entry into practice, and having realistic, quality equipment allows students to have ample practice time. We’re so thankful for the generous donation from The Piqua Community Foundation for top-quality lab equipment.”

Students who graduate with an Associate of Applied Science in Registered Nursing or LPN/ADN Transition at Edison State then prepare to take the National Council Licensing exam (NCLEX) to become registered nurses. Those in the Paramedic program can receive their certificate within a year, while those studying to become an EMT can receive a short-term technical certificate in one semester.

Learn more about these programs by visiting

Wed, 31 May 2023 03:06:00 -0500 en-US text/html
To Hell With the Universities

Affirmative action in higher education is set to face the judgment of the Supreme Court. The moment is quietly exhilarating. This is an injustice that has been hoisted upon so many, for so long, and with the patronage of so many powerful institutions that it seemed perhaps too big and too heavy to ever remove. Yet the same was true of Roe v. Wade, and now Roe v. Wade is gone. 

Some of the details of the case, which was argued on October 31, 2022, are comical. Harvard University claims to take “personality” into account when reviewing applicants. This is understandable, as it takes more than book smarts to excel in life. But Harvard admissions officers, in their great wisdom, apparently concluded that blacks on average have the most interesting personalities, Hispanics are significantly less interesting, whites are less interesting still, and Asians are the least interesting of all — coincidentally an exact inversion of test score averages. It will be a fine day when this sort of barely hidden racial discrimination is gone.

But much like the repeal of Roe, a ruling against affirmative action would only begin a much more difficult fight. The proliferation of liberal policies at universities is, after all, not some historical accident: it is the product of an increasingly large and powerful administrative class in academia. Regardless of the Supreme Court’s decision, these people will remain, as will the diversity, equity, and inclusion (DEI) agenda that they uphold. 

universities. The American Spectator

Linda Helton/The American Spectator

Affirmative action is merely the bluntest instrument in the woke administrator’s tool kit, and there exist other ways of effecting racial discrimination. Take diversity statements, which have now become standard practice for faculty-position applications at top institutions like the University of California, Berkeley. If you are a white applicant, these provide an opportunity to lie prostrate, condemn the fact that there are too many people who look like you in your field, and beg to be the last white person who the hiring committee ever considers. 

A conservative who swallows his distaste may be able to pen a sufficiently orthodox diversity statement. Unfortunately, a progressive statement is no match for a progressive résumé. Academics are more than happy to discriminate against would-be colleagues on whom they detect a single whiff of conservatism, according to surveys. Consequently, only 6 percent of American university faculty self-identify as conservative. 

These same rotten institutions are currently dismantling their own credibility with their obsessive pursuit of diversity over ability. A meritocratic hiring process is a sign of a competent organization. Putting aside questions of fairness, it may be worth asking: How much would it actually benefit Americans to Improve the competence of such a hostile institution as the liberal arts university system? Would America actually be better off if more of its most intelligent young people spent their twenties in adjunct cubicles at Harvard?

Higher Education Is a Prisoner’s Dilemma

For most of early American history, universities served as finishing schools for the upper class. Fewer than 2 percent of Americans were college educated. Latin and Greek were entry requirements; these subjects were of little use in professional life but provided efficient filters for status.

It was not until the turn of the twentieth century that our modern vocational view of college education began to take shape. The US had just become the world’s largest economy and subsequently was in great need of engineers, foremen, clerks, and technicians. Out of this need sprang the first community colleges, which offered vocational courses. By 1950, college attendance rates had jumped fivefold to about 10 percent.

It was on the back of this newly educated middle class that America ascended to superpower status. But as college attendance continued to explode post World War II, the tertiary degree began to come unstuck from its original industrial purpose, and the modern progressive ideology of “college for all” was born.

It is currently unfashionable to take an instrumental view of college education. Notice that leftists stumping for free college will never discriminate between degrees or programs: the mathematician and the gender studies major are considered equally deserving of subsidies. We are so far removed from the vocational schools of the last century that the act of attending college has, in the popular imagination, taken on a sort of alchemical quality. In this view, a student is transmuted into a higher class of citizen merely through attending college — what he learns during that time is relatively inconsequential.

Defenders of the modern liberal arts education retort that colleges teach writing ability, curiosity, critical thinking, good citizenship, and a host of other humanist qualities, regardless of the degree or the major.

Despite their increasing pointlessness, universities carry on like giant parasitic amoebas, sucking up the time and money of entire generations of young people.

There are a few problems with this perspective. To point out the most obvious, knowledge is forgotten over time. Indeed, it is forgotten more quickly and more completely than most people realize. A 2006 study on retention tested the knowledge of students previously enrolled in a course against randomly selected baseline individuals who had never taken that course. The authors found that students of every caliber experienced a similar rate of knowledge decay. Within a year, C-grade students performed worse on the test than the uneducated baseline; within two years, even B-grade students were performing barely above the baseline.

Knowledge decay was not much of an issue in the early days of higher education because college was merely a networking opportunity for the wealthy. Nor was it an issue during the vocational period, when a college-educated technician could expect a job upon graduation that required immediate application of his newly gained technical knowledge. The current chapter of higher education history is not nearly so sensible. The average modern college attendee majors in art history or environmental science, finds a job working with Excel spreadsheets at an insurance company, and by his midtwenties has forgotten nearly everything that he went five figures into debt to learn.

At its essence, the twenty-first-century college degree is frequently an exercise in social signaling rather than education. Unfortunately, status is relative, and if the majority of society attains a particular status symbol, then it must necessarily become banal and unprestigious. The result is a prisoner’s dilemma: both everyone going to college and no one going to college produce the same relative social standing, all else being equal. But because your fellow spreadsheet wranglers go to college, so must you, lest you fall behind.

Your College Is a Temple 

The prestige of the elite college degree is a conduit through which many other forms of prestige are accessed, particularly those in law, government, and industry. This sort of monopoly on social power is not only increasingly undeserved but also dangerous.

It is tempting to imagine that the university system could be restored to some previously unblemished state. But it is probably more accurate to think of pure meritocracy and ideological agnosticism as the historical exception rather than the rule.

Consider England, whose universities have long been regarded as among the best in the world. When in the sixteenth century the country broke with the Roman Catholic Church and established Anglicanism as the state religion, popular adoption of the new religious tendency was piecemeal and gradual. But the most important step in the process was the endorsement of Anglican belief by the ruling and administrative elite.

In 1673 and 1678, the Test Acts were passed by the British Parliament, imposing religious tests as a precondition for holding public office. At the University of Oxford and the University of Cambridge, aspiring students and faculty were required to demonstrate their knowledge and fealty to the Church of England’s Thirty-nine Articles of Religion. This practice remained in place for nearly two centuries, by which point the Anglicanization of England was complete.

The university as a tool of ideological consolidation has taken on new forms today. Across the Islamic world, many universities still embrace the use of tests of religious faith as a requirement for entry. And, of course, in England, America, and elsewhere, the secular religion of social justice fills a similar role.

This is not to imply that the ideological capture of a university system makes it useless. Anglicanization helped to consolidate a unique identity among England’s elite. While the Test Acts were in place, England achieved the Industrial Revolution and laid the foundations for its later empire. But the nature of the ideology obviously matters: it is difficult to imagine a less impressive ruling class than the one currently being created by DEI policies.

As long as there is a culture war in America, higher education will be used as a weapon. The prestige and intellectual legitimacy conferred by universities made these institutions a tool irresistible to ideologues of the past, and today is no different. And as long as universities are weaponized, progressives will wield that power — because more progressives aspire to become academics and are demonstrably more willing to discriminate on the basis of belief. 

Degrees of Rent Seeking

If the concept of universal tertiary education were to disappear, what would supplant it? There is no need to strain the imagination, as the keys to its replacement already stand in place.

Universities no longer possess a monopoly on knowledge. Decades ago, a university might have possessed its city’s most extensive library. Centuries ago, it may have had the city’s only library, and maybe even its only literate people. The internet has made knowledge accessible to all.

Nor are universities now necessary for concentrating human capital. The most impressive reservoirs of genius are today found in Silicon Valley and at enterprises like OpenAI, SpaceX, and the many others that define American scientific prowess.

Nor are they necessary for hiring purposes. The prisoner’s dilemma of education indicates that college degrees are now so ubiquitous that companies use them as a screen for intelligence and conscientiousness; the real job-related education transpires after the hiring. But this screening utility is easily replaced. For example, many tech companies now use coding challenges like LeetCode as the primary method of assessing applicant competence.

Of course, certain fields, like that of medicine, exist in which self-tutoring is much harder, if not impossible. But the dirty secret is that even in these cases, college is hardly relevant. Medical schools and law programs brag about all of the English, history, and drama students in their incoming classes. They make a point of reassuring applicants that their passion matters more than their major. In other words, they utilize the college degree in precisely the same way as most companies — to find smart and hardworking applicants — in lieu of developing better screening methods.

Despite their increasing pointlessness, universities carry on like giant parasitic amoebas, sucking up the time and money of entire generations of young people. Pointless habits do not always disappear easily, and sometimes they disappear not at all. (After all, the Japanese still love their fax machines.)

But there are at least a few steps that can be taken to cut colleges down to size. Offers of federal tuition subsidies and easy student loans should be withdrawn. The virtual certain of taxpayer money has all but eliminated competitive pressures at universities, leading to ballooning numbers of administrative staff, lazy rivers, and insultingly pointless grievance studies programs. These subsidies were introduced at a time when there existed a strong case for higher education as a public good, but that time has long passed.

Young people have a part to play in this as well. No one can be individually faulted for going to college — no virtue lies in being the sucker in a prisoner’s dilemma. But the trend of treating higher education as a backup plan for life, and the master’s degree, doctorate, and postdoc as means of delaying entry into working life, ought to stop. Do not supply the university system any more time and money; four years and tens of thousands of dollars is more than enough.

As for the future scientists and CEOs who will now stand a chance of getting into Harvard if affirmative action is repealed? We can only hope that all of them take their smarts elsewhere afterward, rather than becoming barely paid adjunct fodder.

For now, the possible end of affirmative action is a victory to celebrate, even if it only gives a bloody nose to the ideologues who have taken over some of America’s most venerable institutions. The Supreme Court should do as it ought to and ensure that the Civil Rights Act is being applied fairly for all races of people. However, in the long run, it cannot be enough to simply Improve the fairness of a system that, in its current form, should not exist.


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Sun, 28 May 2023 14:54:00 -0500 en text/html
Five Good Things: Trucking honors U.S. heroes

Memorial Day has passed, and the industry that keeps the nation running has spent the past week honoring its fallen heroes—as well as the many veterans now serving the U.S. trucking industry—in this edition of Five Good Things.

Please pass along good news for our weekly Five Good Things blog by email or through our LinkedInFacebook, or Twitter accounts.

Trucking industry honors Memorial Day

The patriotic trucking industry, all over, honored the fallen in its own way. Uber Freight offices installed empty tables to remind people of those who made the ultimate sacrifice. J.B. Hunt had its annual ceremony, and Werner Enterprises had a parade and concert.

Navistar launches technician skills competition

In an effort to recognize technician excellence, Navistar has launched its inaugural Top Team technician skills competition. Taking place at Navistar’s Service Solutions Expo in Grapevine, Texas, earlier this month, 10 International Truck and IC Bus Master Certified and Diamond Certified technicians from North America competed in a series of skills-based contests surrounding diagnostics, maintenance, and repairs, according to FleetOwner sister brand Construction Equipment.

Nathan Reed from RWC Group in Seattle has been named International Truck’s 2023 Top Team Technician, and Anthony DeCicco from Wolfington Body Co. in Exton, Pennsylvania, has been named IC Bus’s 2023 Top Team Technician.

See also: Five Good Things: Students trucking toward the future

Part of Navistar’s TECH EmPOWERment program’s retention and recognition strategy, the Top Team competition replaces the Technician Rodeo, which was last held in 2019. All Master Certified technicians and Diamond Certified technicians from the International Truck and IC Bus dealer networks were invited to test for a spot in the Top Team competition. Some 420 certified technicians took the test, with the top 10 selected to participate in the contest.

During the competition, the service technicians had the opportunity to display their skills, knowledge, and professionalism as they safely and efficiently diagnosed and repaired different systems in mobile or stationary equipment. The 20 stations included tests on engines, air brakes, aftertreatment systems, electrical systems, wiring, and the Diamond Logic electrical system and fault codes.

DeCicco was inspired to join the trucking industry by his father, an ASE Master technician. After initially training under his dad when he was just 16 years old, DeCicco now has 14 years of experience and points to his Navistar ASE certification as his proudest achievement. Despite his career expertise, this win was unexpected.

“This means everything,” DiCicco said. “Working as a technician has really been my only career. To be able to come here and be recognized as the best is validation that I picked the right career. It’s not necessarily a glamorous job. So, to come here and enjoy a nice resort, get to network, and do all the things that are rarities in our field is going to encourage people to try harder and recruit more.”

Each winning contestant received a first-place medal, a voucher for a future vacation, and a trophy that Navistar designed and built at its Product Support Center in Woodridge, Illinois. Additionally, as the victorious technician from International Truck, Reed earned a sponsorship to participate in the TMC’s 2023 National Technician Skills Competition in September 2023 in Cleveland, Ohio.

Women In Trucking Association announces its June 2023 Member of the Month

The Women In Trucking Association (WIT) has announced Stephanie Klang as its June 2023 Member of the Month. As a professional driver for 38 years with 4 million miles, she provides her knowledge and perspective as an industry advocate and driver ambassador.

Klang began her career in the trucking industry in January 1980. At the time, there were very few driving schools and the regulations were more relaxed, so when she took the written test for her Class A CDL, her husband was allowed to teach her on the job.

The pair drove as a team for 15 years, traveling through 48 states. However, she was often treated as her husband's helper or as an extra logbook.

This changed in 1987 when she started her career at CFI, saying she was treated like a fully qualified driver from the first day and was able to flourish.

Klang learned about WIT and its mission when founder Ellen Voie promoted ride-alongs in 2010. The following year, she was chosen to pick up Debbie Hersman, a U.S. National Transportation Safety Board (NTSB) board member in Washington, D.C., and drive her to the Mid-America Trucking Show (MATS) in Louisville, Kentucky. A film crew was hired by her employer at the time to capture the experience, launching Klang's media career. Due to this successful event, she received Conway's Constellation Award in 2012, an honor only awarded to five out of 30,000 employees.

Klang achieved her goal of retiring from driving at 60, but her influence on the trucking industry was far from over. After retirement, she transitioned into CFI's marketing department to continue attending high school career days and truck shows. When the COVID-19 pandemic began in March 2020, she took it as a sign to retire.

However, in the fall of 2022, she felt called to continue her involvement with WIT as an Image Team member and driver ambassador for the association's WITney trailer program, educating and amplifying how a career in transportation can be rewarding for women. She speaks at industry events, truck shows, and career days.

"In my 4 million miles of driving in transportation, I came away with a few things," Klang said. "Do the right thing when no one is watching. Nothing great is achieved easily or without grit. If you do not like where you are in life, Improve yourself and move up. Practice and Improve every day. And be positive and kind. On the days I did not feel my best, I got up and fulfilled my obligations anyway, and they turned out to be some of my best days."

TCA Highway Angel saves man from stroke

The Truckload Carriers Association (TCA) has named truck driver Ty Hinton, from Georgetown, Louisiana, a Highway Angel for coming to the aid of a man having a stroke in a truck stop parking lot. Hinton drives for Melton Truck Lines (No. 89 on the FleetOwner 500 For-Hire) out of Tulsa, Oklahoma.

On Feb. 15, around 11:30 p.m. in Oklahoma City, Hinton witnessed a man collapse on the ground due to a stroke. The event took place in a Flying J Travel Center parking lot. Hinton immediately recognized the life-threatening situation since he learned the signs of a stroke at an early age, so he called for medical assistance for the driver.

"I heard something hit the side of my truck, and I saw the guy stumbling by the side of the trailer kind of hanging on to it—it was pretty obvious right away," he said. "Just looking at the guy—slurring his speech, the left side of his face was not working. I called the EMT and got them to come to the truck stop."

Hinton also called the man's wife, letting her know what was happening, then waited with him and spoke to the wife until EMT arrived to take him to the hospital.

"I just wanted to make sure he was as comfortable as possible," he said. "I know strokes can be bad enough to be fatal, and I wanted to supply him the opportunity to hear his wife's voice—if I was going through that, I know that is the one person I would want to hear: my wife."

C.H. Robinson

Third-party logistics giant C.H. Robinson welcomed all its Carrier of the Year Award winners yesterday, giving them a standing ovation as they entered the company headquarters.

Fri, 02 Jun 2023 01:36:00 -0500 text/html
Clalit Healthcare Services uses data scientists for proactive innovation for members

Clalit Health Services – the largest of Israel’s four nonprofit public health maintenance organizations (HMOs), which was founded as a mutual aid society in 1911 – is striving once and for all to discard its rather outmoded image that existed until it parted from the Histadrut in 1995.

Then, the National Health Insurance Law separated the health funds from their parent organizations, and Clalit’s owner, the Histadrut labor federation, seemed to be the dustiest of them all.

Until the law that provided universal medical care to all citizens, the other HMOs were not required to accept members because of their age, location or medical or financial status, but what was then called Kupat Holim Clalit had to admit all members of the labor federation.

At the beginning of 1995, 5.2 million people were insured by all four health funds, while at the end of 2014, 8.1 million persons were covered as a right. At the beginning of 1995, Clalit’s market share was approximately 63%, followed by Maccabi at 19% and Meuhedet and Leumit at 9% each. Today, with nearly five million members, Clalit’s share has dropped to slightly over half of all Israelis, compared to a quarter in Maccabi Healthcare Services, 14% in Meuhedet and 9% in Leumit.

But while Clalit’s relative membership has dropped in the last three decades, management is doing its utmost to become the country’s first innovation-driven HMO, making it the most proactive and advanced technologically for the benefit of its patients and its doctors and other medical staffers.

A CLALIT CAMPAIGN for preemptive health care. (credit: CLALIT HEALTH SERVICES)

So says Prof. Ran Balicer, Clalit’s deputy director-general and chief innovation officer, who established the Clalit Research Institute in 2010. He earned his medical degree from Tel Aviv University’s Sackler Faculty of Medicine, a master’s of public health degree from Beersheba’s Faculty of Health Sciences at Ben-Gurion University of the Negev and a Ph.D. in health systems management from BGU.

His chief interests include utilizing data science to drive predictive and precise healthcare practice, outcomes research using large clinical datasets, and epidemiology of infectious diseases. In the last three years he served as Israel’s chair of the expert advisory team to the government on the COVID-19 response, during which time he also published some of the world’s most cited timely evidence on vaccine effectiveness and side effects.

"Turning health data into decision-making insights"

In an interview with The Jerusalem Post, Balicer discussed one of Clalit Innovation’s key missions – to “turn health data into decision-making insights that can be translated into tools and policies that transform healthcare delivery and clinical practice.”

A relatively small proportion of Clalit members, who can leave easily on several dates per year by signing forms online or in the post office, have moved to another HMO, he said.

“The vast majority of Clalit members remain for their entire lives, and it is our mission not to just reactively provide them with care when they are already in pain, but rather to proactively keep them healthy. Clalit owns and operates 14 medical centers including almost a third of the country’s acute care beds and over 1,500 primary care community clinics around the country. Its employees include almost 35,000 doctors, nurses, paramedics, technicians, pharmacists and administrators,” he said.

“Our research institute, fully focused on extremely large dataset-based research – was the first of its kind in Israel and is among the few in the world to be recognized as a collaborating center of the World Health Organization. We have a unique advantage over other healthcare systems, because we provide all types of care integrated under one roof, and our data is likewise integrated and decades-deep,” he said.

In the mid-1990s, Clalit set up an integrated electronic health records (EHR) database made up of comprehensive clinical and administrative data with some records dating back to the early 1990s.

“In our research center, we were able to attract unique talent that received global recognition in winning first place in the one and only Data Analysis Challenge to date of the prestigious New England Journal of Medicine [SPRINT Challenge] that took place in 2017. Boston University was second and Stanford University in California was third. Even though we were at the time small and not as well funded compared to Ivy League institutions, our team led by Dr. Noa Dagan was able to create something truly transformational by addressing urgent meaningful needs from the point of view of both the patient and physician.

“We gradually transformed from a research center to an innovation division, from focusing mainly on data science, to translational use of this science for healthcare practice transformation,” Balicer added. “We believed we must create new tools to recommend the best care for our members at any given time, based on our accumulation and analysis of data.”

Because the American medical system, for example, is private and not centralized and citizens are quite leery of the federal government, Israel is way ahead of the US in collecting and using data for translational medicine.

“We were able to establish one of the world’s most advanced systems of physician decision-support with over two decades of anonymous rich data on patients whose identities are kept strictly private and protected,” assured Balicer.

Artificial intelligence is, in fact, a set of tools, some new and some quite established, but each can be used in clinical practice only if you know exactly what you are able to achieve with adequate precision. Some of the new generative tools like ChatGPT in their current form can be crude and backfire, providing the wrong information, and are therefore not yet integrated in our decision-support systems. If you don’t know how to use your toolset well, you risk going astray. We aim to stay ahead of the curve on the existing methodologies and technology to allow the redesigning of daily healthcare practice for the better.”

The innovation division, which started 13 years ago as a semi-academic research institute, now works from within Clalit in practical ways, to innovate and provide better care for their members. In view of the global shortage of healthcare staff and resources, if an HMO is not focused on innovation, Balicer continued, “it won’t be sustainable.”

Asked how many people work at the institute, he answered that “it’s less than a hundred. But the quality of people, not the quantity, is most important. We have some of the brightest clinicians in the country, whom we train both in public health and in state-of-the-art data science. It’s a full-time job for most of them.”

ONE OF its projects was to create a predictive model for chronic kidney disease; another was to decide who should first be invited in for the flu vaccine – not according to alphabetic order or age but who was at greatest risk for winter severe morbidity due to complication of influenza on top of existing chronic diseases. Another was identifying people with a combination of illnesses that put them at top risk for hospital admissions, providing them with dedicated proactive nurse-physician team support. 

“It has reduced admissions to hospitals of people with flu complications by over 40%.”

But its “crown jewel” has been “our systematic – not piecemeal – way of doing it for the last two and a half years using the platform we called C-Pi [Clalit predictive-proactive interventions],” Balicer explained. 

It took teams of three Clalit divisions working to couple the machine-learning predictive models of the Clalit Research Institute with clinical pathways charted by key clinician opinion leaders based on the most up-to-date literature. These were integrated by Clalit’s digital division software development teams into a new designated platform within the physician’s electronic health record. The system provides proactive clinician decision support that addresses population-level health issues that impact Clalit members.

Even though it functions in a small country with fewer than 10 million residents, “Clalit is one of largest integrated payer-provider systems in the world, providing primary, hospital and specialty care under one roof, as well as dental services, imaging – and all this data is likewise integrated. Already over 1,000 primary care doctors in the outpatient setting daily receive our AI-driven recommendations. Instead of waiting for patients to come in, the doctor gets a prioritized list of what is most likely to happen to their patients and brings them in proactively, even though they feel fine.”

There are personalized specialist-level recommendations. 

“For instance, the system crunches data every night on our 350,000 diabetic patients and sends out to their health records nine million recommendations for improving their treatment based on their individual most updated data. One in 10 older adults have early signs of chronic kidney disease, so our system identifies those patients and suggests adjusting the diabetes treatment to best fit their kidney function. If a certain patient has routine blood tests that show he has a combination of factors that suggest that he unknowingly harbors asymptomatic hepatitis C – which can be cured with drugs – machine-learning algorithms we developed in-house pick it up to prevent him from getting liver function problems and even liver cancer.”

This, says Balicer with pride, “is a new approach – a paradigm shift. Israel is probably one of the only countries in the world that is moving swiftly from reactive healthcare to proactive care. In some countries, it was claimed there is no business case for prevention, but for us it is a no-brainer – they are our members for life, and it is clear that the only sustainable option is to keep them healthy for the long term. This is partly why our system is more patient-centered, and more focused on primary care, where physicians have more time to provide preventive care through conversation with patients.” 

Many get online care and don’t have to go to their health fund clinic often – Clalit has had an online pediatrics service for nearly a decade and a half and was the first to offer TYTO, a digital device placed in the ear or mouth or put on the chest to allow telecare looking in the ear and listening to heart and lungs of children and adults.

During the pandemic, the innovation institute was the first institution in Israel, and, apparently, he said, the first in the world – in April 2020 – that proactively used a machine-learning-based predictive model to identify and warn people who were at high risk to be hospitalized with COVID-19 complications. 

“We created a national ‘points model’ shown on TV channels and showed how viewers could calculate their own risk of severe complications, and change their behavior accordingly to minimize risk. Through our Berkowitz Family Living Lab collaboration with the Harvard School of Medicine Department of Medical Informatics, we created tools and inferences in near real-time that had an impact on decision-making globally.”

Clalit still has the neediest population among all four health funds, as in 1995, “but we have undergone a substantial revolution in the past decades that accelerated in the past few years from being a part of the Histadrut to being at the global forefront of technology and translational science, aiming to serve as a beacon and a model. It was a miracle to be freed from the shackles of the Histadrut, and we have never looked back,” Balicer concluded.

Sat, 03 Jun 2023 22:16:00 -0500 en-US text/html
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