FTO Toolkit | NJRP EMS

Before the Evaluation

FTO Setup Checklist — complete before every psychomotor eval.

Confirm the trainee has passed their written exam — check via /my-certs or the admin panel before starting
Choose a scenario appropriate for the cert level — use the Scenario Library for options
Brief the trainee — explain the format, that it's a roleplay assessment, and that they should verbalize their thinking out loud
Set up the scene — patient in position, bystanders if helpful, establish scene conditions (time of day, mechanism, etc.)
Remind trainee to use MARCH/ABCDE for trauma, primary/secondary survey for medical
Have /log-psychomotor ready — note the date and have their Roblox username on hand
You are an observer, not a helper — only intervene if patient safety is at serious risk

EMT Psychomotor Rubric BLS

Pass criteria: Trainee must complete all Critical Criteria and at least 75% of standard skills. A single Critical Failure = automatic fail regardless of other performance.

🔍Scene Size-Up & Initial Assessment▼

Verbalizes BSI/PPE before approachingDoes itSkips it

Calls out scene safety assessment (safe/unsafe)VerbalizesGoes straight to patient

Identifies MOI/NOI and number of patientsStates bothMisses either

CRITICAL: Establishes responsiveness (AVPU)First thing on patientSkips or delayed

Calls for additional resources if neededIdentifies needN/A if not needed

Auto-fail: Approaches visibly unsafe scene without verbalizing hazard acknowledgment.

🫀Primary Survey (ABCDE)▼

CRITICAL: Opens/manages airway appropriatelyCorrect techniqueWrong technique or skipped

Assesses breathing (rate, depth, quality)All 3 assessedOnly 1–2 assessed

Assesses circulation (pulse, bleeding, skin)All 3 assessedPartial

Identifies and treats life-threatening bleedingTourniquet/direct pressure appliedMissed or no treatment

Determines priority (load-and-go vs. stay-and-play)Correct decision verbalizedWrong or not stated

CRITICAL: Does not miss an airway obstructionRecognized and managedMissed = auto-fail

🩹Treatment & Interventions▼

Selects correct adjunct (OPA vs NPA appropriately)Correct choice + sizing verbalizedWrong choice for patient

BVM technique: EC clamp, rate, volumeAll 3 correctMissing elements

Tourniquet: placement 2–3in proximal, time notedBoth correctWrong placement or no time

Medication admin: correct drug, dose, route, indicationAll 4 verbalizedMissing any one

Reassesses patient after interventionExplicit reassessmentNo reassessment

CRITICAL: Does not administer medication outside BLS scopeStays in scopeOut-of-scope = auto-fail

📋Patient Handoff & Communication▼

Gives verbal report: age, sex, chief complaintAll 3 includedMissing elements

Reports interventions with timesAll interventions reportedOmissions

Reports patient response to treatmentImprovement/deterioration statedOmitted

Maintains professional demeanor throughoutCalm, organizedPanicked, chaotic

Paramedic Psychomotor Rubric ALS

Note: Paramedic eval assesses ALS-specific skills on top of all BLS competencies. Trainee must demonstrate BLS proficiency first. Focus on clinical decision-making, not just skill execution.

💓ACLS — Cardiac Arrest Management▼

CRITICAL: Does not stop CPR for any reason other than rhythm analysis/shockContinuous compressionsUnnecessary pauses = auto-fail

Identifies shockable vs non-shockable rhythmCorrect ID verbalizedWrong ID

Epi dosing: 1mg IV/IO q3–5 minCorrect dose and intervalWrong dose/timing

Amiodarone after 3rd shock: 300mgCorrect timing and doseGiven too early/late or wrong dose

Post-ROSC: SpO₂ 94–98%, 12-lead, transportAll 3 addressedMissing post-ROSC care

🫁Advanced Airway & RSI▼

Preoxygenates before RSI100% O₂ verbalized for 3 minSkipped

Sedation agent choice appropriate to patientKetamine (hemodynamically unstable) or etomidateWrong agent for scenario

Succinylcholine contraindication check verbalizedStates contraindications checkedGoes straight to paralytic

CRITICAL: Confirms tube placement by EtCO₂Capnography confirmation verbalizedOnly auscultation = auto-fail

Post-intubation: SpO₂, EtCO₂ 35–45, secures tubeAll 3Missing elements

💊Medication Administration & IV Access▼

Verbalizes right drug, dose, route, indicationAll 4 stated before givingMissing any one

Checks contraindications before high-risk medicationsExplicitly verbalized (nitro, adenosine, succs)Skipped

IV/IO access: correct site selection, verbalizes confirmationCorrect site + confirms flowWrong site or no confirmation

Reassesses after every medicationVS or targeted reassessment each timeGives and moves on

CRITICAL: No medication given without verbalized indicationAlways states whyProtocol-dispensing = auto-fail

Ride-Along Evaluation Guide

Purpose: The ride-along assesses real-world application — how the trainee performs on actual calls, not a staged scenario. You're evaluating judgment, communication, and consistency.

📋Before the Shift▼

Confirm trainee's exam + psychomotor are both logged
Brief trainee: they will be running calls, you are observing
Clarify that you will take over only if patient safety is at risk
Ask if they have any questions about protocols they're unsure of
Review medications they're authorized to give

🚑During Calls▼

Let trainee run the call — resist the urge to prompt
Note specific strengths and gaps (for debrief)
Watch for: scene safety verbalization, systematic assessment, correct protocol selection
Watch for: appropriate escalation decisions ("do I need ALS/more units?")
Note if trainee communicates patient status to you during call

💬Post-Call Debrief▼

Debrief after at least one call. Lead with positives, then areas to improve:

Ask trainee to self-evaluate first — "How do you think that went?"
Confirm what they did well specifically
Identify 1–2 specific improvements (not a list of everything)
Ask if they have questions about the call
If they're ready to pass, log via /log-ridealong after the session

Pass criteria: Trainee demonstrated consistent protocol application across at least 2 calls with no critical errors. Safe, systematic, and professional.

⚠️When to Fail a Ride-Along▼

A ride-along fail should be the exception, not the rule. Grounds for failing:

Repeated scene safety violations — approaching unsafe scene, not verbalizing hazards
Consistent missed critical assessment steps — not identifying life threats in primary survey
Out-of-scope interventions — attempting medications or procedures beyond their cert
Inability to recover from FTO prompts — correction given, same error made again on next call
Unsafe patient handling — actions that would worsen patient outcome

If failing: Be specific about what needs improvement. Set clear expectations for a remediation session before the next ride-along attempt. Document via /add-note if available.

FTO Quick Reference

Pass Threshold

EMT/Para: 80% (24/30)
NJSP: 80% (8/10)

Cert Requirements

1× Exam
1× Psychomotor
1× Ride-Along

Log Commands

/log-psychomotor
/log-ridealong
/issue-cert

Check Status

/trainee-report @user
/list-pending
Admin Panel

Auto-Fail Triggers

Missed airway
Out-of-scope meds
No scene safety
No EtCO₂ on intubation

After Passing

Log in bot → all 3 done → run /issue-cert or use Admin Panel