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Steven T. Edwards, director of MFRI, where the testing took place, agreed that the mannequin used in the testing was “relatively new technology.” Dr. Augustine also said the paramedics found it difficult because the assessment required them to verbalize their actions during each of 10 critical interventions. But Mr. Edwards said that was not the case, pointing out that the mannequin records the paramedic’s interventions so they can react as they would at the scene of an emergency.

“The paramedic doesn’t stand up and say, ‘I’m going to administer epinephrine now’ or something like that,” he said.

Lowered expectations

The Times first reported details of the testing plan in February 2008 — days after the family of journalist David E. Rosenbaum dropped a lawsuit it had filed against the city, saying they were satisfied with the District’s progress in reforming its emergency medical services. Mr. Rosenbaum was beaten and robbed in his neighborhood in January 2006 and died two days later. An investigation found that a neglectful, botched emergency response contributed to Mr. Rosenbaum’s death.

After that incident, Mr. Fenty pledged in August 2006 as a candidate for the Democratic nomination for mayor to remove emergency medical services from the administration of the fire department.

“In this city, having a fire department and having EMS under it just has left EMS out of the priority line,” Mr. Fenty told The Times in 2006. Mr. Fenty said at the time that as a council member representing Ward 4, he co-sponsored legislation in 2005 to separate the agencies. He pointed out the Department of Motor Vehicles and the Child and Family Services Agency succeeded only after they were spun off from other city agencies.

But as mayor, he backtracked on the pledge. The city set up a task force as part of the settlement with the Rosenbaum family to examine ways to improve the city’s Fire and Emergency Medical Services Department. EMS was left under the fire department, but the task force recommended improvements to training and oversight.

An assessment of all the agency’s paramedics, however, was not among the recommendations.

Dr. Michael D. Williams, the department’s previous medical director who resigned in August, told The Times in February 2008 that he had expected the tests to reveal that some paramedics would need to be retrained, others would need to be reassigned to work as emergency medical technicians who have fewer responsibilities than paramedics, and that some would need to be fired.

“I expect there will be people that fail this process and that I will be saying, ‘You’re really not out there functioning as a paramedic, so we’re going to pull you out’ — which is going to make the operations chief nuts, but my obligation sort of trumps his on this one,” Dr. Williams told The Times. “I’ve really got to make sure that we don’t let someone out there that really isn’t functioning at that level.”

Mr. Edwards said the District “actually ought to be commended” for undergoing the testing — which he insisted should be termed an “assessment,” since no grades were given and no licenses or certifications were at stake. He said such assessments are useful to identify systemic problems and target training dollars.

“When you work to develop a training program, the first step is to perform an assessment,” he said.

Mr. Edwards said MFRI handed over the results of the tests to D.C. fire officials without evaluation or interpretation.

Dr. Augustine said there was no passing grade in the written tests and that the results were misleading, in part because D.C. paramedics were tested on practices and procedures that are in use in much of the country but in some cases are not part of the District’s protocols and in part because paramedics were not instructed to study.

But Dr. Williams, who declined to speak for this article, said last year that he had personally vetted the test questions and that while they were “challenging,” they covered things a paramedic should know. He said the test was part of an effort — required by the Rosenbaum task force — to bring the District’s standards in line with nationally recognized practices and procedures.

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