Competition Success
How You’ll Be Scored
Everything is based on what you do or say out loud — if it isn’t demonstrated or clearly verbalized, it won’t receive credit. Judges are not allowed to assume your intent, so make sure your actions and reasoning are visible. Your team is scored together on a single rubric, so any team member can complete a skill and it will count.
If your primary responder calls out an action but it never gets performed, it will only be scored as attempted — so follow through on what you say you’re going to do.
Before You Enter the Room
When you arrive, your judge will confirm your team name and readiness, then read you a scenario blurb out loud. Listen carefully — this contains everything you need to know: the scene context, the patient’s condition, available equipment, and what’s expected of you.
After the blurb is read, you have a chance to ask clarifying questions before entering. Use this time wisely. You can ask about scene safety, environmental details, or anything that helps you understand the situation. The judge can only answer what’s permitted within the scenario, so don’t expect hints — but do ask anything genuinely useful.
During the Scenario
Verbalize everything. Assessment steps, treatment decisions, and care actions should all be spoken out loud as you perform them. Judges cannot give you credit for something they can’t observe or hear.
Asking for vitals: When you assess the patient’s vitals, you’ll take them for real on the volunteer patient and report what you get. The judge will then give you back the “correct” value from the scenario. Here’s a key point: ask specifically for what you want. If you only give the judge a pulse rate, they’ll only give you a pulse rate back. If you want pulse rate, character, and strength — make sure you assess and report all three. The judge will match the level of detail you provide.
Asking questions: You can ask the judge questions during the scenario, but they can only answer based on the scenario package, and only to the exact question you asked. Be precise — if you ask about breathing depth, don’t expect to also get breathing rate unless you ask for it separately.
No coaching: Judges will not correct you, hint at missed steps, or react to your performance. If you miss something, it will be reflected in your score. There’s no safety net, so stay focused and work through your assessment systematically.
Time Management
Each scenario is 10 minutes long. You’ll receive a verbal warning when 2 minutes remain, so you’ll know when you’re in the home stretch. When time is called, all care must stop immediately and your team will exit the room. Plan your assessment and treatment flow from the start — 10 minutes can go quickly, so don’t leave critical steps to the end.
Safe Word Awareness
The volunteer patient may call “ORANGE” if they’re nearing their comfort limit — the scenario will pause while the judge and patient step out briefly. This isn’t about your performance; stay calm and be ready to continue.
If the patient calls “RED,” the scenario ends immediately. Scoring stops at that point, and any skills not yet demonstrated will receive a zero. Be mindful and gentle with your patient throughout.
Prohibited Skills — Explain, Don’t Perform
Out of respect and safety for our volunteer patients, certain skills may not be performed on them under any circumstances. If one of these skills is indicated by your scenario, you are expected to clearly and thoroughly explain how you would perform it — walking through the steps out loud as if you were doing it. A confident, detailed verbal explanation will be scored in place of physical demonstration.
The following are strictly prohibited on volunteer patients:
- Painful stimuli
- Aggressive airway maneuvers
- Jaw thrusts
- Face-mask seals
- Compressions (a manikin will be provided if this skill is needed)
- Abdominal thrusts or back blows
- Airway insertion
- Glucometer checks
- Traction splint leg extension
- Direct mouth-to-mouth contact
- Sharps
- Real medications
When explaining a prohibited skill, be thorough — include why you’re performing it, how you would do it step by step, and what you’d be monitoring for. Vague or incomplete explanations will not receive full credit, just as an incomplete physical demonstration wouldn’t.
Key Takeaways
- Say everything out loud — verbalize your assessments and actions
- Follow through on anything you announce you’re going to do
- Be specific when asking for vitals or patient information
- Use your pre-entry questions strategically
- You have 10 minutes — pace yourself and don’t leave critical steps to the last minute
- For prohibited skills, explain thoroughly rather than attempting to perform them
- Be professional, composed, and gentle with your volunteer patient throughout
Rubric Overview
NCCER uses a structured rubric to evaluate your performance, but it’s important to understand what that means in practice. The rubric is not a simple checklist — performing skills correctly matters just as much as performing them at all. Rushing through assessments or cutting corners to cover more ground will not serve you well. Judges are looking for competence, not just completion.
The rubric is designed with a high level of detail, which means partial marks can and will be awarded where appropriate. You don’t need to perform a skill perfectly to receive some credit for it — so even if you’re unsure or running short on time, always attempt and verbalize as much as you can. Something is almost always better than nothing.
While we cannot disclose the full rubric, the following are the sections your team will be evaluated on:
Scene Survey (HEMP) — Your approach to the scene before making patient contact, including hazard identification and environmental awareness.
Introduction & Consent — How you present yourself to the patient and obtain consent to provide care.
Primary Assessment — Your immediate, systematic evaluation of the patient, covering ABCs, a rapid body survey, spinal considerations, skin assessment, any critical interventions required, and your transport decision.
Secondary Assessment — A more thorough patient evaluation including a SAMPLE history, a pain assessment using OPPQRRST, and vitals. Vitals must be detailed and accurate — judges will be looking for rate, rhythm, quality, and other relevant aspects. The timing between vital sets and the number of sets taken both matter. If drug administration is indicated, you’ll be evaluated on the 6 rights. A head-to-toe physical assessment is also part of this section.
Ongoing Care — Continued reassessment of ABCs, vitals, and any treatments already initiated. Don’t treat your patient and move on — demonstrate that you’re monitoring and responding to changes.
EMS Handover — Your handover to EMS using the ATMIST AMBO format. This should be organized, concise, and cover all relevant information.
Professional Qualities — How you treat your patient, your judge, and your fellow responders throughout the scenario. This also includes how well you manage your available resources. Professionalism is evaluated from the moment you enter the room to the moment you leave.
Take time to know each of these sections well before competition day. A strong performance means moving through them with genuine skill and clinical reasoning — not just reciting steps.