What is Bloom’s Taxonomy and why does it matter to you? While you may have heard about it in class, we can almost guarantee your instructor pays close attention to each level of it when creating your tests. Bloom’s Taxonomy is a framework for categorizing educational goals and determining if they are being met. It is made up of 6 levels that include: Knowledge, Comprehension, Application, Analysis, Synthesis, and Evaluation. Think of it as a pyramid. Each level is necessary to build on the other. This is used to create test questions and study guides to evaluate if the material is being remembered and understood, or generally comprehended, and if the student is able to apply the knowledge. This framework has been used by teachers in K-12th grade classrooms and in college classrooms.

Here’s a breakdown of what each of these categories looks at:

• Knowledge – the individual is being able to recall specific details, methods, and processes. I.e. what three things make up Cushing’s Triad?
• Comprehension – the individual is able to understand what is being communicated and can use the materials and ideas even if they cannot relate it to other materials. I.e. the patient has an elevated blood pressure, low heart rate, and irregular respirations therefore they have Cushing’s Triad, but not yet able to state what does that mean for the patient, or what may be going on that is causing that.
• Application - the individual is able to use abstracts in situations. I.e. The patient has a head injury, I should evaluate for Cushing’s Triad, they may develop Cushing’s Triad.
• Analysis – the individual can breakdown concepts into separate elements or parts and the relation between ideas is clear. I.e. The patient is developing Cushing’s Triad because there is bleeding or swelling in the brain that is causing poor perfusion, so the blood pressure is rising to try to perfuse the brain, the heart rate is dropping because the blood pressure is rising, and the breathing is irregular because they are starting to herniate their brain stem which controls respirations.
• Synthesis – the individual is able to put together elements and parts to create a whole. I.e. The reason I should not give Atropine to the patient with Cushing’s Triad is because the heart rate is compensating for increased blood pressure, so if I increase the heart rate the pressure will also increase and it will kill the patient. Cushing’s Triad is the brains attempt to stay alive and continue to perfuse itself, so I need to manage the patient in a way that does not worsen them, and I need to get them to the hospital quickly so that they can have definitive care.
• Evaluation – the individual can make judgments about the methods and materials. I.e. My patient has an amputation that is bleeding profusely, but they are also showing signs of Cushing’s Triad. So I will stop the bleeding, but I also need to manage their airway and breathing. The bleeding would cause hypotension and tachycardia but the head injury would cause hypertension and bradycardia. So how do I manage the patient, what is most likely to happen, what do I treat first and why? If I do this treatment how will that affect the outcome of other processes going on in the body?

Now that we have a better idea of the levels in Bloom’s Taxonomy we can see how they are being evaluated in test questions and study guides. Once you master the lower levels with knowledge of an area you can slowly progress into the how’s, why’s, and what do you do’s.

Based on how a question is answered can also tell the evaluator at what step the test taker is on in their understanding and knowledge of the subject. If you don’t understand why something happens or what it is, you can’t really apply it to a situation. You can know what the three elements of Cushing’s Triad is, but if you don’t understand why it happens then you can’t predict that it will happen to your patient, or prepare to treat your patient aggressively. Part of competently treating a patient is understanding disease process. So using Bloom’s Taxonomy allows the instructor to see where an individual is in their learning and understanding, and allows them to design further lessons to fill in the gaps, or tailor to the classes needs. For more great information about what Bloom’s Taxonomy is, and the role it plays in the NREMT and EMTprep.com’s questions, click HERE