# What antics from teachers do you hate the most?



## Veneficus (Feb 24, 2010)

So today I was sitting in class. While playing tic-tac-toe against my neighbor and practicing forging the signatures of various names on the attendance list while the professor was droning on in the background without looking up from his PC in a monotone that could endanger Ben Stein's job security, I was reminiscing about my own start in teaching.

I started out because somebody threw down the gauntlet. I was working on a 911 unit and for some reason (I think it was jealousy) the supervisor decided to always stick me with the new people, which by default meant I had to “show them the ropes.”

I wouldn’t have called it teaching. I was not a teacher and the only thing I knew about it was there were good ones and bad ones. I was simply showing people what was done. Some picked it up, some didn’t. In a month or two these people would be replaced by another new one, and if they learned anything or not wasn’t of interest to me. (call it the world’s worst FTO program) So finally when speaking to one of my favorite instructors I complained the people coming to the field knew less and less and it wasn’t my job to teach them. He tried to explain the quality of students was diminishing and I wasn’t going to accept that excuse. “Then they shouldn’t pass,” was my response. I had no idea about enrollment, pass statistics, or any of those “academic” things. So in his frustration he said if I thought I could do better I could start helping teach skills labs. Now 7 years later, between my own semesters of school, I spend between 40-48 hours a week as a primary lecturer teaching various levels of both EMS and other healthcare providers. I have even picked up some formal teaching training. 

My method is rather simple. I remember the worst teachers I had, and simply do the opposite.  Things I find intuitive, relating to the students, speaking with them not at them, encouraging them not berating them, and most of all, not reading a PowerPoint that is essentially a textbook paragraph word for word. But now I’d like to take it a step further and actually ask people what they think makes a bad teacher. 

So what is it that your teachers have done that you hate the most? 

What makes a good teacher?

If you could make a wish that would make your class time better, aside from not going, what would it be?


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## 46Young (Feb 24, 2010)

I don't appreciate it when a teacher takes up valuable class time with war stories. Also, stick with the course content and don't go off on tangents about "learn it for the test, but then disregard it, this is how we do it in the field".


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## mycrofft (Feb 24, 2010)

*Little Napoleons*

Try to shore up their fragile egos by threatening and frightening people, trying to make it a "boot camp", maybe looking to fail folks rather than teach them.


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## jerm (Feb 24, 2010)

46Young said:


> I don't appreciate it when a teacher takes up valuable class time with war stories. Also, stick with the course content and don't go off on tangents about *"learn it for the test, but then disregard it, this is how we do it in the field"*.



This is one of the ones that bothers me the most. I can tolerate the war stories, but to tell me to ignore my book just irritates me.


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## mycrofft (Feb 25, 2010)

*It irritates me that the books are dogmatic.*

Nothing like watching newbies whacking each other over the head (figuratively) with their respective texts when in the real world the differences are (sometimes) moot. When something really precise comes through, you feel maybe they are just being proprietary again.

You can pick up the mushiness of reality in OJT, I guess it can be confusing when you get exposed to the contradictions early.


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## Noctis Lucis Caelum (Feb 25, 2010)

mycrofft said:


> Try to shore up their fragile egos by threatening and frightening people, trying to make it a "boot camp", maybe looking to fail folks rather than teach them.



Right on the hot spot...i really hate this one right here Crofty, this is why most of my classmates fail

Also teachers that yell and scold at student in class instead of teaching them from their mistake.
Its a class room, we student are suppose to fail in class so we won't fail out in the field.
But instead of teaching us, they scold us telling us we should know this, know that, do this, etc

Students are in class to learn and not to be yelled at what they should already know or don't know


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## Euclidus (Feb 25, 2010)

Yeah, the berating students for making a mistake is pretty asinine in a classroom setting. One of my lab instructors for my EMT-B seemed to derive enormous amounts of joy by doing this, because it was a constant. That kind of attitude sort of just sours the learning environment...

The worst to me, though, is the Powerpoint thing. I can't stand it when instructors just read the slides word for word, which are generally word for word summaries of whatever textbook the powerpoint presentation came from. It's such a waste of time! Powerpoint should be one tool in the arsenal... not the bread & butter of the instruction!


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## Medic744 (Feb 25, 2010)

The two teachers I hated the most were my basic instructor and my paramedic instructor.  

My basic because he was more intrested in coming up with off the wall stuff to show us and berrating us than teaching us.  He had an anxiety attack when I finished his final in 30 min  and made a 98. 

My paramedic because he had spent more time behind a desk than on the street and would become irrate when you pointed out his flawed teaching.  I also had him for an intermediate class and he relied heavily on power point and student information discs.  The information never went together with what we on and he always said if we could prove he didnt teach it or give it to us on a disc he would credit the points back on a test.  I never got less than an A due to that.  

The best teacher I had was my intermediate instructor.  She knew her material and knew how to teach us.  She used real life experiences not to share war stories but would make them into interactive scenarios for us to learn from.  I remember on the day of one of our finals the entire class failed.  I came closest to passing with a 78.  She cried and took it as a personal failing on her part.  She felt that she hadnt given us the info we needed.  On the retest, after many hours reviewing with her, we all passed.  It wasnt her fault, it was the moron who made the test.


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## FLEMTP (Feb 25, 2010)

From my experience.. typically the best medics out there in the field rarely go into teaching.. they're too busy loving their job. Thats of course not the case with everyone.. but it seems to be more of the general trend than the exception to the rule... 

It also seems like a majority of the time that people go into teaching either because they cant cut it in the field, or get so burned out that they want to do something different.. again, not the rule, just an observation on my part from years of EMS in many different locations.

I've thought about going into teaching, but im hesitant. I've done part time instruction in the past, and its enjoyable, but I still very much love running calls, and I'd like to think my skills and knowledge are above average..(not my ego.. i dont have much of an ego, this is from what partners and supervisors tell me, i think they'll just making me feel good, but hey, who knows ) but I feel that EMS programs in general these days are very much lacking in true instruction.  They bring people into a paramedic program, and they teach them to memorize the algorithms...and teach them how to start an IV, how to read a computer generated EKG, and how to intubate, and how to rattle off what conditions you use different medications for... but I notice they rarely teach them critical thinking skills, and good solid assessement skills, and how to form a true differential diagnosis.  The result is a brand new paramedic who gets on a truck, and seem to be little more than technicians who perform skills when people meet the criteria, rather than TREATING the patient. 

Here is an example... you respond for a patient with trouble breathing, you get there, and the patient is wheezing, has a blood pressure of 180/110, SpO2 of 85% room air, and has a known history of COPD. These robot medics as i like to call them, would put them on high flow oxygen, and give them albuterol, and then watch as they go into a flash pulmonary edema, and then treat that with lasix, and then drive fast to the ER while wondering what the hell happened.... where as a medic with critical thinking skills might look at other things, such as the presense of pedal edema, and do a decent assessment of the patient, including history of the illness, asking things such as how do you sleep at night... do you need to sleep sitting up... etc... and be able to realize they are dealing with a new onset CHF and treat them with nitrates and CPAP.

With that said... i realize that some of that comes with field experience and experience on the job, but at the same time, thats an unacceptable excuse. I believe more time should be spent on doing a very thorough assessment, and getting a good history of the illness, social history etc, and doing critical thinking.  I also truly believe that medic students should be spending as much time with a Doctor, or a PA as they do with the nurses, if not more, learning the same critical thinking skills and assessment skills they use.

I feel that these steps would also lead to a higher level of professionalism in our profession, as well as more respect as practitioners from our colleges in the hospital.

I guess my biggest problem going into education, is that I wouldn't be allowed to teach these students to the level that they should be, because most paramedic schools these days are nothing more than medic mills, turning out people capable of passing the NREMTP exam in the shortest time they can, so they can collect money from another class of 30 or 40 and keep making money.

Continuing education is also an issue with me. Many times its an exact repeat of the same things you learned previously, for example, every time you renew your ACLS, you cover the changes to ACLS, and then go over pretty much just the same things you did with the last renewal. Obviously skills and knowledge remediation is important, but I think continuing education should also be used to expand our knowledge beyond those basic concepts, and that is something I have rarely seen in our field.

I just feel many times that our profession could be doing so much more, and be contributing so much more than we do, and many times we are hindered by the old concept of "this is how its always been" and the fact that people dont like change. I feel that change is essential in our field, and while many things we have done and currently do have changed, ( for example, we dont give 2 amps of bicarb first line to every cardiac arrest anymore, and we now have CPAP and Drug assisted intubations) I feel that there needs to be a greater change in what we do and how we do and how we educate if we want to see our profession grow and change in a positive way in the next century.

Some of you might disagree with me, and I would like to hear your arguments against what I have stated in my post.


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## Veneficus (Feb 25, 2010)

*let me make sure I uderstand what you are saying*



Medic744 said:


> The two teachers I hated the most were my basic instructor and my paramedic instructor.
> 
> My basic because he was more intrested in coming up with off the wall stuff to show us



You ought to meet on of my IM profs. I swear he makes diseases up or read the 2 volume of Harrison's enough to commit it to memory. Probably the latter. Sorry, just commiserating.



Medic744 said:


> My paramedic because he had spent more time behind a desk than on the street and would become irrate when you pointed out his flawed teaching.  I also had him for an intermediate class and he relied heavily on power point and student information discs.  The information never went together with what we on and he always said if we could prove he didnt teach it or give it to us on a disc he would credit the points back on a test.  I never got less than an A due to that.
> 
> The best teacher I had was my intermediate instructor.  She knew her material and knew how to teach us.  She used real life experiences not to share war stories but would make them into interactive scenarios for us to learn from.  I remember on the day of one of our finals the entire class failed.  I came closest to passing with a 78.  She cried and took it as a personal failing on her part.  She felt that she hadnt given us the info we needed.  On the retest, after many hours reviewing with her, we all passed.  It wasnt her fault, it was the moron who made the test.



So if I understand, the paramedic teacher was also the intermediate teacher and probably the one making up the tests was a lead instructor, the program director, or some other such title?

Did he have intensive street time, such as in a high volume system or an academic credential that demonstrated his mastery of the material?

The female teacher You felt had more substance and liked the style better?


Which would you say helped you pass your registry or state test more?

Did the repetition of the material in the form of premade PPT. have any positive contribution?


Did the interactive scenarios help you learn the core curriculum material? (some medical schools are moving more towards this method, called "problem based learning," but it is highly structured and requires very small groups of usually no more than 8, as well as very independant learning students. I am not convinced most paramedic students I have met would be able to do this effectively.)


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## Medic744 (Feb 25, 2010)

Veneficus said:


> You ought to meet on of my IM profs. I swear he makes diseases up or read the 2 volume of Harrison's enough to commit it to memory. Probably the latter. Sorry, just commiserating.
> 
> 
> 
> ...



Actually the paramedic teacher also taught Intro to Advance Practice for the EMTIs and unfortunately is also the program director.  He and the MD for the program made up the tests. I have no idea how he got the job.  Im not sure when he was actually on a unit last but while he was he was in a high call area, but old school. Im fairly certain he just accumulated enough letters behind his name to get the spot.  

The female teacher was more helpful in passing NREMT.  It took almost 2 yrs following the completion of EMT P class and rotations for me to study and practice on my own enough to have the confidence to test NREMT.  With the other instructor I tested within 2 months and passed everything the first time. 

The only thing useful on the student disc was a copy of one of final exams...with the answers.  I stumbled across it while studying and studied it as a reference for what he was looking for answer wise.  There was no rhyme or reason to any of his testing so I needed the help.  Still had to take the test twice so guess it didnt really help that much.

The interactive scenarios were extremely helpful in not only learning but remembering the material.  Its easier for me to do and learn than just read and learn.  Im a very hands on learner.  Plus they allow you to have the ability to doubt yourself without endangering anyone.  For example she would give the scenario and even if you provided care perfectly and without missing anything or going out of order it was still possible for your pt to "die."  She did this to me with a motorcycle accident victim.  I called for and performed everything perfect and yet my pt died.  It actually happened to her.

Some people have no place teaching but some who teach because they love EMS and are no longer physically able to be on the street can be a wonderful thing.


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## Veneficus (Feb 25, 2010)

FLEMTP said:


> From my experience.. typically the best medics out there in the field rarely go into teaching.. they're too busy loving their job. Thats of course not the case with everyone.. but it seems to be more of the general trend than the exception to the rule....



My experience has been just the opposite, the best medics and doctors are involved in education. But education is not the only thing they do. I would rather be seeing patients than teaching, but I also would like new people to not be worthless as well.(makes life a lot easier) But I have seen what goes on in many medic mills, so I conclude that my observations are probably in the minority and agree it is the trend.



FLEMTP said:


> It also seems like a majority of the time that people go into teaching either because they cant cut it in the field, or get so burned out that they want to do something different.. again, not the rule, just an observation on my part from years of EMS in many different locations.



I find this in stark contrast to other medical professions. But like I said, my experience has been different. I have noticed though that many EMS educators are moved from the field setting, not because they weren't good at it, but injuries and age prohibit them from functioning in the field capacity but they still have many contributions. A rare few simply love to teach.



FLEMTP said:


> I've thought about going into teaching, but im hesitant. I've done part time instruction in the past, and its enjoyable, but I still very much love running calls, and I'd like to think my skills and knowledge are above average..(not my ego.. i dont have much of an ego, this is from what partners and supervisors tell me, i think they'll just making me feel good, but hey, who knows ).



I'd like to think I am not too bad at taking care of patients  



FLEMTP said:


> but I feel that EMS programs in general these days are very much lacking in true instruction.  They bring people into a paramedic program, and they teach them to memorize the algorithms...and teach them how to start an IV, how to read a computer generated EKG, and how to intubate, and how to rattle off what conditions you use different medications for... but I notice they rarely teach them critical thinking skills, and good solid assessement skills, and how to form a true differential diagnosis.  The result is a brand new paramedic who gets on a truck, and seem to be little more than technicians who perform skills when people meet the criteria, rather than TREATING the patient.



I certainly agree, I also have some thoughts on what causes this. First is having experienced but usually not educated people teaching. "You don't need any of that book learnin" mentality. 

Another contributing factor is the changing curriculum. There is much more basic science involved now than in the past. Many instructors have no background in this material. How do you teach something you don't nderstand yourself?

Adding material but not increasing time is another issue. There is so much new to cover, in the same time constraints as was allocated 10 or 20 years ago. In order to make sure all material is covered paramedic education has become a series of random, disconnected, facts to be memorized. It is impossible to coach people to critical decision making by wrote memorizaton. There are solutions. (I tell students to read before coming to a lecture. My lecture is connecting those dots. If you come expecting to hear what you should have read in the book, you will not be happy.) BUt this then puts the onus of learning on the student. As my afore mentioned favorite instructor pointed out. Quality has decreased. Younger generations are taught to the proficency test. Then they come to college expecting to be taught to the exam. Embracing this mentality is a lucrative business. Most new people will choose a 6 month course taught to the test with a 90% pass rate then a longer often more expensive course that ultimately turns out more capable providers. This has a simple solution also, agencies could stop hiring from the Mills. 



FLEMTP said:


> Here is an example...



Cut for brevity. Again I fully agree. But you see the bullet points. Wheeze, low spo2, the pattern is formed, and the treatment for that pattern is initiated. It is oversimplified education. There is no excuse for it, but it is the fact.



FLEMTP said:


> With that said... i realize that some of that comes with field experience and experience on the job, but at the same time, thats an unacceptable excuse.... I believe more time should be spent on doing a very thorough assessment, and getting a good history of the illness, social history etc, and doing critical thinking.



Exactly! Nobody should even get to the field untill they can demonstrate a proper assessment. The NR skill check sheets are not a proper assessment. But again, unless you increase instruction time, (which inversly affects enrollment that keeps your doors open and food in your mouth) Nothing will change.



FLEMTP said:


> I also truly believe that medic students should be spending as much time with a Doctor, or a PA as they do with the nurses, if not more, learning the same critical thinking skills and assessment skills they use..



Again I agree, and I was fortunate in my own experience to do so, but before you can waste the doctor's time with students who frankly don't know crap, you need to prepare your students to interact at an acceptable level with a physician. They should be refining a students practice, I doubt you will find one in a clinical environment who can be expected to start from the ground up. 



FLEMTP said:


> I feel that these steps would also lead to a higher level of professionalism in our profession, as well as more respect as practitioners from our colleges in the hospital.



For certain.



FLEMTP said:


> I guess my biggest problem going into education, is that I wouldn't be allowed to teach these students to the level that they should be, because most paramedic schools these days are nothing more than medic mills, turning out people capable of passing the NREMTP exam in the shortest time they can, so they can collect money from another class of 30 or 40 and keep making money.



Depends on where you work. I can talk about anything I choose within the alloted time as long as the core material is presented, and I get to choose the form it is presented in as well. But if you cover something very basically and go home early or break for skills, that is the failure of the instructor, not the program. There is more than enough material to fill the time unless your organization operates with razor thin margins. Then it is the fault of the program. 



FLEMTP said:


> Continuing education



Again cut for brevity. This is beyond the scope of this thread, and I could not properly reply in 500 words.




FLEMTP said:


> Some of you might disagree with me, and I would like to hear your arguments against what I have stated in my post.



There are always outliers, but I think you are accurate for a majority of what is out there. We have identified the problems, and put forth solutions which are resisted. But on the lower level, and thread topic, what can the individual instructor do to make things better?


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## mycrofft (Feb 26, 2010)

*How about this radical idea for EMT-B*

1. Hire excellent adult instructors who are ignorant about EMS, give them the best teaching and reference materials, and give them the mission of passing as many people as they can, the final being the NREMT. (Class size: TEN). Students: prepreq classes in basic level anatomy, physiology, public health, nuts and bolts psychology (no Feudian references) and first aid/CPR.
2. Use experienced people for mentoring in the field, or guest lecturers.
3. Do NOT hire people becuase they are experienced EMS'ers. If anything, that is a point off. Hire people who are professional educators to teach.

Who am I starting to sound like now...hmmm....

Down with bullies, down with war story specialists like me. You can get the frosting on the job, you need the basics in class and the instructors need to be accountable.

Pay for your class with a credit card. If the instruction is whack, decide quickly then cancel payment and withdraw under protest demanding refund.


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## Ridryder911 (Feb 26, 2010)

One of the most misunderstood ideas is that a great medic will automatically make a great instructor. The same thinking that has doomed EMS that great Paramedics make great supervisors and EMS Administrators, when in fact most very successful EMS Administrators have no or very little EMS experience and clinical knowledge.. it's a business. 

Now, let's distinguish the difference between an instructor and a educator. Yes, there is quite a bit of difference. Yes, one should have clinical experience and hopefully that the experience is diverse and have extensive clinical contacts. Just because one works at a large busy service automatically give good clinical experience as the same working at a rural low volume can be really accounted because they "placed time" in the field. 

Unfortunately, EMS is one of the only health care professions that does not require professionals to teach the course. 

Ironically, to teach little Johnnie to color between the lines require the minimum of a bachelors degree but to teach how to perform crich, chest decompression, ECG's ... only usually requires a 39 hour course. What should we expect? 

How much education does those that teach really have in adult education? Again, in comparison to almost all other health care professionals that require their educators to have at the least a graduate/masters degree to a doctorate level, ours require a two week course....Wow! Then we gripe? 

Let's get rid of instructors for the base line education and place educators in place. Place instructors for the field level as in FTO's and preceptors .. more training level and clinical evaluation.   

As well, let's prepare student EMT's not accepting everyone. Require reading levels, prior science classes and general education as so they will be prepared to take the course and succeed. Then compare what students think the instructors should know or how to teach.


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## rescue99 (Feb 26, 2010)

Ridryder911 said:


> One of the most misunderstood ideas is that a great medic will automatically make a great instructor. The same thinking that has doomed EMS that great Paramedics make great supervisors and EMS Administrators, when in fact most very successful EMS Administrators have no or very little EMS experience and clinical knowledge.. it's a business.
> 
> Now, let's distinguish the difference between an instructor and a educator. Yes, there is quite a bit of difference. Yes, one should have clinical experience and hopefully that the experience is diverse and have extensive clinical contacts. Just because one works at a large busy service automatically give good clinical experience as the same working at a rural low volume can be really accounted because they "placed time" in the field.
> 
> ...



Where'd you find an I/C course that is two weeks long? The line must be pretty long to get in there, eh?


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## Ridryder911 (Feb 26, 2010)

Actually, the National EMS Instructor Course.. 

R/r 911


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## rescue99 (Feb 26, 2010)

Ridryder911 said:


> Actually, the National EMS Instructor Course..
> 
> R/r 911



Ouch! I've read a bit but didn't pay attention to just how short the highly promoted course is....


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## Ridryder911 (Feb 26, 2010)

rescue99 said:


> Ouch! I've read a bit but didn't pay attention to just how short the highly promoted course is....



Yeah, it's sad... part of the major problems within our profession. 

R/r 911


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## Hal9000 (Feb 26, 2010)

I've seen a lot of bad "educators."  Most of them had no formal education in medicine, and no formal education in education.  That's why I am pursuing/completed both.  I think that educators should understand things such as zones of proximal development.  

I also highly recommend a good college course in educational psychology to anyone planning on becoming an educator.  Mine was one of the most valuable courses I've ever taken.


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## mycrofft (Feb 27, 2010)

*AmRedCross has a course sort of.*

One of two prereq classes to earning their CPR instructor certification is about teaching adults. However, my instructor wasn't very good at it. No fooling, nice guy good role model except not an organized instructor.

I knew Rid would come out for this one.


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## FLEMTP (Feb 27, 2010)

One of the other people mentioned something that had me thinking.. in EMS they take just about anyone into an EMT class...as long as you have the cash.. they'll give you the education.. 

I think they need to make entrance exams into EMT and Paramedic a MUST...and if you arent maintaining a passing grade during the course.. you get booted.. and testing needs to be much more stringent. 

Too many times do I see a paramedic student fail his final.. to have his instructor sit down with him, tell him what he got wrong.. and then pass him because he was "remediated" or give him the same exact test and tell him to retake it. EMS isn't supposed to be a feel good thing... where anyone and everyone can get into it, regardless if they can pass the courses and material... its a profession, and should be treated as such.. seeing as how lives are at risk, and the public trusts us as professionals to know what we are doing.


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## Ridryder911 (Feb 27, 2010)

You addressed a point that EMS educators have been debating and struggling with educational administration and even EMS administrators for years... passing them off!. 

Somewhere, about 15  years ago or so; throughout the EMS community we started assuming that it is was okay for everyone to pass. It might have started with the ACLS changing into an educational seminar and allowing remediation and passing everyone through.. who knows but it followed into the arena of EMS education. 

I and many educators are trying to install that failing is good not just for the system but for the patient. Where and why do we think that is okay and should be allowable for mediocrity? Not everyone can be an astronaut a cardiovascular surgeon or install cable tv but it's okay to become an EMT? ... 

Most programs place the filters on testing such as NREMT. NREMT is as disgusted as we are in that process. Unfortunately, it's just a test... there will be those that should had never been allowed to test.. pass. Then we blame the testing agency.. NO blame the instructors and schools! 

Blame the schools for not just allowing those to pass but to enter the programs. Why is it almost every other health care profession require entry level requirements other than cash, and EMS does not? It's not that there is a shortage of EMS personnel? Then to add that the text books are written at high school level and majority of them are filled with pictures to enhance the poor learning skills of those that take classes. An instructor that has never studied adult education and what do we expect the results to be? Disastrous, in which it is. 

To make it worse, students then acclaim that they had the "best" instructor (albeit they never had another one to compare with) and to develop cocky attitude because the completed an advanced first aid class disguised as a medical program. When in fact all other professional medical programs require additional science courses before being allowed to enter entry level. Yet, we make excuses than to correct the problem.. mainly self inflated egos and ignorance of medicine as even demonstrated on this site acclaims to know what is best. When questioned about credentials, experience and knowledge of health care education, they fall short on relying on their personal single experience or view. One of the MANY reasons those that really affect the changes within EMS pays no attention to EMS forums, and why should they? 

R/r 911


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## NepoZnati (Feb 27, 2010)

FLEMTP said:


> I think they need to make entrance exams into EMT and Paramedic a MUST...and if you arent maintaining a passing grade during the course.. you get booted.. and testing needs to be much more stringent.





Ridryder911 said:


> Blame the schools for not just allowing those to pass but to enter the programs. Why is it almost every other health care profession require entry level requirements other than cash, and EMS does not? It's not that there is a shortage of EMS personnel? Then to add that the text books are written at high school level and majority of them are filled with pictures to enhance the poor learning skills of those that take classes. An instructor that has never studied adult education and what do we expect the results to be? Disastrous, in which it is.


That would be a great for my class! Otherwise I wouldn't have a guy near me failing the CPR test 2 times or others after once or twice, asking us what is BLS or is systolic of 70 good?!


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## Fulch (Feb 27, 2010)

I found the majority of my instructors to be top-notch.  They had great interpersonal skills as well as being great teachers. If you had a question and they didn't know the correct answer (no-ones perfect right?) instead of making something up to look smart, they would go look it up or double check during a break and clarify when they came back to class, or you could E-mail them questions and they would get back to you in the evening.
There was a little bit of "this is how we do it in the field" but it was usually followed by a reminder that we were learning whats in the book first and foremost. I will admit that sometime the "this is how we do it in the field" Would come back and bite us on the *** because we would get mixed up during tests but i feel overall i managed to work it out.

Ok, that said, i do have to vent a little about one instructor. Let me begin by saying before i get jumped all over, the teaching staff was approx. 50/50 male/female and this is not a gender issue. From the start I found this instructor to be condescending and patronizing, I like a loose and friendly class room as much as the next guy but I don't appreciate being spoken to as if I just wandered in to the room in a clown costume. I understand that we're all rookies until proven otherwise but still don't treat us like a A-holes while pretending to be "helping us", at least do everyone the courtesy of just being a straight PR$@K to the class, I don't have a problem with a tough but fair teacher.
 She never really explained anything and just contradicted the other teachers, by teaching "her way of doing things". But the attitude was no worries at all compared to this instructors way of testing. She seemed to have a problem with some of the other instructors and so if she didn't like the way you were taught a certain skill she would change the test, adding extra things or changing the conditions of the skill to trip us up, on one skills day she had a 100% fail rate verses the other instructors 30% fail rate. 
Now at first i thought maybe this was just the luck of the draw, until i took my medical assessment skill test with her and she gave me contraindications for EVERY drug an EMT-B has access to and then failed me for not giving the patient a drug. When i called her on it she informed me that despite the fact that she had given me contraindications for all the drugs (I had to prove this by walking her through the contraindications in the text book. e.g. "Did you say the patient had was unresponsive with no gag reflex?" "Yes i did" Check. "Did you say the patient had a BP of 85 sys?" "Yes". check)  I still should have given the patient a drug, I had decided to give O2 and Transport.  

After I went to the course director about this and she admitted to changing the scenarios on the test sheet, she informed me that the reason she hadn't passed me was because she felt she was giving me "way too much help". Now I don't think staring at me with a half smirk on you're face and changing the test scenarios to trip us up counts as helping, but unless i TOTALLY missed the point of testing, I DON"T WANT YOU TO F@#$ING HELP ME, I want you to test me to make sure I don't accidently kill or hurt someone in the field. If I fail, I fail. Tough luck, work harder, better luck next time, but don't help me or hinder me to prove a point to the other teaching staff about how rubbish you think they are. In the end i was re-tested with another instructor with a different scenario and passed with no problem.

Sadly the flip side of this is that everyone get multiple attempts at everything, which i kind of understand, nerves and all, but if you fail the final three times maybe you didn't fully grasp the material and should go and take another look. Unfortunately this happened to a friend of mine who ended up passing fourth go round and went on to pass the NREMT third attempt, but thankfully ended up going back to work as a personal assistant to a politician, no joke.


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## Veneficus (Feb 27, 2010)

I guess the idea of discussing individual teaching traits is lost on the dilemmas of EMS education so I guess I will add some perspective.

Not because I agree with it, but because there seems to be this grand idea that simply making educational requirements more “intensive” that somehow things are going to change.

Increasing entry level requirements on a tech certification is like putting entry level requirements on a welder or medical assistant. “We’re sorry Mr. Smith, little Johnny is just not smart enough for shop class.” By the very definition an EMT is a “technician.” 

technician [tɛkˈnɪʃən] 
n 
1. a person skilled in mechanical or industrial techniques or in a particular technical field
2. a person employed in a laboratory, technical college, or scientific establishment to do practical work
3. a person having specific artistic or mechanical skill, esp if lacking original flair or genius

Maybe that is why the fire service sees EMS as an add on skill. Lest we forget, most EMS in the US is provided by the FD. Firefighting is a vocation. 
As well, a large portion of EMTs work in interfacility transport. There is no training in EMS education for such.  Even the glorious National Registry is based around emergency care. You need a 2 year degree to give somebody a lift to the doctor? The certification test so easy you don’t even need a class, just a test prep book. How about ranking students who pass the test? "Sorry, you were in too low a percentile to work here." 

The simple fact is Nursing, Physical therapy, etc. were not add on skills to another occupation.

Textbooks. My textbooks have lots and lots of pictures and diagrams. I even purposefully buy ones like “Illustrated review of biochemistry.” Granted it is a review book, not a primary text, but not a page goes by in Pathological Basis of Disease without a picture and that is a primary text in medicine world wide.

Blame a school? For what? In the US education is paid for. Economic means is the barrier. From Harvard to your local community college, SATs, ACTs its all a farce, show up with enough cash and you are in. Schools exist because there are people who will pay for what they offer. From “career centers” to Universities, if nobody is paying for a class, it is not offered. I am all for merit based education, but who is going to pay for it? 

Job to pay ratio. I advocate to increase EMS education. But after a  person takes out a loan for a 4 year degree is the industry going to start paying more than McDonalds? 

http://www.mcdonalds.com/usa/work/careers/shiftmanager.html
http://www.mcdonalds.com/usa/work/careers/assistantmanager.html
http://www.mcdonalds.com/usa/work/careers/restaurantmanager.html

You can reduce the number of EMS schools, similar to Nursing or Medicine, but then who is driving Grandma to dialysis 3 days a week?  At what cost to medicare?

US EMS has a culture of shifting responsibility. “It is not my fault it is the:” Lt. the FTO, the doctor. Sounds like a tech mentality to me. I could rattle off a list of (high performance) EMS agencies that don’t want critical thinking like I was reciting the alphabet in a song.  Maybe a handful are or aspire to be more. They are the exception not the rule. We all know who they are because there are so few.

I’m sorry, there are many people in EMS who should be considered more than a tech. They are more capable and more dedicated than many allied or nursing "professionals". But like every other profession or vocation, they don’t get a special certification or expanded scope. They are held to the same rules and laws everyone else is, the lowest common denominator.

Even in “reputable” EMS agencies, qualifications are often labor focused. “Must have 1 year experience in 911 ops” awesome, one year out at good ole boys volunteer FD. Even in education “must have one year as an EMT working in the field.” Never saw “must have one year as a PA or one year as a nursing assistant. 

It’s not that schools aren’t listening or providers are listening. The public and politicos aren’t listening. They don’t know good EMS from bad. EMS has shot its own foot with BS like response times to justify its existence. It has been legislated by a number of parties to a vocational position. From trucking companies in the dialysis derby to FDs who need $600+ dollars for a cab ride with lights to a hospital. You can find doctors who are also firemen, you cannot find firemen who are also doctors. (Change “doctor” to “medical professional” of your choice.)

Blame does not lie with the schools or with testing. If you want to find fault, start with hiring managers. “if you don’t have a degree you cannot interview.” Move on over to finance, “If you cannot pay the fee, you cannot have an ambulance.” How about the providers? “I was just following protocol when I forced the 90 year old lady onto the backboard.” Or “Our agency follows the standards of care no matter what evidence to the contrary has been presented because we cannot be the first to change so the stndard remains.”

If US EMS is ever to be a profession, an increase is education is a given. But you could increase it to a doctorate, exclude anyone you don’t subjectively feel is worthy, and certify yourself as all knowing all powerful raiser of the dead. But there is too much money and therefore special interest involved to think any educational increase will solve EMS’s problems.

Let’s not also forget if you take away “low level” jobs, you will increase unemployment. EMS especially today is a quick “retraining” to get back to work before your unemployment benefits run out. Such is the savior of a fallen economy.


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## mycrofft (Feb 27, 2010)

*So indiscriminately passing students is annoying?*

Maybe even lethal.


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## goodgrief (Feb 28, 2010)

*thast is how it is at my school*



FLEMTP said:


> I think they need to make entrance exams into EMT and Paramedic a MUST...and if you arent maintaining a passing grade during the course.. you get booted.. and testing needs to be much more stringent.




i am currently in school for EMT-I and in our program if you dont pass a test you get one retake, if you fail you are out. You are also out if you fail more than 3 test over all.  Forget entrance exams, I think anatomy and phyology should be required before emt school. I havent taken it yet and it is really hurting me..

My teach says it best, if a class cant pass the NREMT, blame the teacher not the test.


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## DrParasite (Feb 28, 2010)

want to hear something funny?  when I took my first EMT class was in NJ, and taking my EMT, I was told if the student doesn't complete the EMT curriculum, then the course host would not get paid by the state.  as long as they completed the course (regardless of if they passed the state test as well), then payment was given.  so it was in the teaching agency's best interest to pass everyone.  I think for ALS it's different since the state doesn't pay for ALS training, but it was for BLS.

out of curiosity, what education and formal training do most firefighter instructors have?

Additionally, I have taken an instructor class or two, and surprisingly enough, they had very little content about what I would be teaching. it was all about "how to teach" and "teaching techniques" so I guess the theory was if you know the content well enough, you could apply these techniques to pass the information to others.

btw, I have had some :censored::censored::censored::censored:ty educators when I was in college.  these were people with doctorate degrees that just didn't give a damn about what they were talking about, didn't know what they were talking about, or didn't care.

As for good/bad antics, I actually enjoy war stories.  tell me of a situation where what you are telling me actually helped, and I will pay attention.  tell me a story where you got thrown a curveball, this is what happened, and this is how you dealt with it.  for my A&P classes, if the instructor has a medical background, tell me how knowing this thing about the human body helps diagnose something.  tell me how what you are telling me was actually useful in the field, and I will pay attention.  Call me ignorant if you want, but I like knowing that what is being taught to me has real world applications, and if you can give examples of when the education you are giving me was actually used, well, that's worth it's weight in gold in my book.

unfortunately, education is about money, and if you have sky high failure rates people won't want to go to your school.  it also reflects poorly on the instructors (at the EMS and academic level).  Or they will take it as the easier place, because as long as you get your medic cert, few will care where you get it, as long as you have it.

One thing I do wish is EMS instructors would have high level of training.  so medics are teaching BLS, and nurses and MDs are teaching.  and if you have a lecture on airway, an RRT is teaching.  if I have a question about the content, the instructor should have a knowledge far surpassing the student, and if a question is asked that isn't covered in the course, then the instructor should be able to answer it, even if it's not in the text book.


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## rescue99 (Feb 28, 2010)

DrParasite said:


> One thing I do wish is EMS instructors would have high level of training.  so medics are teaching BLS, and nurses and MDs are teaching.  and if you have a lecture on airway, an RRT is teaching.  if I have a question about the content, the instructor should have a knowledge far surpassing the student, and if a question is asked that isn't covered in the course, then the instructor should be able to answer it, even if it's not in the text book.



So, are these Docs and nurses Medics too? The world outside is very different for Medics. I've found Docs to be extremely helpful for some subjects but a waste of time on others in the classroom. Unless a Doc can teach it all, I'd prefer he/she stick to being a content expert.


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## LucidResq (Feb 28, 2010)

DrParasite said:


> One thing I do wish is EMS instructors would have high level of training.  so medics are teaching BLS, and nurses and MDs are teaching.  and if you have a lecture on airway, an RRT is teaching.  if I have a question about the content, the instructor should have a knowledge far surpassing the student, and if a question is asked that isn't covered in the course, then the instructor should be able to answer it, even if it's not in the text book.



This is something I felt the school I went to for EMT-B got right. Our primary instructor was an experienced medic. Our skills instructors were medics. Our pediatric classes were taught by an experienced ED RN from a Children's Hospital. 



rescue99 said:


> So, are these Docs and nurses Medics too? The world outside is very different for Medics. I've found Docs to be extremely helpful for some subjects but a waste of time on others in the classroom. Unless a Doc can teach it all, I'd prefer he/she stick to being a content expert.



I think it's awesome to have experts with a high level of training teach specific elements of each class. I don't think DrParasite was implying that an MD teach the entire course, rather perhaps focus on particular content that they are an expert in. If the person doesn't have a solid, recent background in the prehospital elements of that subject, those can be addressed by the primary instructor, who should have that prehospital background.


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## DrParasite (Feb 28, 2010)

rescue99 said:


> So, are these Docs and nurses Medics too? The world outside is very different for Medics. I've found Docs to be extremely helpful for some subjects but a waste of time on others in the classroom. Unless a Doc can teach it all, I'd prefer he/she stick to being a content expert.


really?  so the human body changes whether you are in a hospital or in the projects?  you mean the drugs work differently inside the hospital vs on the streets?  really, wow, I guess I have to tell my medical director that anything he says doesn't apply to the world outside.  thanks for educating me 

this is the type of thinking that has keeps ups back.  you don't need to be a medic to be an expert in an area involving EMS.  a poison control specialist might be a great person to teach an overdose class.  a resp therapist might be great at dealing with treatment for breathing problems.  and a trauma surgeon would be great at dealing with trauma victims.  if you are overseeing the course, yes, EMS experience might help, but there can be a lot learned from specialists that a medic don't know


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## rescue99 (Feb 28, 2010)

DrParasite said:


> really?  so the human body changes whether you are in a hospital or in the projects?  you mean the drugs work differently inside the hospital vs on the streets?  really, wow, I guess I have to tell my medical director that anything he says doesn't apply to the world outside.  thanks for educating me
> 
> this is the type of thinking that has keeps ups back.  you don't need to be a medic to be an expert in an area involving EMS.  a poison control specialist might be a great person to teach an overdose class.  a resp therapist might be great at dealing with treatment for breathing problems.  and a trauma surgeon would be great at dealing with trauma victims.  if you are overseeing the course, yes, EMS experience might help, but there can be a lot learned from specialists that a medic don't know



Again...if they have no clue how to do a field job, they only make good content experts. It is a personal opinion..not meant to be anyone else's. 
Not being anyone's keeper but, I do have some observations of my own. 

The days when Doc's did quite a lot of the teaching are long gone. They  made great cardiology / ACLS experts but, Medics must not be worth their time because Doc's quit teaching it over 10 years ago. Since ALL courses have to have a medical advisor, one does have to ask; where the heck are they while all this so-called crappy education is taking place???


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## Ridryder911 (Feb 28, 2010)

Medicine is medicine.. yes, they make great expert LECTURER but that is different than being the primary instructor/educator of having knowledge of the working environment and the expectations that is required. The same as if an EMS expert was to try teach nursing, RT, etc.. 

R/r 911


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## redcrossemt (Feb 28, 2010)

To the OP's initial question, hated the teacher reading off the powerpoint slides. Seriously, he would stare at the screen with his back to us and read the screen word for word without interruption, explanation, clarification, or creativity; and go to the next slide. Sometimes he would even mispronounce a word, or not be able to say a word at all because he didn't know what it meant. After he was done way early, we would be assigned what he himself termed "busy work" that had very little to do with anything taught in class.

When asked to explain certain things, the teacher would say, "look it up in your book". Please, educators out there, admit to your students when you don't know the answer to a question, and make the effort to answer it at a later point in time.


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## Melclin (Mar 1, 2010)

We have always had units provided by other faculties, multidisiplinary guest lecturers, and indeed, the faculty itself retains many disciplines to teach other things. Eg,

-In A&P, the lectures on various body systems were taughter by experts in each specific area, all of whom had at least a doctrate. 
-A sosciologist specialising (with a PhD) in healthcare took us for health systems. 
-An intensive care paramedic completing his doctrate in paramedic education took us for basic resus and clinical assessment. 
-A doctor of clinical psychology runs the research and mental health subjects. 
-An RN with a law degree and a PhD took us for legal aspects of healthcare. 
-An RN with a PhD takes us for management of medical conditions. 
-Many guest lecturers:The Head of the State Paediatric Trauma centre gave our lectures on paediatric trauma. An Intensive Care Physician took us for Neuro trauma. Crash specialist from the accident research centre taught us about MVA dynamics and patterns of injury. A paramedic with a PhD in Paramedicine took us for trauma triage and evaluation. The Neo Natal Retrieval team clincal educaters teach us neonatal resus. A midwife takes the obstetrics classes. We have lectures from disability groups, mental health interest groups and specialist paramedics from the air wing and retrieval services.
-The department maintains nurses, psychologists, an anthropologist, research and information specialists as well as many highly educated and successful paramedics, and is headed by a Physician who was also an ambulance officer many years ago.  

Their obvious knowledge in their respective fields is incredibly helpful and their skill for teaching, a credit to their own educators. The university would be doing us a horrible diservice if it thought we would benefit from ONLY being taught by paramedics. I can't think of how narrow my education would be if I sat in a class room with a paramedic/s with only 2 years (probably at the most) of education himself teaching me entirely out of one text book about all subjects. Thats simply absurd. 



Ridryder911 said:


> One of the most misunderstood ideas is that a great medic will automatically make a great instructor.



Truth.


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## MidwestFF (Mar 2, 2010)

I have a displeasure for Instructors that will not allow students that are excelling at class to work ahead. We are stuck working at the pace of the slowest student in the class uhhggg.


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## Veneficus (Mar 2, 2010)

MidwestFF said:


> I have a displeasure for Instructors that will not allow students that are excelling at class to work ahead. We are stuck working at the pace of the slowest student in the class uhhggg.



Have you considered using the time to learn the subject material in greater detail?


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