# Annoying EMT student back for round 2...



## AMPEMT85 (Nov 1, 2008)

So, I help teach the EMT class where I live. I basically just teach skills (splinting, airway, OB, backboarding, pt assessment...) and there's this student who is back for another try from last semester. They drive everyone crazy. It took this individual an *hour* to do a pt assessment on mid-term testing last week....

Anyways, when the semester starts out, I almost always run one of the airway stations and just like last semester, this person made me second guess myself on a question he asked me and said they were going to consult the book. Now when I went through, the NR hadn't taken over our county protocols yet, nor the curriculum, but 2 years later, things have changed.

This person is very book "smart" (I say the word smart not referring to intelligence, but rather the only thing they're good at). I had to walk them through the entire process of airway management because "I've never done this before"....*sniff sniff* I smell something that belongs on a ranch from a male cow....

I've never had a problem with a student before, and this one is getting on my nerves all over again. They didn't pass final last semester so they decided to come back again. They're in their 50's at least, are very cocky, always asking stupid questions, and trying to make the proctors feel stupid. They always verbalize what they're going to do, not actually do it. Ex: "I would palpate the abdomen" or "I would check for a gag reflex"...

I did put them back in their place last week when I made him be lead EMT for a broken femur at my sager traction splint station. II told him that he had "lost his license" because he didn't continue to hold traction after setting the leg straight...he was dumbfounded and I was elated...(don't mess with me!!!)

I don't know why they're in the class and why they want to be involved in EMS...no known history of public service or anything that would call for an interest or need for an EMT cert/license.

Have any of you had this problem, and how have you delt with it, and if you haven't what would you do if you were in my shoes? 

PM me if you want anymore details...h34r:


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## Ridryder911 (Nov 1, 2008)

I don't know which is worse a pseudo instructor with an attitude or a student that is challenging just because they can. 

First, you demonstrated *your ignorance * by stating... _"the NR hadn't taken over our county protocols yet, nor the curriculum"..._ National Registry has *NO PROTOCOLS!* Never has nor never will! In fact one of the reasons for such a high fail rate is because they have NEVER  tested upon protocols. They can't. It is not a medical provisional service. 


Second, the student won. He challenged you and you lost by letting them intimidate you. The best advice would be have the real or lead instructor discuss his attitude and inability to adapt and perform the skills within a timely manner. Inability = failure; failure = termination from the class. Proper documentation and records of the student inability to produce passing results after allotment of practice, is grounds for termination. Since this is the students second attempt, administration needs to inform the student that this course is no longer available to them at this facility. 

I too hate cocky students but remember you are supposed to be the teacher. You control the tempo and mood of the class. As well, I highly promote verbalizing skills with the demonstration at the same time. If you do NOT perform and verbalize in the NREMT skills station(s) the chances of failure is high. Furthermore, I truly doubt that releasing traction after a leg has been moved is automatic grounds for loosing one's license. Favorable no, but unless it caused a permanent injury or death, it would not even be investigated. Again, spouting and demonstrating that you, yourself have improper knowledge. 


Wanting to know why, they are taking the class is really immaterial. They should had been screened prior to allowing them into the program. Many never have any reason to take a medical program. Then again, we still continue to allow firefighters and wanna be firefighters into the EMT program all the time? 


R/r 911


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## Sasha (Nov 1, 2008)

AMPEMT85 said:


> I don't know why they're in the class and why they want to be involved in EMS...no known history of public service or anything that would call for an interest or need for an EMT cert/license.



I didnt know there was an age limit or a required reason to be interested in EMS. Boy am I in the wrong profession, then, I was interested in EMS just because! No history of public service, etc.

Your attitude towards this student is extremely negative which will not make for a good outcome for either one of you. Can you ask one of the other instructors to maybe mediate between you two? Have a sit down, put it all out on the table. Maybe he doesnt realize why you have a problem with him. Talk it out, cry, hug, and ride off into the sunset?


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## AMPEMT85 (Nov 1, 2008)

I'm not the only person who has had problems with this student. They have given every instructor in the class a hard time. The lead instructor hasn't talked to him yet about his attitude or his inability. Which lead us (the proctors) to wonder wether or not we should talk to the lead instructor about all of us going to the dean at the JC and telling him about our student.

I have no problem with his age, it's just that usually everyone who comes through our EMT class is 18-30 and looking for a career as ff/medics. It's rare to see anyone above that age, if they are they're usually SAR or retired FF's. 

I did let him win, and I shouldn't have. I know the skills that I teach and any student who thinks they know more than me when they can't even demonstrate the skills shouldn't get to me.

I wish that you could see them in action...it's totally different in person than it is when I type it out. 

I've never had a problem with any students before and I've been doing this for 3 semesters. My fiance has been doing this for 6 or 7 and he's never seen a student like this before either.


I used the wrong word when I said protocols with the NR...I meant for when he reads the NR stuff out of the book, they're different from our county protocols. The instructor teaches that if one does let go of traction on a broken femur before the traction splint is applied, you will lose your license because you could damage the leg and all CSM is gone.


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## Ridryder911 (Nov 1, 2008)

AMPEMT85 said:


> The instructor teaches that if one does let go of traction on a broken femur before the traction splint is applied, you will lose your license because you could damage the leg and all CSM is gone.



Well the instructor is wrong. Yes, it may cause muscular spasms but truthfully it is doubtful it will cause an obstruction to cause ischemia, unless there was not a pulse to begin with. What do you think happens when they place fixators to the femur? Traction is released in surgery all the time. Again, a statement like .. "_You will loose your license_".....only demonstrates to me that one does not really know what they are talking about. 

Not sure about California; but I bet that one gets to be represented and a hearing would be performed before any such occurred even if it is per county or state. Now, really think about it.. lost of traction during splinting would cause a license to be revoked.. naw! It happens daily. 

I have had and continue to have difficult students. Its part of the job. One must remember as an instructor and educator that you have to act and demonstrate that you are the one in charge and must as well act more professional and mature. 

I ask if the student has demonstrated so much trouble has there been an official report made? If not, then the instructors is just as much to blame. The lead instructor needs to address the student and start the process rolling. 

Good luck!

R/r 911


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## Onceamedic (Nov 1, 2008)

AMPEMT85 said:


> I have no problem with his age, it's just that usually everyone who comes through our EMT class is 18-30 and looking for a career as ff/medics. It's rare to see anyone above that age, if they are they're usually SAR or retired FF's.



I went to EMT school when I was 48 because it was a hoop I had to jump through to got to paramedic school.  I started medic school and was 50 2 months before graduation.  I am in my first EMS job as a medic and I plan to get in a good 20.  I am sorry, but you do have a problem with this students age and your generalizations prove it.  I would have challenged you in class too.


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## AMPEMT85 (Nov 1, 2008)

Kaisu said:


> I went to EMT school when I was 48 because it was a hoop I had to jump through to got to paramedic school.  I started medic school and was 50 2 months before graduation.  I am in my first EMS job as a medic and I plan to get in a good 20.  I am sorry, but you do have a problem with this students age and your generalizations prove it.  I would have challenged you in class too.



Actually, I don't. For the class that I teach and attended, the majority of the students were from ages 18-30. I was stating that it is rare to see anyone above the age of 30 in the class. I think that as long as you know your stuff, it doesn't matter what age you go into EMS. Hell, if David Lee Roth can do it after being a rock star for ages, I don't see why anyone else couldn't.


Back to the student...last semester they said that they might hit one of the other students because they were trained in martial arts and it was a reflex reaction when being touched on the abdomen. We were just practicing patient assessment and every student is lead and is also patient, so they know how to do it and how it feels. I was not the proctor helping with this station, but was warned about the student from the instructor. This individual  challenges the proctors, is nervous when doing so, and could be a danger to the class. The instructor knows this, but because the dean is breathing down his neck this semester, he hasn't said anything to him. It's a crappy situation and I'm trying to make the best of it, but it's hard some nights.

The instructor teaches us to not let go of traction just like not letting go of the head until the patient is properly secured to the backboard. He teaches us this way so that we don't encounter the worst case scenario of being in court and having our license in jeopardy. The rather be safe than sorry approach. So we teach it the way he wants us to. he's in charge and if we notice something wrong, we let him know professionally.


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## Ridryder911 (Nov 2, 2008)

My suggestion then is to formally write a discipline documentation about specific points and dates/times on what the student has said and performed.All instructors that has witnessed and has problems should do the same. Any student that even threatens in my classroom is automatically dropped. It is a ticking time bomb for litigation and problems. Best you cover your self, for professional reasons. 

R/r 911


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## AMPEMT85 (Nov 2, 2008)

Ridryder911 said:


> My suggestion then is to formally write a discipline documentation about specific points and dates/times on what the student has said and performed.All instructors that has witnessed and has problems should do the same. Any student that even threatens in my classroom is automatically dropped. It is a ticking time bomb for litigation and problems. Best you cover your self, for professional reasons.
> 
> R/r 911



hmmm....very good idea. I'll run it by the other proctors. We have the same policy, no harassment of any kind is allowed. It is grounds for removal from the class and they're not allowed to take it in the county again. Thanks for the help.


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## mycrofft (Nov 2, 2008)

*Sit down with a piece of paper. Print out this post and replies.*

Take a pen and strike out any mentions about age or attitude. Underline any statements citing actual events and rules.
That will be the foundation for your stripping way the excremento de los vacas and get to the nubbin of the matter.

1. List the curricular hardpoints the student as "passed" or "failed" objectively. In other words, the class curriculuim has to have a set of performance standards the student meets. Doesn't matter if the student sings the steps of femoral immob to the tune of "Raindrops Keep Falling On My Head", if he passes, he passes (but you can encourage him to maybe hum it to avoid bothering the other students).
2. Cite particular instances you have personally observed the student being disruptive of the other students' learning. Date time quotes etc.
3. Take this to your lead instructor and talk to him/her. You two will work out what to do in accordance with the rules. Maybe the student is salvageable, maybe not, but whatever happens has to be by the rules to make it stick.

This sort of person wants to get in a micturation contest with you, so don't. One approach you will want to discuss with your lead instructor is making the student spend his break time, with allowance made for toilet and eating, spending time with the instructor away from an audience. Maybe require the student to submit his contests with what's being taught in writing. But do not threaten or try to "even up". Work this through your lead.

Oh, and that "I might reflexively hit you" line is BS and the sign of some sort of dramatic oddity going on. Any threat of assault or battery may be grounds for dismissal, but _consult your lead_!  
(So now he's going to come down and take it in Sacto? Or did they push him up to you!?)


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## ChargerGirl (Nov 2, 2008)

i've had professors who had problems with annoying students in class. they generally start to tease the student about how annoying they are etc and when the student raises his or her hand the instructor would just say "does anyone else have a question besides so and so" and they would ignore the student. basically shame them into not wanting to volunteer information or at least make it seem like he or she does not have anything valid to say. mean but it works


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## Ridryder911 (Nov 2, 2008)

ChargerGirl said:


> i've had professors who had problems with annoying students in class. they generally start to tease the student about how annoying they are etc and when the student raises his or her hand the instructor would just say "does anyone else have a question besides so and so" and they would ignore the student. basically shame them into not wanting to volunteer information or at least make it seem like he or she does not have anything valid to say. mean but it works



The problem with that method makes the professor or instructor look like they cannot control and act as juvenile as the one with the problem. After they perform such action, then no one will want to ask questions or participate with fear of retaliation from the staff. 

Do it the right way. Keep a record of the student and their action. Confront the student and according to the schools handbook and rules, act accordingly. It may require a warning or confrontation first or possibly disciplinary measures such as termination from the class.


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## Foxbat (Nov 2, 2008)

It may sound stupid, but... Did you confront the student and tell him exactly what is the problem with him, what impedes his progress? You can't smell your own ****; some people are annoying without realizing that until they are told in their face.


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## joemt (Nov 3, 2008)

I would tend to agree with foxbat..... I live by the saying in both teaching and practicing that I can't fix what I don't know is broken.  Give this student the benefit of the doubt and talk with them.  You may find out that you have some things in common... if you have the time then take them on as your cause....not only will the student appreciate it in the long run, but so will every peer that works with them in the future.  If you're not willing to come up with a solution to the problem, then quit complaining.


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## Sasha (Nov 3, 2008)

ChargerGirl said:


> i've had professors who had problems with annoying students in class. they generally start to tease the student about how annoying they are etc and when the student raises his or her hand the instructor would just say "does anyone else have a question besides so and so" and they would ignore the student. basically shame them into not wanting to volunteer information or at least make it seem like he or she does not have anything valid to say. mean but it works



Thats rather cruel.


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## BossyCow (Nov 3, 2008)

Anyone who has taught runs into this student in many forms. They want to make the class all about them. Their knowledge, their life experience, their stories .... and Rid is correct.. as an instructor you need to maintain control of the class and its students. The suggestion of belittling the student and shaming them in front of the class as a tool is one of the most ludicrous suggestions I have ever seen. I'm hoping it was a story and not a suggestion, presented more for humor or history.

I have found an effective tool for dealing with this type of student. First, if you understand that the student is seeking attention and status within the group, removing the student from the group helps. Telling the student that the rest of the class has to move on, and they will have to take it up with you after class is one of the best solutions. It gives you a mechanism for dealing with the student without the rest of the class as an audience. It also gives you some time to regain perspective and to quiet that voice screaming.. "Why do I have to deal with this frickin' idiot" 

One way I've presented it was... "I'm sorry.. but to give you the explanations you require will hold back the progress of the rest of the students doing the practicals. For right now.. do it as you were taught.. and I'll be happy to explain things further to you after class." This does a lot of things.. it drops the student from 'guy who knows more than the instructor' to 'guy who doesn't get it' in the eyes of the other students. This removes the problem student's incentive for a repeat performance on another topic later. It shows the rest of the class that you are willing to meet with them for further explanations on things and sets up an open, learning environment where students feel comfortable about approaching you. It also gives you as an instructor an opportunity to address the confusion. Everybody wins.


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## AnthonyM83 (Nov 3, 2008)

I understand this is a difficult student. They happen. I know how frustrating it can be. I use every difficult student as a chance to become a better instructor. Everytime someone asks a question I can't answer or a contradiction, I gives me motivation to study and prep for hours next time....which in turn makes me a better EMT and better instructor due to knowing material better. Just makes me up MY bar.

Another tip:
Avoid tangent discussions. "You know Bob, that's a good point. The school has decided this is the best way to teach this skill. I want you to address the topic in lecture tomorrow, because I need to get everyone through this skill training." (Then advise lecturer of question)

Basically, don't let limited skills time get wasted as class discussion time. Cut them off early. "I see what you're saying. We're going to do it this way."   "No. Next question?" 

Don't take the manipulation. If they want to take extra time being walked through, tell them other students also haven't done it and you need to divide your time through. That he's going to need to practice on his own a lot.

Or: "There is no one set way for a lot of procedures in EMS. We're trying to teach you one specific way, for testing purposes and so that you can get efficient at one." Then keep going, cut off any comebacks and remind him everyone needs to practice.

Don't allow him to get by not following rules. If he keeps verbalizing without demonstrating, don't let scenario proceed. "You need to demonstrate every step, as if this were a real patient. His airway hasn't actually been opened." If he really pushes you, put a time limit on scenario.

Also, many book smart students want the whys. Get good at coming up with generic answers that are actually logical.  If they say they did something, just didn't verbalize, say "The test will require to verbalize, thus we're requiring you to do so in training."

Difficult students make class less fun for all, but they also push you to know your stuff. In the end, just address the issue. If they're being super technical about it, just say: "We like addressing questions, but your question volume is taking up too much of skills time. We have a duty to get the skills practice in, so you're going to have to limit the questions. That makes logical sense, right?" (That personality type will probably want to seem logical, so will say yes. If they say no, again differ to: well that's what the school decided is best for greater number)

Or start using the "It's in your book" line and move on.


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## AnthonyM83 (Nov 3, 2008)

As far as age, I've noticed this is harder to absorb for older students. The skills instructors all tend to be younger, speak fast, speak the same "language", and know what makes more sense to someone their age so explain it in those terms. For some people or simply non full-time students, it can be overwhelming

So do try to have some empathy to experiences and personality type (but not at expense of rest of the class). 

A lot of book smart students don't seem to "get" EMS material, thought processes, importance of steps of ABCs, etc. I tell them find those doing best in class and study with them and try to pickup their style of thinking and ask how they come to conclusion to every practice question they answer.

And if they insist their method/logic is right, and others' wrong remind them that the material is has been proven and validated by MDs etc etc (aka if they try to be know it all, remind them there are higher up know it alls who agree with you, so the problem must be in the student's logic).


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