# Opinions from EMT-B Instructors?



## Chip (Dec 5, 2011)

New Basic instructor here... many questions...

What textbook do you use?
What are its strengths?  Weaknesses?  
Have you ever used a different text? 
How do they compare to each other?

Do you teach from publisher slides? Whose?
Make your own slides?  Skip the slides entirely?

Do you use online resources?
Which are your favorites?
Which are a complete waste of time?

How many hours is your program? 
Shift? Days? Nights? 
Do you run short on time?  
Send students home early?

Do your students have to prove college-readiness before taking the class? (Accuplacer, SAT, ACT, TASP, THEA, etc)

What are your biggest frustrations and how have you overcome them?

And last but certainly not least...
Do your students study on their own?  
How do you make them do that?


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## AlphaButch (Dec 5, 2011)

Chip said:


> New Basic instructor here... many questions...
> 
> What textbook do you use? AAOS before, Brady now.
> What are its strengths?  Weaknesses?  AAOS - written for low level comprehension (bright, big, simple) which is good and bad - being simple allows for easier explanations of concepts. However, I found that I then end up having to remold those concepts if the student advances to EMT-P+ and the book doesn't really cover the material as thoroughly as I am comfortable with. Brady - a little higher reading comprehension level required, better all around content. At the EMT-B level, I can get by on either book but both require me to add content for my own sake of mind. At the EMT-P level, I go exclusively with Brady. I do use other AAOS books though and find them great (basic pharmacology, etc)
> ...



It is too early and I need more coffee.


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## DrankTheKoolaid (Dec 5, 2011)

*re*

If you are able, teach and use the presentations from one author and use a test bank from another author.  This will help ensure a understanding of the material instead of just learning that particular books view on the subject.  All of the main authors tend to put emphesis on different areas as they see important.


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## Veneficus (Dec 5, 2011)

As I mentioned I do not teach Basics, 

but I find that 2nd or 3rd order questions ensure understanding.


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## medicdan (Dec 5, 2011)

I'll bite as well. I'll preface by telling you that I am a newish Basic instructor myself, and teach for a larger department of a University with 15-20 I/C instructors. Materials have been developed over time (many before I arrived), but are constantly being revised/reviewed/renewed/reframed, and I am generally active in that process as we "upgrade" the curriculum. 


Chip said:


> New Basic instructor here... many questions...
> 
> What textbook do you use? AAOS 10th Edition. I think we're the only program in the area using the longer/more detailed book. As others have said, a bit simplistic at times, but we augment it significantly with slides, which students print and are responsible for the content on as much as the textbook. Not too long ago, we gave out the textbook but told students they didn't need it-- they could study just the slides, but as the level of the class has increased, that is no longer possible.
> 
> ...


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## Chip (Dec 5, 2011)

Thanks for the good answers!  This is what I needed.

What have your experiences been with NR?  What percent of students pass 1st try?


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## Chip (Dec 5, 2011)

*2nd/3rd order questions...*

What exactly are 2nd/3rd order questions?
Can this be done with multiple choice?
[Do you believe multiple choice can be used at all to effectively measure comprehension?]
Can Fill-in-the-Blank be used efficiently?
Does this mean more scenario-based?  

For example, instead of...

"Which drug do you give for anaphylaxis?"
A. .4mg Nitro B. 324mg Aspirin C. 0.4mg Epinephrine D. 15g Oral Glucose

Would it be more along the lines of...

"You arrive on scene to a 19 y/o male complaining of extreme respiratory distress; you hear bilateral wheezing, see accessory muscle use, red blotches, and severe swelling of the face and throat. In addition to oxygen at _____LPM via _____, the appropriate medication would be _____, in a dose of _____ given by the _____ route."


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## Chip (Dec 5, 2011)

How do you make it all fit into 150 hours?

Does that include clinical time?

Do you have to handle registration-type work such as verifying drug screens, TB tests, liability releases etc?


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## Chip (Dec 5, 2011)

For those that do their own slides...

Do you start completely from scratch or do you revise the publisher's slides?

If you are revising, do you find yourself changing content, adding info, or mostly deleting redundant slides?


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## Veneficus (Dec 5, 2011)

Chip said:


> What exactly are 2nd/3rd order questions?



A second order question is one that requires understanding of another concept in order to answer the question.

A third order requires understanding of 2 other concepts. 

Here is an example a bit beyond basic but you get the point:

You are examining a patient with crushing substernal chest pain raidiating to the arm and jaw, upon examinning the 12 lead a STEMI is suspected and the proper treatment is initiated. If you suspected an NSTEMI, how would that alter the treatment of the patient?

(multiple choice ABCDE, a combination stemi treatments, treatments for both, and 1 best answer.)

This question tests whether you know the pathophys between the 2 conditions. It also tests whether or not you know the treatments of both, because you will not be able to narrow down the distractors to the best answer if you don't. 



Chip said:


> Can this be done with multiple choice?



It most definately can be and is. Any medical student will attest to it.



Chip said:


> Do you believe multiple choice can be used at all to effectively measure comprehension?



I believe it can at a minimal level. I do not think it is the best method. An oral board I think is the best.




Chip said:


> Can Fill-in-the-Blank be used efficiently?
> Does this mean more scenario-based?



I think fill in the blank is a waste of time. It promotes memorization which in medicine today, even at the medic level, there is simply too much to try to memorize. I think the new basic curriculum will also preclude memorization.


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## Veneficus (Dec 5, 2011)

Chip said:


> Do you have to handle registration-type work such as verifying drug screens, TB tests, liability releases etc?



No. Instructors teach.

That stuff is handled by our outstanding secretary and you won't get passed her into the classroom/clinical unless it is all squared away.

She has total authority over it and instructors have all agreed never to over-rule her. She protects the program from not meeting the proper administrative requirements and getting in trouble with the State.



Chip said:


> For those that do their own slides...
> 
> Do you start completely from scratch or do you revise the publisher's slides?



I do all my own original work. 

Students can read the book. The book has important concepts highlighted in various ways. 

My job is not to recite bullet points to them. It is to connect the dots, explain how to apply theory to the field, and make difficult or troublesome concepts easier.

I also know how to put together a powerpoint. I do not read from it. It is more of a visual outline for me so I stick to my script, cover what I need to, and not waste time wandering off topic.

I also add in lots of funny and spectacular pictures so the slide visually grabs the students' attention everytime I change it.

When lecturing I always call on random students at random times to get thier opinion or force them to reason out the topic.

The lead instructor over the years has collected, revised, and handed out topic notes that contain every important detail on every chapter. They can read them on their own time and look up concepts they don't understand.

I encourage the students not to take notes and give their full attention to what I am saying and drawing on the white board as I am talking. 

I encourage questions at anytime and after asking students if they understand important concepts I just explained, I wait for them to say "yes" and then I summarize them again because I know nobody wants to be the one to say "no."


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## medicdan (Dec 5, 2011)

I'm with Vene. I think my despise of teaching lectures off of powerpoints approaches my student's dislike of it. Whenever possible, I prefer to teach through my own stream and processing of the subject, using slides as a framework. I really like talking through pictures with the class-- talking through assessments based on a single image and discussing options. I have terrible illustration skills, so also like to include diagrams and figures in the slides. At different venues, I've experimented with using a smart board or interactive display, but not yet figured out how to use it to actually augment my lectures. 

Frankly, I hate my own voice, and as a student and instructor prefer everything to be a guided discussion. 

The 150 hours mentioned does not include clinical or ride time, simply lecture and in-class labs.

I'm also still a very very new instructor, so working hard to develop my style.


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## Chip (Dec 16, 2011)

*Thanks*

I really appreciate the feedback! Y'all are awesome!


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## Chip (Feb 8, 2012)

*New Question*

The ability to study/learn independently is a necessity for a successful career in EMS. Agreed?

Instructors who fail to teach ensure that only those who *do* study on their own will pass.

(Actually explaining things to students is sometimes referred to as "helping them too much" or "babying" them.)

So... which is better?

A. Allowing intelligent students to graduate who are under-educated because they were not taught, but preventing students who aren't naturally self-educators from becoming EMT's.

OR

B. Explaining the reasoning behind and relationships between what we do & why we do it, providing self-educators the extra knowledge and insight of an experienced clinician, but also allowing students who aren't self-educators to become EMT's.


-- -- 
Keep in mind, that, for the present discussion, we are only referring to EMT-Basic students.

Vene? Dan?


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## Chip (Feb 8, 2012)

*Tried to edit but it was too late:*

After taking the few minutes to formulate the above concepts into concise thoughts, it seems too stupid a question to even ask.

Therefore... new questions:

What are your favorite ways of encouraging independent study?

What are your favorite ways of stimulating critical thinking & measuring students ability to do so?


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## Veneficus (Feb 8, 2012)

Chip said:


> What are your favorite ways of encouraging independent study?



I tell them upfront that I am not going to teach them everything, that I am going to only cover difficult concepts and will spend most of the time teaching them how theory applies in the field. 

I simply state "unless it is a concept that people routinely have trouble with, it is up to you to come prepared with at least a minor understanding of the topic."



Chip said:


> What are your favorite ways of stimulating critical thinking & measuring students ability to do so?



I demand of my students what I demand of my peers. 

I will help them if they struggle, but the bar is set and known from the beginning.

I never tell them things like "at your level, you don't need," etc. I am fond of the phrase "poor is the student who doesn't exceed his master." (attributed to Leonardo Da Vinci) 

By treating them like my peers and offering them positive feedback and rewards for their successes, it seems to inspire them to try harder and do better. 

Some are even bent on trying to "live up" to the respect I show them.

I think the Japanese culture defines my veiw of being a teacher best. They are not my students, they are my junior colleagues.

http://en.wikipedia.org/wiki/Senpai_and_kōhai

(and yes they are expected to do menial tasks like clean up the equipment, coffee pot, and keep the room in order)

I also point out mistakes I have made over the years as well as frequently tell them their fears and frustrations. (that I understand from being a student myself) It seems to assuage their frustrations that I am making unreasonable demands on them and I am not in touch with what they are going through.

"If I can make it, they can make it." The only thing seperating me from them is time and effort. 

Acknowledge the effort that goes into progress. When the slower students figure something out that they should have known months ago, praise their success, it encourages them to keep up the effort.

Never be sarcastic or use sarcasm to a student.

Do not focus on failure, acknowledge failure but always make the focus what must be done.


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## JPINFV (Feb 8, 2012)

Chip said:


> For example, instead of...
> 
> "Which drug do you give for anaphylaxis?"
> A. .4mg Nitro B. 324mg Aspirin C. 0.4mg Epinephrine D. 15g Oral Glucose
> ...



That would be a second. Another way to do a second would be "You're patient is in anaphylaxis, what receptor does the first line treatment work at?"

Alternatively, you can do a third level which would be the scenario with asking what the mechanism or side effect of the treatment is. You can even go to a 4th degree by asking the mechanism or treatment of a side effect.


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## Jon (Feb 9, 2012)

Hey Chip - A quick comment about you first question. From observation, if you contact the publishers (Elsiver, Brady, AAOS) and explain that you are shopping around for a book for you class... they will often send you out sample copies to review at low or no cost.

Jon


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## sdover (Feb 10, 2012)

Great info in this thread.
I guess the point is you can't please everyone as everyone learns in different ways.


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## Veneficus (Feb 11, 2012)

sdover said:


> Great info in this thread.
> I guess the point is you can't please everyone as everyone learns in different ways.



When any student fails, the instructor fails.


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