BAD ACLS Instructor??

pinetree

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I've never had a course so poorly taught, and so poorly tested. Please advise if this is how ACLS is currently taught. This is a letter I sent to the facility director:

Dear J.......,

From advisement of the ECC, I would like your feedback
on the ACLS class offered last Saturday. As you are
the program director, I am to bring it to your
attention first. I believe the instructor for the
course was Jason, who might be related to yourself.

In my opinion, the course was grossly deficient and
not up to AHA standard in the following manners:

1. Megacode testing was not carried out individually.
Each individual student must be tested on 2 rhythms in
addition to VF/Vtach and PEA. Instead, the students
were tested as a group, and were allowed to use their
cards and notes.

2. Written examination was to be close book. Instead,
open book, open note, and open discussion was allowed,
and encourage. Multiple individuals loudly
communicated with each other on the answers to
difficult problems. Needless to say, every one
passed.

3. The course was truncated from 4 hours to 2, at the
expense of NO INDIVIDUAL megacode testing. The group
was tested together as a group, and we discussed the
procedures and methods of running the code during the
testing. AHA standard require individual testing with
no coaching, no prompting, and no discussion.

4. Individual's previous ACLS cards were not check to
assure that they are current, and are qualified to
take the recertification course.

5. One individual, who arrived 1 hour late, attended
only about 10 minutes of the discussion, was allowed
to complete the course, and was told "go read the
book". This is contrary to AHA standard that all
individuals must attend the entire training program to
pass the course.

6. Individual skill testing for BLS skill, and
individual written testing for BLS were not carried
out. Individuals who desired the BLS card simply had
to pay a fee for their card. This is done inspite of
significant change in the BLS instruction since 2005.

7. The instructor knowingly passed students who many
by their own admission, have never studied the new
guidelines, and one did not even have her book removed
from the cellophane wrapper.

Based on what I have observed in this class, and
comparing to the many ACLS, BLS, and ATLS courses I
have taken since 1989 - this program was completely
sub-par by any testing organizations' standard.
Individuals who passed and received their ACLS and BLS
certification can not be assured of competency based
on the teaching and testing protocol of this class.

As there might be conflict of interest in the facility
director, and the instructor in this case, I would
like a feedback from your organization on this matter
within 1 week before advancing the concerns to ECC.

Thank you,
 
All I can say is ... Wow!
 
ACLS is a joke now. Instructors are not required to have megacodes and there is no failing the course. As long as you sit through the class, you get a card.
They need to go back to the old days where it was pass or fail!!
 
The sad part is, the class really didn't exist. We barely touched the tip of the iceberg in the changes since 2005.
 
The sad part is, the class really didn't exist. We barely touched the tip of the iceberg in the changes since 2005.

So, wait...did the class actually happen? Confused.
 
1. Megacode testing was not carried out individually.
Each individual student must be tested on 2 rhythms in
addition to VF/Vtach and PEA. Instead, the students
were tested as a group, and were allowed to use their
cards and notes.

** I am not sure how they do that considering the MegaCode testing scenarios come from the instrcutor CD.***

2. Written examination was to be close book. Instead,
open book, open note, and open discussion was allowed,
and encourage. Multiple individuals loudly
communicated with each other on the answers to
difficult problems. Needless to say, every one
passed.
**** It is closed book here******

3. The course was truncated from 4 hours to 2, at the
expense of NO INDIVIDUAL megacode testing. The group
was tested together as a group, and we discussed the
procedures and methods of running the code during the
testing. AHA standard require individual testing with
no coaching, no prompting, and no discussion.

**** Our avg. refresher lasts over 8 hours******

4. Individual's previous ACLS cards were not check to
assure that they are current, and are qualified to
take the recertification course.

**** We make everyone have the new BLS and provide proof of "current" ACLS card. If the card is expired, our entity requires a person to take the full class*****

5. One individual, who arrived 1 hour late, attended
only about 10 minutes of the discussion, was allowed
to complete the course, and was told "go read the
book". This is contrary to AHA standard that all
individuals must attend the entire training program to
pass the course.

**** If we start and you a re not here, you cannot attend*****

6. Individual skill testing for BLS skill, and
individual written testing for BLS were not carried
out. Individuals who desired the BLS card simply had
to pay a fee for their card. This is done inspite of
significant change in the BLS instruction since 2005.

*** Can't see how that would fly either. The main focus of the new ACLS is performing GREAT BLS!!!****

7. The instructor knowingly passed students who many
by their own admission, have never studied the new
guidelines, and one did not even have her book removed
from the cellophane wrapper.

*** How can that be? We require everyone to turn in the pre-test that MUST be completed PRIOR to attending the course!*****

Based on what I have observed in this class, and
comparing to the many ACLS, BLS, and ATLS courses I
have taken since 1989 - this program was completely
sub-par by any testing organizations' standard.
Individuals who passed and received their ACLS and BLS
certification can not be assured of competency based
on the teaching and testing protocol of this class.

As there might be conflict of interest in the facility
director, and the instructor in this case, I would
like a feedback from your organization on this matter
within 1 week before advancing the concerns to ECC.

Thank you,

I put little ** where I made my responses during your post.

Man, no wonder why people are giving ACLS a bad rap lately. I have nothing but hundreds of positive evals from ACLS and PALS classes here. We have had great success with the new guidelines.

I have had ACLS since 1991. I happen to like the way it is taught now. People actually get it. Sorry you had such a crappy deal. Come see us! We have a blast but work hard too!

Kip
 
The class didn't really happened, as it was simply a group discussion of 6 cases on a two sheet (4 page) of 6 rhythm that was handed out to each student.

No overhead projection, no kodachrome, no going through the guidelines. We simply discussed 6 cases, then go to the "group" megacode testing. I can't call it a class. It was a one hour group discussion of 6 cases using our little cards.
 
As one of the first non-physician ACLS instructors; I can attest the now course outline is a joke and there is no longer any credibility in having it. I look for the NREMT to remove it from re-registration requirements soon.

Clarity, first NO one is certified in ACLS per AHA. It is only an educational course, describing you have successfully attended and completed their recommended standards. THAT'S IT!

It is up to the Instructors discretion on how to conduct the course. It is highly recommended to follow their guidelines and suggestions as set forth from the ACLS Task Committee. For as passing the test or not.. who cares? One can re-test after counseling.. so take it & pass somehow.

Megacode testing is no longer evaluating your knowledge and emphasis on per say of cardiac arrest, rather as much as performance as a team leader. Prompts are suggested and can be used, in fact encouraged especially for hospital providers to prevent medication errors.


Pretest is nice. I recommended it since it much harder than the current written forms. However; it again is suggested.

Because of poor course, the availability to recert on line, computer base testing with no skills (except team leader) has led this once accountable course to be nothing and a waste of time. I teach it because we are required to have it... and that's it!

I now see that AHA has invented an "advanced airway" class (that used to be in ACLS) for an optional fee of course $$$$. What is next and IV course, arrhythmia course, defib course... think of the possibility $$$$

R/r 911
 
Actually, I like the 2005 protocols. I like the format of the book, and the comments on effectiveness of the meds that we once memorized so faithfully.

The pretest was good, and I learned so much from zipping through it till I exhausted all the questions it had. The supplemental information was good reading, once you printed it out, about 100 pages.

I think the 2005 book is a big improvement over the last one. Too bad, comments I've gleaned from 2 physician sites similarly commented about the deterioration of ACLS and ATLS programs alike.
 
I put little ** where I made my responses during your post.

Man, no wonder why people are giving ACLS a bad rap lately. I have nothing but hundreds of positive evals from ACLS and PALS classes here. We have had great success with the new guidelines.

I have had ACLS since 1991. I happen to like the way it is taught now. People actually get it. Sorry you had such a crappy deal. Come see us! We have a blast but work hard too!

Kip

Hey Kip you working at TCAD?
 
Hey Kip you working at TCAD?

Nope. Richard Cotter is the EMS educator there. I am the EMS Educator at Ozarks Medical Center in West Plains :)

I run at least 2 PALS and ACLS refreshers a month and an Initial of each every other month. If I ran a class like what was described earlier in this thread I would be out of a job.

We are really strict with ours and follow the AHA guidelines and have great results.

I am lucky though. I have some great instructors to work with including on of the best respiratory/airway guys in the country. He is a respiratory therapist who loves sharing with EMS. For every Medic refresher he brings in pig lungs and vents.

You can't imagine 300,000,000 alveoli until you "see" 300,000,000 alveoli :)
 
Nope. Richard Cotter is the EMS educator there. I am the EMS Educator at Ozarks Medical Center in West Plains :)

I run at least 2 PALS and ACLS refreshers a month and an Initial of each every other month. If I ran a class like what was described earlier in this thread I would be out of a job.

We are really strict with ours and follow the AHA guidelines and have great results.

I am lucky though. I have some great instructors to work with including on of the best respiratory/airway guys in the country. He is a respiratory therapist who loves sharing with EMS. For every Medic refresher he brings in pig lungs and vents.

You can't imagine 300,000,000 alveoli until you "see" 300,000,000 alveoli :)

I still thought he was but was just curious since I know you do a lot of dt classes in that part of SW MO.
 
Oh, it gets even better.

In alot of the ACLS courses around my area--the ACLS card does not reflect the ability of the provider, rather it merely reflects that they have attended the class.
 
I took the eACLS just to be different 2 years ago, didn't quite like it, as it might not be as vigorously proctored as I would like. But the megacode still had to be done in person to get the eACLS card - which, depending on your testing center, can be very vigorous.

Based on what I've read here and elsewhere, ACLS instructors are not following the AHA's guideline on testing. OR that it is the fault of AHA not to make the guideline clear enough on the requirement of testing.

The ECC folks read me the testing standard, and it seems quite clear that Megacode testing is still required. They probably need to make it much more clear on how individuals should be tested.

I agree, a certificate is not an indication of competency, but neither is an MD, DO, DDS, or any other certifications.. But a minimum standard must be made at the point of certification to assure that the instruction is adequate, and that the student preparation is adequate.
 
Yes, I agree. Insructors like the ones mentioned above; not following the proper guidelines, are going to slowly but surely detriment the certification process. I think ACLS should be tested at Pearson Vue centers just like the NREMT, in a controlled environment. This information is critical, and it can mean the difference between life and death in some situations.
 
An example of what I've seen in both a recent BLS class I took, and this pseudo-ACLS class is that not enough emphasis is made on the use of AED's in this transition.

As many AED's in the public are pre-2005 protocols (made before DEC 2006), we will encounter many AED's that will direct the rescuer on the old method.

I believe the current guideline is that for all rescuer to follow the prompts of their AED and follow the format of the AED irregardless of your current BLS/ACLS training.

That means, you can't do CPR immediately after defibrillation if your AED if made in the pre-2005 AHA protocols. Which might mean up to 1/2 of the AEDs found in the community.

This point was not emphasized in my ACLS nor my BLS class.
 
An example of what I've seen in both a recent BLS class I took, and this pseudo-ACLS class is that not enough emphasis is made on the use of AED's in this transition.

As many AED's in the public are pre-2005 protocols (made before DEC 2006), we will encounter many AED's that will direct the rescuer on the old method.

I believe the current guideline is that for all rescuer to follow the prompts of their AED and follow the format of the AED irregardless of your current BLS/ACLS training.

That means, you can't do CPR immediately after defibrillation if your AED if made in the pre-2005 AHA protocols. Which might mean up to 1/2 of the AEDs found in the community.

This point was not emphasized in my ACLS nor my BLS class.

You are correct. The main reason we found behind that practice is under stress people would forget to turn the AED back on. Plus it takes a lot of time (increases hands-off time).

I am glad you take enough pride to want to do it right. I get sick of earing people whine becuase we expect them to do it right. Like I said............ no pre-test.......... you can't stay here.

In our medic refreshers I caught flack for making them pick up a packet and complete about 70 pages of homework prior to the start of the refresher.

After the first one, most quit griping. It made the class easier for everyone.
 
Here is the facility's response, essentially saying that the AHA is blessing their new method of teaching, VERY SAD :sad:

Dear D,

I want to thank you for bringing this issue to my attention and allowing me to respond to each of your concerns.

It is the policy of Life Support Services, Inc. to provide a high quality educational program, consistent with the guidelines of the American Heart Association. When an issue is identified either through the instructor monitoring the program evaluations, or through an email such as yours, it is the policy of Life Support Services, Inc. to take corrective action.

The instructor for this class has been reprimanded and is being reeducated to the AHA testing and evaluation guidelines. His future classes will be monitored closely for adherence to both AHA guidelines and the educational policies and procedures of Life Support Services, Inc.

You had also brought to my attention that the cards were issued with the wrong instructor name on them. This was a clerical error, and new cards with the correct instructor name are being sent to the individual students.

As per your email regarding the class, we can offer a response by referencing the American Heart Association’s Advanced Cardiovascular Life Support Instructor Manual, dated 2006.

1. “Megacode testing was not carried out individually. Each individual student must be tested on 2 rhythms in addition to VF/V-tach and PEA. Instead, the students were tested as a group, and were allowed to use their cards and notes.”
a. Pages 41-42
i. Students are to be tested in groups, and demonstrate competency as the team leader in a cardiac arrest situation.
b. Page 10
i. The Handbook of Emergency Cardiovascular Care may be used during all learning stations and at the Megacode testing station within limits.
2. “Written examination was to be close book. Instead, open book, open note, and open discussion were allowed, and encouraged. Multiple individuals loudly communicated with each other on the answers to difficult problems. Needless to say, everyone passed.”
a. Page 29
i. There are to be no resources used, and any displayed algorithms are to be covered up. The students are not allowed to cooperate with each other. The instructor has been reprimanded.
3. “The course was truncated from 4 hours to 2, at the expense of NO INDIVIDUAL Megacode testing. The group was tested together as a group, and we discussed the procedures and methods of running the code during the testing. The AHA standard requires individual testing with no coaching, no prompting, and no discussion.”
a. Page 42
i. The student is allowed to rely on his/her team for help, but not to over rely or manage most/all of the case
ii. Students should play roles during the test.
b. Page 10
i. The Handbook of Emergency Cardiovascular Care may be used during all learning stations and at the Megacode testing station within limits.
4. “Individual’s previous ACLS cards were not checked to assure that they are current, and are qualified to take the recertification course.”
a. Page 8
i. The “what to bring and what” to wear section simply states to bring the ACLS manual to class. Students are able to use the Handbook of Emergency Cardiovascular Care for Healthcare Providers (which is optional to bring to class) and are also able to use it as a reference guide at some of the stations.
ii. The AHA does not require students to bring their current ACLS card with them to class.
5. “One individual, who arrived 1 hour late, attended only about 10 minutes of the discussion, was allowed to complete the course, and was told “go read the book”. This is contrary to AHA standard that all individuals must attend the entire training program to pass the course.”
a. While it is the intent that students attend every minute of the course, I would hate to think that the door should be closed once the instructor starts talking.
i. Tardy students should be proficient in the knowledge and skills necessary to pass the ACLS course before the exam is taken.
6. “Individual skill testing for BLS skill and individual written testing for BLS were not carried out. Individuals who desired the BLS card simply had to pay a fee for their card. This is done in spite of significant change in the BLS instruction since 2005.”
a. The 2005 changes necessary for BLS competency were covered in the lecture.
b. BLS hands-on was evaluated for competency during ACLS scenarios.
c. Each of the students will be given a BLS written test at their convenience. Life Support Services, Inc. will be contacting each of the individuals in need of the written exam to set this up. The cards have been recalled, and will not be re-issued until the process is completed.
7. “The instructor knowingly passed students who many by their own admission, have never studied the new guidelines, and one did not even have her book removed from the cellophane wrapper.”
a. The students were passed because they demonstrated the knowledge and skills which are required to pass the class.
b. It is necessary to be familiar with the information in the book. It is understood that this is a renewal course, so the students in the class, in fact, already have an understanding of the materials. The instructor does go over the materials, and any questions may be asked during/after the lecture, so long as it is not during the skills testing.



Respectfully,



R.
President, Lif Services, Inc.








CC: J, CEO
 
Is the lack of seriousness regarding this training a reflection of the possibility that if it isn't watered down, that no one would take those courses? I've run across some documents online about training requirements being a reason why many choose to leave EMS, especially in my state.

Not saying it's right or wrong, just wondering why it would be structured the way it is.
 
Crash,

If people can't handle the training, then they need to leave EMS. I left NE because the state won't bring EMS into the 21st century.
 
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