Education - How to Reach not only Brain but Heart

[medic417]

To actually get a true education that will stay with you it needs to be truly in you. To just have an "educator" whether college or diploma mill stand there and tell you everything barely puts the material where it can be recalled long enough to test.
To get truly educated requires effort on your part. You must use all your senses. You must excersise your mind and heart. If you expect and get used to everyone giving you the answers you are cheating yourself and the patients you touch.
It is far better to be given just enough information to get you thinking then go read, research, write out the material. The more effort (excersise) you put into the more it becomes a part of you. Then when you are in the field all alone with the worst case you will know what to do. You will draw that education that you earned, that you worked for back up. You will do what is right for the patient. But if you have just been lectured and done nothing for yourself you will be sitting there sweating going can't my partner drive faster.
So guess what the best "educator", "instructor", "teacher", is the one that makes you work for the education. They give you ideas, they give you illustrations, they point you but they refuse to do it all for you. They make you excercise your mind and heart.

So get mad at me for my vague answers if you want, but I refuse to make it easy for you, because I want you to be the best because your patients deserve the best.

 

[reaper]

We should have milk and cookie time, like we had in medic school.



Oh wait, that was in kindergarden, not medic school. Never mind!!!!!!!!!!!!

 

[JPINFV]

^
You mean like story time?

 

[Ridryder911]

Interesting point. One can attend any program and may graduate representing a piece of poop or maybe the next Vivien Thomas. One cannot predict with 100 % certainty the type of practitioner a program will graduate. Alike anything else, it is dependent upon the person receiving the information on how they apply it.

The basic problem with rushed information is how well is it delivered and covered. How in-depth was it covered and then if possible was their ability to study it in a lab or clinical setting? Was there the ability to debate, research alternatives or study more in-depth such as in thesis or true research studies?

I alike many others know of college, high academic graduates that provide poor care and may not be able to discuss past the basic level. On the other hand, I also know of some that completed a ten month Paramedic program that have excelled and became excellent practitioners.

So then one may ask; then what is the difference?

The difference can be made by several factors:

Usually those that have the desire the drive to really become proficient and ensure to the industries standards will choose the program that has the most detailed program. That is usually at a collegiate and being of full length.

Now, that is not saying one cannot excel. Obvious some do, but they have to so such with it being upon their own accord and without any formal guidance. I would say these type would have excelled no matter what program they attended. We can ask though; how much easier would it had been if they had went to a traditional program?

I will use the analogy I have been using for years. All medical schools use the same minimum standards. They basically teach out of the same texts and curricula and require the same residency standards. Yet, when one is expecting proficiency and above average one will usually look at graduate of Harvard, Yale, etc. The same as in legal profession. Why? The demand placed upon them while in school to achieve more than minimal standards.

Not all countries universities require Medical Doctors to have three to four years after graduate. I know of foreign physicians that Doctorate was only five years total. Not even considered to be graduate level in length to comparison to those in the U.S. Yes, they were smart enough to pass the license level so technically they are physicians. Does this make them inferior or equal? On my personal opinion I feel there might have been something in those two years they missed out on.

We have seen several posters here exclaim how excellent their program was. The evidence sole based upon anectodotal feelings or that they passed their test the first time. Many then later find out that maybe their program was not so great after all; especially after discussing with others the lack of clinical exposure, the lack of depth material and information were presented and explained, the lack of lab and scenario time to ensure that skill and practicum knowledge were safe before entering any patient area.

The main problem I see with "accelerated programs" is the inability of the student to comprehend, adsorb, question the material, and then practice it fully before instituting it. They cannot. Time will not permit a student to challenge a theory or research it fully. One must assume all is correct before the next topic is given. Then how much reaffirmation of theory and skills is tested to ensure that a true comprehension was retained?

Fortunately, EMS curriculum's are simplistic and short enough one can technically cover material in a short simplistic manner. Unfortunately, the current curricula does not meet the demands of our industry nor the requirements of delivering quality patient care. Yes, one can just know enough to be able to deliver the initial therapy or first aid and transport the patient. Obviously, they are able to be hired and work; but are they truly representing the best in EMS and best in delivery of patient care? Again, it goes back to the desire of the individual.

We need to ask ourselves within in the profession; What is the rush? What is the hurry? Why does our industry allow such programs to start or continue?

Again, I believe it goes back to repeated posts. Intense screening of applicants, enforcing of education over training and ensuring the students have the best opportunity to hone their skills and knowledge.

R/r 911

 

[medic417]

Interesting point. One can attend any program and may graduate representing a piece of poop or maybe the next Vivien Thomas. One cannot predict with 100 % certainty the type of practitioner a program will graduate. Alike anything else, it is dependent upon the person receiving the information on how they apply it.


Fortunately, EMS curriculum's are simplistic and short enough one can technically cover material in a short simplistic manner. Unfortunately, the current curricula does not meet the demands of our industry nor the requirements of delivering quality patient care. Yes, one can just know enough to be able to deliver the initial therapy or first aid and transport the patient. Obviously, they are able to be hired and work; but are they truly representing the best in EMS and best in delivery of patient care? Again, it goes back to the desire of the individual.

R/r 911

There are exceptions to every rule. These are the students who take it upon themselves to do what I require of myself and my students. A person must dig. Hopefully the educator provides the treasure map so they can be guided just enough to help find that treasure. Then as you mentioned adding educated discussio/debate even reinforces the education more.

Hopefully we will soon see a much tougher curriculum nation wide. Then we can all provide much more in depth patient care. Then all EMS providers will be actual Medical Professionals rather than ambulance drivers.

 

[VentMedic]

Fortunately, EMS curriculum's are simplistic and short enough one can technically cover material in a short simplistic manner. Unfortunately, the current curricula does not meet the demands of our industry nor the requirements of delivering quality patient care. Yes, one can just know enough to be able to deliver the initial therapy or first aid and transport the patient. Obviously, they are able to be hired and work; but are they truly representing the best in EMS and best in delivery of patient care? Again, it goes back to the desire of the individual.

We need to ask ourselves within in the profession; What is the rush? What is the hurry? Why does our industry allow such programs to start or continue?

I am going to refer to an article that has been around for awhile and some organizations, services or Paramedic program use it as their justification for their minimum standards.

http://www.fd-doc.com/2000Hours.htm

2,000 Hours to train a Paramedic?

by Charles E. Truthan, D.O., FACOFP
Copyright 1998 by FD Doc®

The way some have used the information in this article sets the tone for the educational environment and the mindset of the student approaching the decision to enter EMS.

"In a few short weeks we will teach you everything you need to know to save a life".

Some may hear that quote on a commercial for the school, from the school's admission personnel or the instructor on the first day of class. That instructor probably heard the same statement when they were choosing career and educational options.

The colleges and universities will state something like: "Our job is to provide the students a foundation for the future as well as putting them on the path for a successful career".

While the colleges furnish the student with resources needed to excel, they do put much of the responsibility on the student to make the correct decision to utilize the resources offered to them. The goals the colleges have in mind are for the student to acquire and apply a broad foundation of integrated knowledge, skills, and behaviors needed to live productive, responsible lives.The college will however play a large role in its own success by selectively recruiting students who do have the ambition to succeed by putting the extra effort into their future. The students who want to be part of a college that has high recruitment and educational standards must work a little harder and set their own goals.

The college philosophy does scare some. It involves a little more effort than signing your name on a loan to the school and it involves a long term commitment with a higher goal to achieve to get to graduation.

Trade schools teach students skills to get a job. Entry and exit are both relatively easy. Often the programs are broken down into shorter segments which are easier to accomplish. EMS practices this with its many short steps of "certs". Thus, one is never really made to feel they must go through all the steps. The goals are all presented on the short term with getting an entry level job being the primary focus.

That is not to say trade school training cannot later be developed if the student takes the initiative to gain more knowledge and education. It is just that the design of the training does not focus on the greater good of the profession or patient care which is why most of the "career" health care programs are now in the colleges. These career health care professions have also written their standards to reflect their professional focus with their accrediting agencies present to see the educational goals for the profession are met.

I guess the question still is "Does EMS want to evolve beyond providing first-aid and a ride to the hospital?"

Do the people entering EMS want to be considered as medical professionals? There is still the mentality of "being different" and street smarts are better than knowing theories of medicine. Some have failed to see the relationship between street smarts and medicine. Other healthcare professionals, including doctors, also have "street smarts" but it is referred to as experience. They also found that the more education and knowledge one has enables them to apply street smarts or the experience in many more different ways.

 

[triemal04]

Unfortuately, while that is a valid way to teach sometimes, it can't be the end of it.

Having to find information for yourself is most definetly appropriate, and will usually lead to learning a couple of new things along the way. As well, it can be similar to what happens when someone makes a mistake; that experience gets seared into them, so they (hopefully) don't make that same mistake again. The extra effort required can do the same. But once that information has been found, it is up to the educator, as you've called yourself, to go over that info with the student, ensure that they truly do understand it, argue and debate with them if needed and and thus bring even more knowledge. And if the student hasn't grasped the information, explaining why they are wrong, what the correct answer is and why it's correct, is wholey appropriate. There is more to being a teacher than just saying, "Come back tommorow and tell me everything about the digestive system." Or, "short schools are bad. You figure out why." Effort is required from both sides.

With that being said, there is also definetly a time and place when a teacher will be lecturing students and "giving away" information. Is that the end of the student's learning on that particular topic? Absolutely not, unless the teacher is brainless. Perhaps that is a problem for some. A lecture, or debate, or what have you, lays out a foundation for someone's knowledge; they are still expected and REQUIRED to learn more on their own through study, hands on experience, etc. And then confirm that knowledge by argueing and debate etc etc etc... But something has to be "given away" by the teacher; if the student won't understand what they find on their own, it's pointless. If they don't have some knowledge of the topic, what they learn on their own will take much longer to understand, if done at all. And guess what, that means that the teacher, or educator as some fancy themselves, has failed.

Rather important piece to remember is that when a student who has not, and very well cannot grasp the topic on their own asks for help, it should be given, to one degree or another. Does that mean holding their hand and spoon feeding them info? No. Does it mean ensuring that they have a basic grasp on the information given, that where to look for some extra info can be given is passed on, that answering their questions with actual info not vague answers that will not help them is appropriate? Yes.

There is more to being a teacher than giving a list to people of the topics they need to know and walking away.

 

[VentMedic]

There is more to being a teacher than giving a list to people of the topics they need to know and walking away.

This is why I have always held that if EMS is to evolve, the educational standards must first be raised at the instructor level. Having the minimally educated teaching those even at the entry level does not always foster future growth potential if the instructors themselves have not explored it.

It the instructors were also graduates of schools that offered little in direction or practiced spoon feeding test questions, that may be the only teaching method they know.

Thus, instructors not only need a higher level of understanding of the material they are teaching than their students have but also must be knowledgeable in the methods of educating and training students.

Preceptors should also have some knowledge of these methods also if the clinical experience is to be successful. Rarely will any other career health care program put students into a clinical environment without a designated and qualified instructor/preceptor readily available by some means to that student. Having students just show up at the ambulance company or hospital ED with a list of things to do to be handed to whoever is not the best method for achieving a good clinical experience.

 

[silver]

To actually get a true education that will stay with you it needs to be truly in you. To just have an "educator" whether college or diploma mill stand there and tell you everything barely puts the material where it can be recalled long enough to test.
To get truly educated requires effort on your part. You must use all your senses. You must excersise your mind and heart. If you expect and get used to everyone giving you the answers you are cheating yourself and the patients you touch.
It is far better to be given just enough information to get you thinking then go read, research, write out the material. The more effort (excersise) you put into the more it becomes a part of you. Then when you are in the field all alone with the worst case you will know what to do. You will draw that education that you earned, that you worked for back up. You will do what is right for the patient. But if you have just been lectured and done nothing for yourself you will be sitting there sweating going can't my partner drive faster.
So guess what the best "educator", "instructor", "teacher", is the one that makes you work for the education. They give you ideas, they give you illustrations, they point you but they refuse to do it all for you. They make you excercise your mind and heart.

So get mad at me for my vague answers if you want, but I refuse to make it easy for you, because I want you to be the best because your patients deserve the best.

Well this seems like it is applicable in any subject matter. However in EMS how many of the instructors have degrees in teaching or an advanced degrees? Are they considered academia? Do they do research? What do they specialize in?

Not even all of them have EMS-Is. In know in CT only the head instructor needs to have an EMS-I, the rest are basically viewed as guest lecturers. So when taking the class, I'm basically learning from someone who has more experience than me or is a paramedic instead of someone that is in the academic community. I don't know if this is true with everywhere though, and it is just a general sense that I have.

^^Well vent's post wasn't there when I started, but I agree/expanded on.

 

[medic417]

Does it mean ensuring that they have a basic grasp on the information given, that where to look for some extra info can be given is passed on, that answering their questions with actual info not vague answers that will not help them is appropriate? Yes.

There is more to being a teacher than giving a list to people of the topics they need to know and walking away.

You are correct. But before going in depth and giving them more, they need to prove they have attempted to find the answer. Present the facts they have attained to this point. Then yes you give more guidance. You do instruct them with discussion.

One of the greatest problems I have seen in EMS education is the "professor", "teacher", "instructor", just goes up basically reads the material that should have been studied by the students prior to class. This leads to lazines on the part of students. They then do not even crack a book much less do in depth research. I do not allow this. You will have input for the class discussion, even if its more questions that you have encountered. But you will prove even by pop quiz that you have prepared to be in my class.

If a student is trying but struggling yes I will take them "by the hand" and work with them to help them find the information. Again if they are excersing that is working for the material they will benefit more from it than if I just stand there and give them the answer.

Here on the forums I have seen Vent, Rid and others, including my worthless self, even give them the links and based on responses the ones asking and responding often obviously do not even bother reading. They often want us to spoon feed them the answer which benefits no one in the long run. They want us to provide them a condensed answer rather than reading, digesting, digging more, then returning and discussing intelligently based on their efforts.

 

[triemal04]

That's pretty good. But it's not often followed by you unfortunately. As I said, even from the beginning some information has to be passed on or a student won't know what to look for, or neccasarily understand what they are seeing. This is especially important when dealing with people with less base education than yourself; something every teacher should ALWAYS be aware of and take steps to resolve. Waiting for them to fail and then deciding to help is completely wrong; do not set someone up for failure in learning, they will be more apt to stop than anything. Set them up for success by giving them some info on a topic and a push in the right direction. And then when they ask questions, as they should, given them answers and thus more info, and thus more things they need to look for on their own, not vague halfassed "go do it yourself" crap.

Teaching is a balancing act of teaching the student yourself, and them teaching themselves. It's easy to lean to heavily on one or the other, and it's remarkable how often problems occur when that happens.

What approach works better:

Teacher: We'll be going over cardiac meds next. In class we'll cover what meds they are, the indications/contraindications, and doseages and how to fix potential problems they cause. You will be expected to know how they work, why they work that way, why the indications/contraindications are what they are, how they affect other systems in the body. As always, my office hours are XXX.
Student: takes notes during the lecture, then hits their textbooks, drug reference, study group, etc etc.

Or, you could do this:
Teacher: We'll be covering cardiac meds next. You need to know everything about them. And I of course will never have office hours if you have any problems.
Student: So, which specific meds are we talking about then?
Teacher: The ones that affect the heart.
Student: ...thanks.

 

[medic417]

In education balance should be found. On the forums I do not go into giving the answers. Surprisingly some have done some research then PM'ed me. Then I was able to give them more. But Triemal this is a discussion of EMS education rather than a critique me. Thanks for letting it focus on methods where EMS could improve including pointers for better educating on the forums. Perhaps I can be swayed to try additional methods on the forums as well. Thanks.

 

[mycrofft]

Some potshots, some in the same downrange direction.

1. Some folks learn a lot from a briefing or a lecture, but they tend to be the ones who are mostly "there" already. New folks need to get immersed.

2. Large classes are ineffective except to re-cover rote learning because ther is not enough Q/A and discussion. Too easy to "lay low" and regurge your exam answers. How about you use the big lectures for the undergrowth subjects (anatomy, physicology, and geared to the practitioner not the scientist), then break out to classes of no more than eight per instructor (and one class per instructor) to go "learn the real thing".

3. Consider that some studies show that information learned fully but under duress (fear, rigorous living conditions) stays better than those in friendly low key atmospheres. I hate that but there it is.

4. An observation: I have over the years watched quite a few highly polished, top of the class nurses and EMT's hit the real world, skip off like a stone and become administrators and supervisors. Their real world performance is marginal and either dependent on others', or they are good at shifting blame and covering their tracks, so their paper record is spotless. Then they go on to write the rules, and they promote others like themselves because line people won't play nice. (Sort of like GW Bush's State Department and CIA). Sometimes they can be useful as an interface or with a wider perspective, but they have a tendency to promulgate obfuscation (i.e., "spread manure").

NO program representing themselves as producing working line providers should graduate anyone until the student has exhibited real-life, real-time, no-BS activity.
(So sez me! )

 

[karaya]

I know Rid has touched on this subject last September, but it seems other posters here are not aware of the sweeping EMS educational and Scope of Practice changes that will be implemented starting in 2010 thru 2014. These significant changes include a National EMS Certification Agency, Required Accreditation, a new Scope of Practice that standardizes the levels of EMS education, and most notably, all levels of the new Scope of Practice incorporate competency based education and not just hours based as detailed in the new National EMS Education Standards.

As stated on the NHSTA site:

More importantly, the new Standards represent a major step forward in fulfilling the vision set forth in the 1996 EMS Agenda for the Future (Agenda) and the 2000 EMS Education Agenda for the Future: A Systems Approach (Education Agenda). Unlike the current NSC, the less prescriptive format of the Standards will allow for more frequent and ongoing revision of content consistent with both scientific evidence and community standards of care.

In fact, adopting and complying with the Standards will also enhance flexibility for educational institutions and programs because instructors will be free to develop their own lesson plans — or use any of the wide variety of high-quality publisher-developed lesson plans and instructional resources available. In addition, publishers will be free to update their text books and their instructor lesson plans as frequently as the market demands.

What's more, the Standards are designed to bring about the greater consistency in EMS education called for in the Education Agenda. Based on the EMS licensure levels identified in the National EMS Scope of Practice Model, the Standards define the entry-level competencies, clinical behaviors, and judgments for each level of EMS personnel (Emergency Medical Responder, Emergency Medical Technician, Advanced Emergency Medical Technician, and Paramedic).


Gary Ludwig provided an article last year about the upcoming changes that gives a basic overview of the changes:

http://www.emsresponder.com/print/F...New-EMS-Education-Standards-Are-Coming/3$7705



The current US DOT National Standard Curricula is being replaced with the new National EMS Education Standards (due to be released in 2010). This fulfills the 2000 EMS Education Agenda for the Future: A Systems Approach. The NREMT has endorsed this agenda in numerous areas and beginning in 2014, graduation from an accredited EMS program will be required for NREMT testing. The soon to be National EMS Certification will also mandate accreditation.

The upcoming changes are quite impressive as well as prolific and to save on belaboring the changes, here is a link to see what changes are coming:

http://www.ems.gov/portal/site/ems/...toid=dc4a10d898318110VgnVCM1000002fd17898RCRD

 

[Ridryder911]

Glad to see you brought that up. Unfortunately, the majority of EMS are not educated rather they are trained. Even worse most that perform such are not actually educators rather are instructors. Thus one of the major problems that lie within the EMS itself.

I am glad to the focus upon to allow flexibility of teaching. I am however; horrified that the majority of those that teach EMS are not properly educated enough to perform this. How many of those that teach actually have "lesson plans" formally written other than the curriculum objective?

Fortunately, the publishers of EMS will be placing some insight on how and what to teach as objectives within the first few years as we attempt to increase our educational system.

The problem lies within that our system and profession has outgrown the "training and instructor" mode of teaching. The role and demands of the Paramedic far out weighs the simplistic nature of this distribution way of teaching. We must emphasize that we no longer be thought of as a trade or vocation but actually profession within the medical system.
When declaring such; we must embark as well the demands and requirements that those of that profession require. This means removing the philosophies of training and replacing with those of the adult education. Academia should require more education not only within the profession itself but as well requiring education background too.

Part of the requirements for accreditation is that the Program Director of the EMS site, must possess a Baccalaureate degree. It does make mention that it prefers and advanced graduate degree but at this time does not require it.

For those that do not or have not formally been educated for teaching; there is a far different philosophy of education and training. They are NOT semantics and definitely have opposite goals and ideologies.

It really does comes down to a very simplistic reasoning. If you want to be thought as (respect, pay, benefits) as a professional then one must have achieved the requirements that was placed upon the other health care professionals. You can't have your cake and eat it too.

R/r 911

 

[mycrofft]

YES Rid!! Wholeheartedly agree.

I had that lesson rubbed into my face last summer, and while it was a tough lesson it was not a mean one. Start educating line workers with the interest and aptitude to become educators, not just trainers.
Caveat: have to take some measures to make sure the material stays current and true. Maybe "term limits" for professors between sabbaticals, not just attending seminars and conventions and reading EMTLIFE.

 

[medic417]

Research. Personal effort is the key to getting education. If your instructor tells you everything including exactly where to look you will suffer. It is a true educator that make you dig for the buried treasure.

 

[BossyCow]

One of my biggest training hurdles has been to get the older, more experienced members allow the new folks to do the task incorrectly without correcting them. They learn 'we do it this way' instead of how and why. Allowing a team to stumble through a training leads them to a lot of.. "Okay, go back, start over" and those lessons are never forgotten.

Teaching rote memorization of tasks doesn't help in the real world. I am really irritated with the direction of education in our profession. At least in my state. Canned presentations that efficiently document the presentation of the material to employee x on this date at this time for an interval of y hours doesn't mean shinola. Instructors are being turned into fleshy remote control devices who's job is to advance to the next lesson or administer the practical exam. The agencies that are buying these programs do so because their liability is more of an economic priority than the standard of education in the profession.

I am an adult educator and I take that role very seriously. I wish more did.

 

[medic417]

One of my biggest training hurdles has been to get the older, more experienced members allow the new folks to do the task incorrectly without correcting them. They learn 'we do it this way' instead of how and why. Allowing a team to stumble through a training leads them to a lot of.. "Okay, go back, start over" and those lessons are never forgotten.

Teaching rote memorization of tasks doesn't help in the real world. I am really irritated with the direction of education in our profession. At least in my state. Canned presentations that efficiently document the presentation of the material to employee x on this date at this time for an interval of y hours doesn't mean shinola. Instructors are being turned into fleshy remote control devices who's job is to advance to the next lesson or administer the practical exam. The agencies that are buying these programs do so because their liability is more of an economic priority than the standard of education in the profession.

I am an adult educator and I take that role very seriously. I wish more did.

Very good response. It is true there are to many "instructors" out there. We need more educators. People that make the students work for the answer while guiding them rather than just standing there telling them you need this for the test.

I to wish more took seriously the responsibility of being an educator.

 

[Ridryder911]

Here are some good proverbs of education:

..."If you give a man a fish he will eat for a day, but if you teach him to fish he will eat for a lifetime"......

and for those that prefer short cut courses..
..."If you study to remember, you will forget, but, If you study to understand, you will remember."....


...."Education is a companion which no future can depress, no crime can destroy, no enemy can alienate it and no nepotism can enslave."....

......."Mark Twain
There is nothing education cannot do. Nothing is above its reach. It can turn bad morals to good; it can destroy bad principles and recreate good ones; it can lift men to angelship."...

Ralph Waldo Emerson
..."There is a time in every man's education when he arrives at the conviction that envy is ignorance; that imitation is suicide".....

Malcolm Forbes
..."Education's purpose is to replace an empty mind with an open one."....

Joseph Joubert
.."To teach is to learn twice"....

And the one we should be honoring for our profession is by Laurence Lee
..."The world does not pay for what a person knows. But it pays for what a person does with what he knows."....

Anthony J. D'Angelo, The College Blue Book
..."Never stop learning; knowledge doubles every fourteen months.".....

Anthony J. D'Angelo, The College Blue Book
...."Learn not only to find what you like, learn to like what you find."........

Anthony J. D'Angelo, The College Blue Book
...."Develop a passion for learning. If you do, you will never cease to grow"...........


R/r911