How Do We Bridge The Gap In EMS Training?

[RocketMedic]

Inspired by this TED Talk: http://www.ted.com/talks/ken_robinson_how_to_escape_education_s_death_valley

Let's be honest with ourselves here- American EMS training is wildly variable in quality, accessibility and employment potential, does a generally-horrific job of preparing us to work and hobbles us both personally and as an industry due to a massive emphasis on certain areas to the total exclusion of most other relevant topics and the near-total exclusion of things that aren't commonly-tested NREMT skills. We've all seen it firsthand- the EMT training that dictates C-spine/Maybe hemorrhage control/A/B/C (until like 2010, and still in a lot of places) as the only treatment for trauma, the total reliance on AHA or protocol books for knowledge for most of us, the near-complete disregard for college education, etc.

We, as a profession, don't just eat our young, we actively teach them wrong, eat them when they're confused and often can't actually teach them ourselves, and we tend to hold up the same inadequate standards we claim to be beyond as holy grails for students.

How can we change this?

 

[irishboxer384]

Inspired by this TED Talk: http://www.ted.com/talks/ken_robinson_how_to_escape_education_s_death_valley

Let's be honest with ourselves here- American EMS training is wildly variable in quality, accessibility and employment potential, does a generally-horrific job of preparing us to work and hobbles us both personally and as an industry due to a massive emphasis on certain areas to the total exclusion of most other relevant topics and the near-total exclusion of things that aren't commonly-tested NREMT skills. We've all seen it firsthand- the EMT training that dictates C-spine/Maybe hemorrhage control/A/B/C (until like 2010, and still in a lot of places) as the only treatment for trauma, the total reliance on AHA or protocol books for knowledge for most of us, the near-complete disregard for college education, etc.

We, as a profession, don't just eat our young, we actively teach them wrong, eat them when they're confused and often can't actually teach them ourselves, and we tend to hold up the same inadequate standards we claim to be beyond as holy grails for students.

How can we change this?

Without wishing to hijack your thread....do you ever think the EMS industry (paramedics and emts) can be a bit hard on themselves regarding the advancement of education and protocols etc? For the record I am not saying things are fine as they are, far from it...but my opinion is that is that paramedics are not lacking education or decent protocols anymore than the police for example.

When I compare Medics to law enforcement (and fire fighters), then I do so because collectively they are the first response that the public requires...I'm not talking here about comparing EMS with a physician or a nurse...because I see them as being in a different career...they are in the 'HQ' not 'in the field'. In the same way as a doctor has the end product of a patient after a paramedic...a judge has the end product of a suspect/criminal..yet we do not expect the police to have the same knowledge about the law as a judge...nor could we expect a paramedic to have the same knowledge as a physician.

The biggest difference is that medics in the US seem to seek recognition/respect in the same fashion as the law/fire service, which I believe is already earned and merely not given. Perhaps more blame is on the system itself- the lack of suitable respect/reward, rather than paramedics not being sufficiently educated/trained?

 

[RocketMedic]

Disagree, Irish. The police constantly apply new practice and law to their daily operations, those that don't adapt make expensive mistakes. Fire is mired in tradition. EMS as a whole will keep performing many of the same treatments, but our educational system is broken.

 

[Carlos Danger]

I don't think there's any question that paramedic education has plenty of room for improvement. We can debate exactly what that means, but suffice it to say that we are all in agreement that our education could and should be of better quality and of a higher degree of standardization.

However, I also think we tend to inaccurately blame too many of our profession's problems on our education. Everything from low pay to lack of opportunities to lack of respect to system status management to the fact that some less-than-stellar paramedics exist seems to get blamed on the current educational model.

So while I do think we need to work towards better education, we also need to recognize that many of the factors that we like to fantasize about changing probably actually have little to do with the way we are educated, and more to do with things like public safety culture, the basic role of EMS, the lack of effective PR as compared to police and fire services, the fact that the field naturally attracts relatively young and inexperienced and "enthusiastic" personalities, the way EMS services are funded, etc.

I just don't see how adding a few pre-reqs and tweaking the curriculum (which is pretty much all we can realistically ask for; let's fact it - MS or even BS degrees are not going to be the norm in paramedicine any time soon) is really going to change much. It's a good start, but it's not a panacea.

 

[irishboxer384]

Disagree, Irish. The police constantly apply new practice and law to their daily operations, those that don't adapt make expensive mistakes. Fire is mired in tradition. EMS as a whole will keep performing many of the same treatments, but our educational system is broken.

Entry techniques, arrest/restraint techniques, law...is constantly changing and some departments and agencies differ from others in how up-to-date they are, I think it is similar to how some EMS systems are more up-to-date with current studies/protocols. Agree to disagree though

 

[RocketMedic]

Irish, that's a very fair and valid point. Not all services are antiquated.

 

[irishboxer384]

I only come at the discussion from this angle for 3 main reasons:

1- education and skills are at a similar level between 3 services- police academy, fire academy, and paramedic school

2- 3rd service county providers have similar levels of testing and background checks to apply/be employed for city/government department

3- when you dial 911 the basic idea is you have a fire, medical emergency or criminal activity in your vicinity

As a non-US citizen it saddens me to see paramedics not treated with the same level of respect/benefits as our other emergency service counterparts. As for bridging the gap in education, it's like a chicken/egg scenario...will there be pay incentives in place to attract degree holders, or will those incentives only come about once the majority of EMS possesses a degree within the field?

 

[RocketMedic]

I honestly don't think there will be any pay increases or educational incentives until the market demands additional services that we currently cannot provide.

 

[MedicRx]

Without wishing to hijack your thread....do you ever think the EMS industry (paramedics and emts) can be a bit hard on themselves regarding the advancement of education and protocols etc? For the record I am not saying things are fine as they are, far from it...but my opinion is that is that paramedics are not lacking education or decent protocols anymore than the police for example.

When I compare Medics to law enforcement (and fire fighters), then I do so because collectively they are the first response that the public requires...I'm not talking here about comparing EMS with a physician or a nurse...because I see them as being in a different career...they are in the 'HQ' not 'in the field'. In the same way as a doctor has the end product of a patient after a paramedic...a judge has the end product of a suspect/criminal..yet we do not expect the police to have the same knowledge about the law as a judge...nor could we expect a paramedic to have the same knowledge as a physician.

The biggest difference is that medics in the US seem to seek recognition/respect in the same fashion as the law/fire service, which I believe is already earned and merely not given. Perhaps more blame is on the system itself- the lack of suitable respect/reward, rather than paramedics not being sufficiently educated/trained?

I must respectfully disagree with this... While EMS is part of the emergency response system, we are different from firefighters and police officers. Unless you wish to revert to the days of throwing someone in the back and praying they make it while you hastily make your way to the hospital, EMS needs to evolve with medicine, which is its base. If you're suffering from an asthma attack, you expect the same care to be rendered, no matter the provider. This does not necessarily hold true for law enforcement, as in your example. It is the judge's job to decide guilt or innocence, just like it is the lawyer's job to defend or prosecute, and the LEO's job to arrest. It is inherent in the EMS profession that we maintain a certain level of care, and education is essential in that regard. Like it or not, EMS is very much a healthcare field, and it should be treated as such. The development and inclusion of higher education can push this field into a true profession, and allow us, as EMS providers, to regulate ourselves and decide our own fate.