I am already an ARC CPR Instructor, and sent for materials to become an EFR Instructor. Emergency First Response is a company, formed partially by PADI (SCUBA certification agency). Essentially, EFR reframes and rebrands the same material that other courses teach. They teach Primary Care (CPR, life-threatening injuries, assuming quick access to EMS) and Secondary Care (First Aid, longer EMS response times). The materials are all in line with international standards (AHA 2005, ILCOR, etc)
Let me start by saying that I believe as many people as possible should learn CPR, First Aid, etc, but I think they need to be trained properly and refreshed often (I saw a study not too long ago that cited that lay responders only retained their skills for 9 months after training, anyone know where I could find the study again?)
EFR courses are modeled to be self-study for what would be the lectures (using a book and DVD), then a shorter meeting time with skill sessions and a practical assessment.
Several times in the instructor materials they emphasize that "Adequate care provided is better then perfect care withheld", they continue later in the materials, "You want to do the best you can, but it's unlikely a minor error will make much of a difference, much less hurt or kill a patient".
I understand that they are trying to reduce hesitations to act or care. To some degree I agree that participants focused on performing perfect care or perfect skills might possibly be more hesitant to care in an emergency, but I think this goes too far.
"Minor Errors" like poor hand placement in CPR (breaking the xyphoid, causing abdominal injuries, etc, WILL make a difference, and may hurt or kill a patient. What about forgetting a step in assessment, opening an airway before checking for obstructions (like vomit) WILL make a difference, if the patient ends up aspirating, if the patient lives causing PNA, and making the airway harder to control in the short term.
Because of this insistence on “Adequate care”, there are fewer repetitions of practical skills, leading to students learning less and absorbing less material and for less time. As an aside, while AHA and ARC recommend one mannequin for every 2-3 participants, EFR says 1:12 is an appropriate ratio. How much practice are you going to get if you have to wait in line after 11 other students?
What do you think of all of this? I have not yet observed or taught a class for this agency, and I have no idea what actual compliance is like (although I am sure it varied by audience), but I wonder how many students actually do the self study. How many finish it? How well do they retain the knowledge? Do they ask the same questions after the fact that they would while learning the material? What is the pressure to “skim” the book, then “skim” over the review in class? I know that I will be very careful when I teach not to do so, but what do other instructors do?
I can bet that some combination of KEV, Rid and Bossy are going to tell me to run away, fast, but I’m curious what this course has to offer.
So? Among my other questions, what I am really asking is what the value is of perfection in lay response. What is the value of instructor-led lectures? What is the value of repetition in skill retention?
Let me start by saying that I believe as many people as possible should learn CPR, First Aid, etc, but I think they need to be trained properly and refreshed often (I saw a study not too long ago that cited that lay responders only retained their skills for 9 months after training, anyone know where I could find the study again?)
EFR courses are modeled to be self-study for what would be the lectures (using a book and DVD), then a shorter meeting time with skill sessions and a practical assessment.
Several times in the instructor materials they emphasize that "Adequate care provided is better then perfect care withheld", they continue later in the materials, "You want to do the best you can, but it's unlikely a minor error will make much of a difference, much less hurt or kill a patient".
I understand that they are trying to reduce hesitations to act or care. To some degree I agree that participants focused on performing perfect care or perfect skills might possibly be more hesitant to care in an emergency, but I think this goes too far.
"Minor Errors" like poor hand placement in CPR (breaking the xyphoid, causing abdominal injuries, etc, WILL make a difference, and may hurt or kill a patient. What about forgetting a step in assessment, opening an airway before checking for obstructions (like vomit) WILL make a difference, if the patient ends up aspirating, if the patient lives causing PNA, and making the airway harder to control in the short term.
Because of this insistence on “Adequate care”, there are fewer repetitions of practical skills, leading to students learning less and absorbing less material and for less time. As an aside, while AHA and ARC recommend one mannequin for every 2-3 participants, EFR says 1:12 is an appropriate ratio. How much practice are you going to get if you have to wait in line after 11 other students?
What do you think of all of this? I have not yet observed or taught a class for this agency, and I have no idea what actual compliance is like (although I am sure it varied by audience), but I wonder how many students actually do the self study. How many finish it? How well do they retain the knowledge? Do they ask the same questions after the fact that they would while learning the material? What is the pressure to “skim” the book, then “skim” over the review in class? I know that I will be very careful when I teach not to do so, but what do other instructors do?
I can bet that some combination of KEV, Rid and Bossy are going to tell me to run away, fast, but I’m curious what this course has to offer.
So? Among my other questions, what I am really asking is what the value is of perfection in lay response. What is the value of instructor-led lectures? What is the value of repetition in skill retention?