Not entirely true...All the Paramedic programs in Maryland I've checked out (HCC, AACC, and BCC...I think UMBC as well) require a minimum number of patient contacts at the basic level before acceptance to their paramedic programs will be granted. That number is either 100 or 150, or may vary between schools.
I would very much like to tell whoever came up with those requirements how absolutely foolish they are. It is blatent stupidity.
Keep in mind at least more than 70% of all EMS instructors have no education other than paramedic class. Even amongst the higher end educators, few of them actually have some knowledge about educational processes.
If an EMS program requires OTJ after the educational period which is not specifically in an academic setting, like a medical residency, clinical, or the like; that program is a diservice to the students and just ripping them off. There is no promise, no telling, and no direction to what those people may be learning in the academically unsupervised employment. There are no learning objectives that must be met, there is no criteria as to what constitutes "patient contact" and no ability to correlate the patient contact with specific experience or understanding.
How exactly does that benefit anyone?
In my last full time employ I worked for a hospital and in the ED we could expect to have 150 patients in a 12 hour shift. Does that mean I saw all of them? certainly not. What if I just poked my head in, said "hi" and asked why they were there? I could have decided they all needed to see a physician and had 150 patient contacts in 12 hours. While you could learn a lot, how much do you think one 12 hour shift would benefit you? Especially when you had no idea what you were looking at as the Basic EMT curriculum is on a lesser level than WebMD.(which is not even for healthcare providers)
At the same time you could work for Dewey, Cheatum, and Howe, IFT company running the dialysis derby and other than lifting a cot and learning how to get from the local nursing homes to the local dialysis center, see 150 patients in a bout a week. What would you do? Take some vitals? Not exactly a difficult skill to master. If it was so critical why wouldn't your EMT program require a week of clinicals? Every program has the authority to exceed the minimum standards. Clearly they don't think it is so important or they would.
What if you volunteer for a year and only see 149 patients? What if none of them are "sick" as often referred to by people who take care of critically ill people regularly? You could see 150 patients and never once perform CPR, attach an AED, control a life threateing bleed, or even put somebody on a backboard. (a skill which is given more time in lifeguarding class than EM class)
Would you be on par with a paramedic student who started clinicals thier second week of school?
I know you didn't come up with this gem on your own, but I hope you can see just how fake it is.
Fear not, I know we all had the best EMS instructor ever. They are all number 1. As well as the only ones any of us ever had.
How about the skill of dealing with people?
What about it? I know doctors who have practiced for decades who can't deal with people. They are absolutely brilliant people and I would trust my life to them, but they are a bit short on people skills.
But aside from that little anecdote, go back to the volunteering scenario. What if you spend 2 years volunteering and only go on 100 calls? Will you know how to deal with people any better than say...the person who works at McDs?
Because they actually lose financially, McDs takes customer service a lot more serious than most EMS or IFT agencies. They actually put you through customer service training. (So does Wendy's for that matter.) So now the McDs grill cook has more customer service training than many EMS providers.
If it was so important, why isn't it given more attention in EMT school?
See the pattern here?
I like to say the purpose of education is so that students don't make the same mistakes I made. They should come up with new and amazing ones. It is the purpose of collective knowledge. It is how we advance as a species.
In short, if a teacher tells you that you have to spend time outside of the educational environment to learn or master specific skills, if those skills are so damn important to the job they should be part of school. You don't get out of any other healthcare related school without all the skills you need to function in your role. even medical residency is an educational position.
I have to see ~40 patients tomorrow morning, strangely enough, I have already mastered all the skills I will need to see them, and I am still a student with clear and predetermined objectives on what I need to accomplish.
