Those of you who teach EMT-B ...

[MtJerry]

I am heading to a course this weekend to become a lead instructor for EMT-B courses here in Montana.

I have been reading (lurking is more like it) here over the course of about a year and have noticed a distinctive trend by the well-respected members here that there is a longing for EMT-B's to be better training.

What kind of suggestions do you have for a new instructor? Obviously, I have to get students to be prepared for the NREMT testing, but what kind of skills do you see as critical for new EMT-B's to learn and master.

Please, this is a serious question and not a stage for "they should move on up to Paramedic" stuff. Most of these students will be volunteers in rural settings stabilizing patients while waiting for ALS to arrive either by ground or air.

I appreciate your comments.

Jerry

 

[JPINFV]

What kind of suggestions do you have for a new instructor? Obviously, I have to get students to be prepared for the NREMT testing, but what kind of skills do you see as critical for new EMT-B's to learn and master.

How strong is your scientific background? Have you at least taken college level anatomy, physiology, chemistry?

What sort of field experience do you have?

What sort of experience and training do you have in terms of educating others?


I think some of the major skills missing is critical thinking and inventiveness. A lot of providers want to run off of flow sheets and one size fits all treatment plans instead of looking at what they're patient has and what's appropriate treatment response. Most of the scenarios I had when I was a student featured patients who were essentially perfectly healthy prior to onset of the obvious disease. Try to make scenarios that have major symptoms for minor complaints (Example from one I ran on the forums). Alternatively, run scenarios with minor complaints that add up to something major.

As an EMT-B, I find my most challenging calls aren't the really sick patients (there really just isn't much an EMT-B can do) or the minor patients. It's the patients in that gray zone who have several symptoms that can amount to major bad ju ju or something relatively minor.

 

[Ridryder911]

First; I hope you have at least one year teaching experience as a lab or practicum instructor prior to ever being a lead instructor.

The other points is all the material is essential. In fact, there is so much left out that is essential it is shameful. Be sure to never say or think .."you don't need to know this"... If you do, you need to be replaced, everything in curriculum is as essential as the next.

Be sure to time yourself for half lectures and half practice time, with plenty of time to allow scenarios.

Good luck,

R./r 911

 

[fma08]

I know you were asking other instructors, but here's the thing that I think would be good from a student perspective. Get them working on their critical thinking skills. Volunteering to help out basic students while I was a medic student, I couldn't count on both my fingers and toes the number of students that followed their NR sheets to a T and didn't stray an inch from it. The questions on the sheet do NOT equal what they should be asking or doing. So let them know that it is ok to step out of the box and that they should be, even if it is at a basic level, trying to figure out what is going on in the body. Do not let them have a "Need to know" attitude.

 

[MtJerry]

How strong is your scientific background? Have you at least taken college level anatomy, physiology, chemistry?

I have a college degree ... but not in those areas ... I don't plan to teach in a college setting, or to those above the Basic level.

What sort of field experience do you have?

I was first certified as an EMT-B in 1979.

What sort of experience and training do you have in terms of educating others?

I was employed by a large Developmental Disabilities agency as their corporate trainer for a number of years.

I think some of the major skills missing is critical thinking and inventiveness. A lot of providers want to run off of flow sheets and one size fits all treatment plans instead of looking at what they're patient has and what's appropriate treatment response. Most of the scenarios I had when I was a student featured patients who were essentially perfectly healthy prior to onset of the obvious disease. Try to make scenarios that have major symptoms for minor complaints (Example from one I ran on the forums). Alternatively, run scenarios with minor complaints that add up to something major.

As an EMT-B, I find my most challenging calls aren't the really sick patients (there really just isn't much an EMT-B can do) or the minor patients. It's the patients in that gray zone who have several symptoms that can amount to major bad ju ju or something relatively minor.

That's what I'm looking for .. thanks!

The other points is all the material is essential. In fact, there is so much left out that is essential it is shameful. Be sure to never say or think .."you don't need to know this"... If you do, you need to be replaced, everything in curriculum is as essential as the next.

Be sure to time yourself for half lectures and half practice time, with plenty of time to allow scenarios.

We talked about this quite a bit at the Lead Instructor's course this last weekend. Good advice ... thanks!

 

[LucidResq]

I just completed a whirlwind adventure as an assistant instructor for an "advanced first responder" course (it's an in-house SAR thing - EMT-B level minus OPAs/NPAs and meds).

It was one of the most frustrating, yet ultimately rewarding experiences I've ever had. Some students astonished me with their aptitude and I found those learning partnerships very enjoyable. Others astonished me with their complete ineptitude and inability to understand the simplest concepts, no matter how much extra attention and guidance they were given. Some people simply cannot understand EMS - no matter how smart they may or may not be.

Anyways, I'd like to place emphasis on creating a strong foundation in anatomy, phys, pathophys and medical terminology. It's impossible to think critically as an EMT student without a functional understanding of anatomy and physiology. It's easier to learn the A&P thoroughly first and then allow an understanding of disease processes, treatments, etc to flourish out of that, than to do the "A&P crash course" common in most EMT courses today and then try to learn the clinical stuff by rote memorization and trying to work backwards to understand the A&P behind symptoms, treatments, etc.

With my students, I focused on teaching word parts in medical terminology. So instead of simple rote memorization of the term tachycardia, for example, they understood that tachy meant fast and cardia meant heart. They could then apply this to tachypnea, bradycardia, cardiac arrest, etc. I took a medical terminology course prior to my EMT and I found it to be unspeakably helpful, and I received extremely positive feedback on my extended, voluntary medical terminology study sessions.

I also recommend pushing your students outside of their comfort zones. We almost all initially learn to take a BP on a young, healthy adult in a warm, well-lit, and quiet room, which is fine and all - for the first few times. Hopefully the first time we take a BP on a screaming child, an elderly woman with loose droopy skin, or in the back of a noisy rig won't be while we're on our own out in the field. We did pediatrics day in my EMT class - everyone brought their kids in and we practiced assessment, backboarding, etc on them. We took vitals in the back of a running training ambulance with the doors open to a busy road. My first scenario in EMT class was an old guy who vagaled out on the toilet and fell off, wedging himself tight between the toilet and bathtub (we had scenario rooms set up just like real bedrooms, bathrooms, restaurants, etc) and boy was extricating him fun.

Anyways, good luck with your journey as an instructor.