Guest guest Posted August 29, 2004 Report Share Posted August 29, 2004 Phil- It really becomes an expectations game. If you only expect mediocrity, your students certainly aren't going to give you anything more than that. I believe some of it does have to do with the current curriculum. Instead of teaching students that beta blockade is useful in ischemic chest pain, they need to be challenged to understand WHY it is useful in ischemic chest pain. This isn't about teaching individuals to think critically- if they can't do that they have no business in EMS. It is about requiring some synthesis and evaluation instead of just requiring them to regurgitate some worthless little saying like " All chest pain gets MONA " . I suppose everything comes down to expectations. As Dr. Bledsoe pointed out, most EMS companies only expect a patch and a pulse. You have the problem of the best and brightest choosing NOT to enter a field where they will consistently make between $9 and $15 per hour, so it is a perpetual cycle. Let's not be mistaken here- high schools are still turning out some VERY intelligent people. There isn't a vacuum in that regard. They just don't want to think about EMS as a career. I have decided to go back and get my bachelors degree in EMS. But do you think anyone I will work for will give a damn whether I have a baccalaureate degree vs. a certificate from the local mom and pop? NO! Nobody cares, and so there is no incentive. Because there is no incentive, I don't think it will change. - RE: Entrance testing --- scotterems@... wrote: The individuals who fail the > National Registry exam with a 69% > do not fail it by 1 percentage point. They > fail it by 31 points. If you > can find a couple of questions that you do not > consider to be appropriate, > there are still 29 or 30 that were perfectly > legitimate. Nicely stated. My very first EMT instructor told me 20 years ago that a standardized test only tests about 70% of the curriculum anyway, so if a candidate writes a perfect score, s/he has demonstrated knowledge on only 70% of the curriculum. I don't know if that's true or not, but it lead nicely into his very next statement, which was " so keep studying forever. " > So where is the problem? I believe it > originates from both the students and > faculty of paramedic training programs. Maybe. I'll argue that it is not the Paramedic Program's job to teach a student to read and write English. A student should have those basic skills when they graduate from 6th grade. What I disagree with, however, is that (a) a program should test at the 6th grade level, and ( that a 6th grade level should be acceptable performance for a Paramedic student. After all, I don't want my 6th-grade daughter making life-and-death decisions, [ALL UNITS: Stand by for Proud Daddy moment] even though she reads at the 12.8 grade level, according to standardized tests. > However, I also believe that > instructors have failed miserably in requiring > at least some degree of > critical thinking from students. I hate having to teach adults to think. Thinking, in my opinion, should be a basic skill. That's like saying I'll give you a tool set and then teach you to work on cars. You mentioned > that " Not any one > protocol... will fit every system " . That is > very true, and it clearly > represents why the emphasis must be placed on > understanding the rationale > behind the protocol rather than merely > memorizing the protocol itself. Well said. > There is probably not one protocol that is > appropriate for every EMS system- > at least not one I have seen. But if you teach > students to understand the > fundamental concepts that underlie the > protocols, they can take those > concepts and use them to develop a basic > understanding that can be applied > to almost any protocol or treatment strategy. Again, well said. The > cream floats to the top and the sludge sinks to > the bottom, and when you > only expect a sixth grade level of reasoning, > you are dragging the bottom of > the bucket. You don't suppose that bears any relation to the generally sorry pay scales, do you? I wonder... stay safe - phil Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2004 Report Share Posted August 30, 2004 How about using high school GPA's and/or references along with a entrance exam? I've noticed that it's not all the student fault, but sometimes the instructor. Many courses in my area are weak because all the instructor does is read the slides and has no interaction with the ones needing the knowledge and scenario training. The students may say they understand but in all actuality they don't. Lee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 31, 2004 Report Share Posted August 31, 2004 Dudley, I agree whole completely. It is just that Politics and Administrastion sometimes set the rules we have to live by. I do everything I can to insure that the students have the knowledge they need to compete on a national basis, but even then their previous education makes it imposible for them to compete in the market place. In my early career I thought well maybe if I just make them good at skills they will do O.K., but that was a self defeating trap. If you don't know why you do something, then you may never know when. This has always been a burr under my sadle, and it is a sosre that never heals. Until we as a group are able to set down and devise a way to wrest controm of EMS from Politics we may be dooooooommmmmmmeeeeeed as you put it. Re: Entrance testing > , > > Although it is frustrating, we cannot have this type of self-defeating attitude. Many of our stellar paramedics and emt's came into this business knowing that what they would get paid was probably not the best they could do, but they had a drive to do it in the first place. They have natural talent and they have excelled. > > There is another group who has the potential to excel but needs the assistance and instruction provided by a " center of excellence " in EMS education. These folks can/could also excel given the proper training environment and the proper work and problem solving instruction. > > Lastly are the group of people who either do not have the talent/ability or are merely looking for a quick answer that can get them by. This group of people are served by educational environments where they can merely coast along, be given 2nd, 3rd, 12th chances with plenty of " namby-pamby " extra credit assignments so they can squeak over the passing bar by 0.01 points to try 6 times to pass a 'standardized' test so that they can go to work where they hope to never have to answer a nap-interrupting EMS call. > > It should be our job, as experienced EMS leaders and providers to take steps to do everything possible to encourage and help the 1st 2 groups of people I described while trying to weed out the last group. > > This is a 'chicken or the egg' argument, but if we just accept whatever walks in the door, we attract more of group three and drive those in groups 1 & 2 to other professions (nursing, PA, RT, etc). > > If we want to cry and complain about money not attracting the right people, then we are ddddoooooooooooommmmmmmmmmmeeeeddddd to that self-fulfilling prophecy. If we work on providing the learning environment that attracts 1 & 2 at the expense of 3, then we will be able to advance our practice of medicine to a point where we can continue to prove and provide care and services for more and more reimbursement. > > If we do not reverse the current trend (caring more about people passing and feeling good about themselves than we do about them actually knowing the information and able to practice it) then we will continue to progress more towards ambulance driving yahoo's who occasionally get a new toy to play with and farther away from respected partners in the overall health of our patients and communities. > > YES...entrance exams should be mandated...and students should be rigorously educated to be able to effectively pass written and practical exams appropriately on repeated occasions. Everyone who has been a paramedic longer than 12 years...how was your ACLS class back then compared to the last one you took??? Which one did you sweat having to do a mega-code in??? Truly, which one did you take away more from? > > Having to pass a mega-code the night before the state exam or being dropped from the class was tough, probably " unfair " and VERY stressful...BUT I learned the information and can perform well today from instinct based upon that level of training and practice. > > Just my thoughts...but anything we can do to make it harder to get into the training programs will draw better candidates and decrease problem-children...leading to better EMS practice regardless of what the pay is. > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 31, 2004 Report Share Posted August 31, 2004 Dudley, I agree whole completely. It is just that Politics and Administrastion sometimes set the rules we have to live by. I do everything I can to insure that the students have the knowledge they need to compete on a national basis, but even then their previous education makes it imposible for them to compete in the market place. In my early career I thought well maybe if I just make them good at skills they will do O.K., but that was a self defeating trap. If you don't know why you do something, then you may never know when. This has always been a burr under my sadle, and it is a sosre that never heals. Until we as a group are able to set down and devise a way to wrest controm of EMS from Politics we may be dooooooommmmmmmeeeeeed as you put it. Re: Entrance testing > , > > Although it is frustrating, we cannot have this type of self-defeating attitude. Many of our stellar paramedics and emt's came into this business knowing that what they would get paid was probably not the best they could do, but they had a drive to do it in the first place. They have natural talent and they have excelled. > > There is another group who has the potential to excel but needs the assistance and instruction provided by a " center of excellence " in EMS education. These folks can/could also excel given the proper training environment and the proper work and problem solving instruction. > > Lastly are the group of people who either do not have the talent/ability or are merely looking for a quick answer that can get them by. This group of people are served by educational environments where they can merely coast along, be given 2nd, 3rd, 12th chances with plenty of " namby-pamby " extra credit assignments so they can squeak over the passing bar by 0.01 points to try 6 times to pass a 'standardized' test so that they can go to work where they hope to never have to answer a nap-interrupting EMS call. > > It should be our job, as experienced EMS leaders and providers to take steps to do everything possible to encourage and help the 1st 2 groups of people I described while trying to weed out the last group. > > This is a 'chicken or the egg' argument, but if we just accept whatever walks in the door, we attract more of group three and drive those in groups 1 & 2 to other professions (nursing, PA, RT, etc). > > If we want to cry and complain about money not attracting the right people, then we are ddddoooooooooooommmmmmmmmmmeeeeddddd to that self-fulfilling prophecy. If we work on providing the learning environment that attracts 1 & 2 at the expense of 3, then we will be able to advance our practice of medicine to a point where we can continue to prove and provide care and services for more and more reimbursement. > > If we do not reverse the current trend (caring more about people passing and feeling good about themselves than we do about them actually knowing the information and able to practice it) then we will continue to progress more towards ambulance driving yahoo's who occasionally get a new toy to play with and farther away from respected partners in the overall health of our patients and communities. > > YES...entrance exams should be mandated...and students should be rigorously educated to be able to effectively pass written and practical exams appropriately on repeated occasions. Everyone who has been a paramedic longer than 12 years...how was your ACLS class back then compared to the last one you took??? Which one did you sweat having to do a mega-code in??? Truly, which one did you take away more from? > > Having to pass a mega-code the night before the state exam or being dropped from the class was tough, probably " unfair " and VERY stressful...BUT I learned the information and can perform well today from instinct based upon that level of training and practice. > > Just my thoughts...but anything we can do to make it harder to get into the training programs will draw better candidates and decrease problem-children...leading to better EMS practice regardless of what the pay is. > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 31, 2004 Report Share Posted August 31, 2004 Dudley, I agree whole completely. It is just that Politics and Administrastion sometimes set the rules we have to live by. I do everything I can to insure that the students have the knowledge they need to compete on a national basis, but even then their previous education makes it imposible for them to compete in the market place. In my early career I thought well maybe if I just make them good at skills they will do O.K., but that was a self defeating trap. If you don't know why you do something, then you may never know when. This has always been a burr under my sadle, and it is a sosre that never heals. Until we as a group are able to set down and devise a way to wrest controm of EMS from Politics we may be dooooooommmmmmmeeeeeed as you put it. Re: Entrance testing > , > > Although it is frustrating, we cannot have this type of self-defeating attitude. Many of our stellar paramedics and emt's came into this business knowing that what they would get paid was probably not the best they could do, but they had a drive to do it in the first place. They have natural talent and they have excelled. > > There is another group who has the potential to excel but needs the assistance and instruction provided by a " center of excellence " in EMS education. These folks can/could also excel given the proper training environment and the proper work and problem solving instruction. > > Lastly are the group of people who either do not have the talent/ability or are merely looking for a quick answer that can get them by. This group of people are served by educational environments where they can merely coast along, be given 2nd, 3rd, 12th chances with plenty of " namby-pamby " extra credit assignments so they can squeak over the passing bar by 0.01 points to try 6 times to pass a 'standardized' test so that they can go to work where they hope to never have to answer a nap-interrupting EMS call. > > It should be our job, as experienced EMS leaders and providers to take steps to do everything possible to encourage and help the 1st 2 groups of people I described while trying to weed out the last group. > > This is a 'chicken or the egg' argument, but if we just accept whatever walks in the door, we attract more of group three and drive those in groups 1 & 2 to other professions (nursing, PA, RT, etc). > > If we want to cry and complain about money not attracting the right people, then we are ddddoooooooooooommmmmmmmmmmeeeeddddd to that self-fulfilling prophecy. If we work on providing the learning environment that attracts 1 & 2 at the expense of 3, then we will be able to advance our practice of medicine to a point where we can continue to prove and provide care and services for more and more reimbursement. > > If we do not reverse the current trend (caring more about people passing and feeling good about themselves than we do about them actually knowing the information and able to practice it) then we will continue to progress more towards ambulance driving yahoo's who occasionally get a new toy to play with and farther away from respected partners in the overall health of our patients and communities. > > YES...entrance exams should be mandated...and students should be rigorously educated to be able to effectively pass written and practical exams appropriately on repeated occasions. Everyone who has been a paramedic longer than 12 years...how was your ACLS class back then compared to the last one you took??? Which one did you sweat having to do a mega-code in??? Truly, which one did you take away more from? > > Having to pass a mega-code the night before the state exam or being dropped from the class was tough, probably " unfair " and VERY stressful...BUT I learned the information and can perform well today from instinct based upon that level of training and practice. > > Just my thoughts...but anything we can do to make it harder to get into the training programs will draw better candidates and decrease problem-children...leading to better EMS practice regardless of what the pay is. > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
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