RE: Rantings of an EMS educator

November 3, 2004

,

You set forth the problems very well. The college programs have been beset

by problems caused by know-nothing administrators and clueless bean counters.

College is a BUSINESS. Forget any notions of lofty educational ideals.

And EMS programs are not money makers as a general rule.

I have some comments below.

Gene

>

> Are the problems we see in EMS education an education problem or a

> problem with what employers expect from a person leaving one of our

> training faculties?

>

Yes, of course. Doctors are not expected to be able to practice like a

veteran at the end of medical school. There are internships and residencies.

Again. EMS is a BUSINESS. Whether it's carried on by private providers or

public, business concepts drive it, not healthcare concepts.

When Jane and I and were at Tyler Junior College, our program was

structured to make students street ready. We did this through extensive

clinical and internship training, beginning almost immediately after the

beginning of

the course. We had many battles with those who thought that students should

only go on internships after the course and clinicals are complete.

They're quite wrong. There is much about being a medic that has little or

nothing to do with medical skills. Learning the business aspects, how to check

out the ambulance, where things are kept, what the supplies are, call

response policies, radio procedures----and a zillion other factors can be

learned

before a student is ever ready to touch a patient. Starting internships

early gives the student time to see how calls go, and gradually to learn how to

assist in very important ways such as going and getting things, listening and

watching before being put into a position to have to perform under pressure.

Getting to see how to get stretchers in and out of tight places, tricks of

moving and lifting that are never covered in class, how to talk to patients.

All these things are important. And too many courses do not afford the

student time to learn these things prior to actual patient care beginning.

> In very few education settings do we expect

> those who are completing their formal education to be fully

> functional in there profession? By example when my son finishes his

> degree in business I do not expect him to be hired as the chief

> executive officer for a fortune 500 company, nor does the company

> hiring him expect the same, what they want is someone who understands

> the general concepts of the job and that is will to learn from a more

> seasoned person within there company. For many years within this

> country we had an on the job training process through internships or

> apprenticeship for many technical professions and we choose to leave

> them behind for a more formal training such as college or prep

> schools. Many EMS employers want these new medics to be able to fill

> a spot in there rotation with out additional experience.

> I ask these questions because of the dialog on this list of the last

> few days has had a lot of discussion on EMS education and the

> pitfalls of the education process. I for one do agree that there are

> many ways to improve the education process and improve EMS through

> education. I am all for the meetings that have been discussed here on

> this list. And look for ways to improve this program and myself as an

> instructor. As an EMS educator with approximately 7 years experience

> teaching and the last 5 of those as an assistant program director at

> a Community College, I too am becoming fully frustrated by many thing

> that have been discussed that affect our ability to educate our

> students. Some of the most frustrating are students that arrive in

> our classes with NO study habits, students that can not read a text

> that is written at a 9th grade level, students that within the local

> public schools that have been allowed to retake exams multiple times

> until they pass, students whose mothers call because I must be

> picking on her child and he really should be given more attempts to

> complete projects and such.

>

There's no question in my mind that students are less prepared today than

they were 15 years ago. My first class at TJC, in 1989 was made up of people

of

the average age of 27. They were well motivated, could read, write, and

spell, and had learned good work habits through several years in the workforce.

We discouraged 18 year olds from coming to the program. Enter greedy

administrators. You WILL enroll as many as possible. Damn the entry

requirements. You WILL graduate them. Then, as you say, the administrators

lambast you

because your students cannot pass the national exams.

This bullshit about testing students and passing exams that the politicians

have imposed upon our public schools has led to a situation where students are

taught nothing except how to pass a specific exam. No wonder they cannot

think critically. High schools are doing a criminal job of education, but

parents and a generation of students who are lazy, spoiled, and arrogant are

also a

part of the problem.

I have actually had the mother of a student, a college student, argue with me

because little Suzy was failing. Little Suzy couldn't spell, read, or

write, was lazy, had no sense of responsibility, didn't understand anything

about

deadlines, couldn't understand why cheating wasn't allowed, and so forth.

> I am frustrated by administrators at my

> school that think I should pass a certain percentage on students that

> start a class and then are upset that the student has trouble passing

> a National Certification Exam. I think you get the idea that we can

> find many things to be frustrated about. But what amazes me the most

> that many employers expect that they should be able to hire a fresh

> graduate and use them as though they have years of experience in all

> aspects of emergency care a new grad should never have trouble

> intubating a patient, never have trouble starting IV's if they do it

> has to be a education problem.

> I know that many students I have will have trouble with written exams

> and those exams tell me very little about how they will perform in an

> actual emergency, I many times wished that there were a way to

> certify a individual that included more than a multi-guess exam. Yes

> we test skills but under very sterile conditions. What I really want

> to know is how did the person perform under the distress of an

> emergency.

>

A big part of the education summit will be examining ways to do just that.

It involves extensive scenario practice with lots of stressful situations

built in, allowing the students to critique themselves and structure their own

improvement strategies, use of problem based learning, group learning, team

learning and practice, and so forth. That's what this summit will be about.

GG

> I guess what I am trying to say is that there are bad students, bad

> instructors, bad programs and bad employers. NO I am not saying

> everyone or every program must be completely redone. What I suggest

> is that we try to look at all aspects of the problem and not just

> focus on a small part and hope it will repair all the problems within

> EMS Education at one time.

> Sorry that I ran this so long but today has been one of those

> wonderful days at the college and I had much to vent about. I am sure

> that some on this list will disagree with the above statements, and

> if you do and reply I will listen to your thoughts as well on this

> subject, because that is where we learn many things is listening to

> each other.

> Thank you for reading my rants of the day and any comments that you

> might have.

>

November 3, 2004