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On-the-Job Training: Part 2


In the November issue, we discussed appropriate field training for new hires. This month we review best practices for teaching the EMT student.

The responsibility to train our future coworkers is a big one. These people may be administering RSI medications to facilitate an intubation you will be performing, or they may be driving your ambulance while you’re attending to a patient in the back. An even scarier thought is they may be treating you one day!

Look at the knowledge of the future EMT or paramedic as a snowball. Each generation should have slightly more snow than the last. But this snowball effect can only work if we all do our part to bring up the next wave of wide-eyed, eager-to-learn EMTs and paramedics. What this means is that it is important to provide criticism in the right manner. We must teach without demotivating the future of our great profession.

Make a Good Impression

A young and very nervous EMT student wakes up on the morning of his first ride-along. He puts on his spiffy uniform while thinking about the smock his instructor told him he used to wear when he was a student. “Thank goodness I don’t have to wear that thing,” the student thinks. He zips up his boots, grabs his stethoscope, penlight and trauma shears, and is on his way. He is on track to be 30 minutes early because he was told if you’re early, you’re on time.

He shows up to the station only to find a locked door. He knocks and waits patiently. The door swings open and a grumpy medic and sleepy EMT greet him. “Just sit down until our relief gets here,” they tell him.

Unfortunately, the crew that shows up is even less enthusiastic about the presence of this future EMT. “Great, we have to baby-sit today?” they ask. The student then tags along for the next 12 hours. He sees things he has never seen before, but he is far too scared to ask any questions. He would love to help, but doesn’t want to get in the way. He has essentially become an ignored inconvenience.
The student has his papers signed at the end of the shift and heads home, learning no more than he could have from an old episode of Rescue 911. He was cheated out of 12 hours of quality education, and he now has his first impression of EMS.

Do you remember your first experience in the world that is prehospital emergency medicine? Do you remember showing up at the station for your very first ride-along, nervous and naive? Your first impression of this job, which you intended to make your career, was put in the hands of the crew who greeted you that day.

Students can be like sponges, soaking up every bit of knowledge. It is our job to provide that knowledge. If there was ever a time to give 100%, it is when you have a student rider. As mentors to these disciples, we can teach things we consider are of the utmost importance, and we only have ourselves to blame if they end up lacking these values. Many may look at a student as more work for the same pay. Imagine if you were looked at that way. If you were, wasn’t it awful? Let’s keep the snowball growing. Think about what you have to offer these eager minds.

Create an Appreciated Experience

Teaching while at work does not have to be stressful. There is a multitude of things you can do, which may seem effortless to you, yet are valuable to the novice rider. There are a few simple techniques that may help you create a truly appreciated experience for your next observer.
First, create a comfortable learning environment. This is not the military, and while discipline is important, keep chastising to a minimum. Greet them like a peer, and show them around the station. Introduce them to anyone they may frequently come in contact with. If you make the pupil feel like more of an equal, he or she will be more willing to help out whenever possible.

Avoid patronizing young students. If you treat them like children, they may act like children. Each student’s personality and level of sensitivity will be different. Keep this in mind during moments of feedback. It is important to figure out what will work with each type of personality, and what should be avoided.
It is also important to avoid presenting opinion as factual information that may contradict what their text states. Remember, they still have tests to take on their provided material. Separating the “street way” from the “book way” will help them in the future, but you don’t want to be responsible for them missing questions on their next pop quiz. Times of uncertainty provide opportunity for both the student and teacher to learn.

The apprentice should be a part of every aspect of the job. From truck checkout to patient offload, have them there. They can read their book at home. This may be one of the first times they will actually be in an ambulance or have patient contact, so it is crucial for them to have hands-on experience with the tools of our trade.
At the beginning of the shift, inform the student what is expected from them, and allow them to elaborate on what they expect from you. Let them know what skills they can do while on actual calls. This may motivate them to become more familiar with the placement and use of any equipment they might actually get to use.

Teaching as the lessons become relevant is paramount. To maintain professionalism, tell your patients you are mentoring a student. While actually on the call, explain treatments or skills performed. Emphasize the importance of what they are doing. This will keep them from feeling like they only get to do the needless stuff. For example, explain to them that AHA has recently emphasized chest compressions as the most important resuscitation tool we have. These are the out-of-the curriculum lectures they may remember for their entire career.

It may be difficult to step back and let the observer become the clinician, but it is something they will appreciate greatly. This tutelage may leave a future patient in your debt without you ever knowing.

Important lessons to consider include:

  • Let them give a radio report
  • Allow them to give a report to a receiving nurse
  • Help them develop good bedside manners
  • Teach them about your EMS agency
  • Explain the hiring process

Provide the Right Snow

The main focus is to recognize the importance of our role as leaders. We all have the unique capability to influence EMS by our one-on-one interactions with future EMS professionals. When you consider the snowball metaphor, think about those who added snow as your knowledge grew. We all take bits and pieces from each other, just try and provide the right ones.

Top Tips for Student Riders


  • Greet them and introduce them to others
  • Tell them what is expected of them
  • Explain your pet peeves
  • Teach them everything you love about this job
  • Make them part of the crew
  • Teach them about outside-the-box thinking
  • Explain tunnel vision and why it should be avoided


  • Don’t be too critical
  • Don’t patronize them
  • Don’t present opinion as fact
  • Don’t make them drop out of school in fear of having to work with you someday

Adam Thompson, EMT-P, is a paramedic with Lee County EMS in southwest Florida and an EMS educator with Edison State College. Contact him at

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