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Head of the Class

“Teaching is not a lost art, but the regard for it is a lost tradition.”

—Jacques Barzun, author and educator

After giving and taking ACLS and PALS classes for 20 years, I generally expect less of those courses when I attend them past the midpoint of five-year AHA cycles. It’s hard for teachers and students to get excited about covering the same material as last time.

That’s why I was pleasantly surprised by my PALS instructor’s engaging approach during a recent refresher. Elizabeth Clinard, RN—an ED nurse most days—annotated the compulsory videos with real-world commentary and was particularly good with first-time PALS students who needed lots of encouragement during practical exercises. At the end of the two-day session, the class’s performance in the dreaded megacodes was the best I’ve seen.

Clinard must have understood that good teachers subordinate themselves to their material. If you think it’s easy for instructors to offer expertise and decode relevance without shifting focus from the curriculum to themselves, try telling your significant other about something that happened at work without making yourself the point of the story.

On the way home from PALS, I considered how lucky I was to have had so many outstanding lecturers during my primary EMT and paramedic programs. Although none of my teachers had formal training as educators, they shared qualities that should make some career instructors envious:

  • Commitment—The best teachers I’ve known have been “all in”—as dedicated to excellence as the finest EMS providers. So many people are affected by our performance, I can’t imagine doing either job without caring about outcomes. Educators on automatic pilot miss almost as much as their students.
  • Creativity—Some EMS lectures can be pretty boring; trust me, I’ve given enough of them. Good instructors try extra hard to punch up material with imagination and even trickery. I had a teacher who used to write with his left hand once in a while instead of his right, just to see if anyone noticed. Sometimes he’d come to class in homemade costumes to help illustrate the day’s lesson. We thought Mr. Clark was crazy, but we sure paid attention to see what stunt he would try next.
  • Availability—Teaching is one of those occupations like medicine and law that doesn’t always conform to eight-hour days. When students or patients or clients need you, they usually need you now—not when you’re next in your office. Unlike doctors and lawyers, though, most teachers don’t have the option of billing for their discretionary time. Excellent educators have to be okay with accommodating pupils’ sometimes-frantic, often-inconvenient phone calls, e-mails and texts. 
  • Enthusiasm—It’s difficult to get excited about presenting dry material after a busy day or night doing your other job, but successful instructors find ways to self-start. Whenever I’d catch myself mumbling to the class about the mysteries of that week’s body system, I’d raise my voice a notch, start walking up and down the aisles and make eye contact with as many students as possible.
  • Charm—I think it would be hard to thrive as a teacher without a baseline fondness for people. Successful instructors can be serious and even strict while publicly rooting for their students to succeed. Gaining a class’s attention without instilling fear often means adding a measure of warmth to each day’s lesson plan.
  • Knowledge—Rule No. 1 of teaching is know the material—trite, perhaps, but I’m betting most of you have endured at least as many unprepared instructors as I have. Trying to anticipate students’ questions was always a big part of my preparation.
  • Experience—You’ve probably heard the saying “Those who can, do; those who can’t, teach.” I’ve seen examples of that, but a more accurate statement, in my opinion, would be “Many who do, can’t teach.” I think field experience is a necessary but insufficient prerequisite for EMS instructors. Classroom experience—as educator and pupil—is just as important.
  • Humility—Formal instruction is an exercise requiring mutual respect between teachers and students. That sometimes breaks down when educators wait to show respect until they get it. I’ve seen much better results when teachers begin their very first lesson with vocabulary, tone and body language that say, “This isn’t about me; it’s about you mastering the material. I’m going to help you do that.”

With self-assured wisdom, we lecture that EMS isn’t for everyone. I can almost hear a student’s cynical comeback: “Neither is teaching.”

Author’s note: Thanks, Bob, Ed, Eric, Paul and Reeve. I was paying attention even when I looked like I wasn’t.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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