“Don't try to fix the students, fix ourselves first. The good teacher makes the poor student good and the good student superior. When our students fail, we, as teachers, too, have failed.” —Marva Collins
There is a recurring theme that surfaces whenever the topic of EMS continuing education comes up, and that is the value of the card courses. Regardless of where you stand on the topic, there is little else offered in the way of options for a majority of the country.
There are definite weaknesses in the canned-courses model. These classes do not provide a complete education, nor should they be expected to. Their parameters do not allow for enough time to learn the full range of skills or knowledge needed. They provide basic outlines and training in tasks that might help in high-acuity, low-frequency situations. The reality of programs today makes even that questionable, where the ability to “fail” no longer exists and certifications have morphed into course completion. One of the known and major downsides to canned card courses is that everyone walks out with the same card, regardless of the quality of the instruction.
Two and a half years ago I wrote a piece called “Occupy EMS,” and part of it addressed the responsibilities of both students and educators in improving the quality of education. Today I’d like to turn that focus to the people who coordinate the courses.
Even if it hurts to hear it, it is important to remember that EMS is a minimum-competency profession. You must meet the standard in order to become certified, but nowhere does it say you must exceed it. The same holds true for the canned courses. You must provide the content, meet the learning objectives and account for the hours. Beyond that it’s left solely up to the discretion and ability of the instructors and the expectations of the coordinators running the program.
The delivery model of the canned course teaches nationally agreed-upon guidelines to the lowest common denominator. In this age of instant information, they can represent outdated information, at least by today’s standards. The information is also presented to a mix of education and experience levels, some of whom will be unable to use the information or lack the background to incorporate what’s being taught. Then you must factor in the ability and experience of the presenters. How familiar are they with the material? Can they translate it into information usable by the student mix? Are they willing or even able to answer questions and remediate mistakes?
All of these factors work in direct opposition to the point of a canned course, consistency of information. It is possible (and even likely) that two people can carry the same course-completion card from the same year and even geographic area, yet have vastly different educational experiences and subsequent impacts on their performance in the field.
When is a card not a card? When the class did not deliver usable information.
So What to Do?
As a course coordinator, what are some steps you can take to improve your product?
Use quality instructors. Invest time in them. Monitor their progress and have plans for performance improvement. Debrief them, provide them with their reviews. If they are not successful, then address it or do not use them.
Stay apace of the science. Do current literature reviews and keep up with the changes being considered. Open discussions on current controversial topics. Use that information to enhance what is being presented—it will inspire interest in the subject matter.
Make handouts. Create supplemental material with easy-to-read key points, alternative source materials and articles that enhance or further explain the material being presented.
Keep it dynamic and have fun. Nobody likes being put to death by PowerPoint, so don’t. Take the time to use moulage, props, whiteboards and response devices. (Avoid smoke effects indoors; they do not work out so well.) Be creative so the material becomes memorable and therefore usable.
Monitor your student mix. Look at what level of education and experience they are from. Is it heavily weighted toward EMTs? Are there unique providers in the group, like respiratory therapists or physicians? Brief your instructors on the mix so they can adapt lectures accordingly. If time permits, offer additional skill stations that will reinforce high-acuity, low-frequency skills.
Watch your timing. Provide expectations up front. Do not even suggest that students will get out early, because they will hold you to it, and you will fail. Pad your agenda, tack on extra time for topics (or instructors) you know risk going longer than expected. This way, if everything goes well and they get out earlier than the magic paper says, it leaves them with a positive experience, and they’ll feel like they’ve gotten a bonus. With the first topic that runs over, however, they will fixate on that agenda for the rest of the day. So be careful of overruns. You can hold their interest, but you can’t hold them hostage.
You cannot teach self-motivation, but you can do your best to inspire. If students come out with renewed interest and realization of how much more information is out there, then they walk away with a card and applicable knowledge. We have to take that seriously, or we’ve done nothing but contribute to the overall problem.
With all the talk of turning us from technicians into clinicians, of embracing the concept of diagnosing versus describing and with the overall push to create a solid educational foundation to this profession, perhaps we should not be shunning the card courses so much as using them as one of our available vehicles to drive improvement.
Keep them current, keep them dynamic, and invest in opportunities to turn the core content into expanding or embracing new ideas. That’s how we can influence the lowest common denominators and help change paradigms. Love them or hate them, the cards do carry some weight, so ride them instead of shredding them and use them to our best advantage to initiate change, at least until we can come up with a better model.
For students looking into additional classes, there are a lot of excellent programs out there. The NAEMT classes have great content, good textbooks and can improve your practice, especially if they are taught well and you invest in participating. Shop around. If you are going to invest the time and money, make it worth your while. This may be a minimum-competency profession right now, but it doesn’t have to be.