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Duckworth on Education: Teaching BLS Resuscitation in the Classroom

Agree or disagree with the American Heart Association’s recommendations for what medications to use when or how many compressions for each ventilation, the latest AHA scientific statement, “Resuscitation Education Science: Education Strategies,” is something every EMS educator can get behind.

This statement is the AHA’s attempt to answer, “What are the most important things we can do in the classroom to improve performance on the street?” This question is one EMS educators want to answer beyond BLS, ACLS, and PALS programs, and the AHA acknowledges these strategies as “applicable to all resuscitation programs (not exclusive to AHA).”

The statement suggests eight strategies, each with 4–5 recommendations to focus classroom efforts and improve real-world performance. The strategies are:

  • Mastery learning and deliberate practice (practice until learners demonstrate mastery);
  • Spaced practice (shorter, more frequent learning sessions);
  • Contextual learning (use of real-world training contexts);
  • Feedback and debriefing (providing structured opportunities for reflection and feedback);
  • Assessment (measuring competency throughout a course);
  • Innovative educational strategies (exploration of tools to make learning “stick”);
  • Faculty development (continuous coaching and training of instructors);
  • Knowledge translation and implementation (localizing programs to fit learners’ specific needs).

They may not be the most exciting or innovative titles, but when you combine use of evidence-based practices (learning the right things) with evidence-based education techniques (learning the right way), then all the time and effort you spend in the classroom becomes worthwhile with improved patient outcomes.

Strategies for Teaching BLS and ALS Resuscitation

One of the most important but subtle bits of information in the statement is the lack of changes to the AHA education materials. This is because the recommendations are more than simple education tips and tricks. These are true strategies. Employing them successfully can mean changing how you approach teaching. While not every strategy is appropriate for every class session, taken together they can help every healthcare educator improve engagement, test scores, and performance.

One of the criticisms leveled at the AHA and similar organizations is that they are sometimes seen as “card factories” focused more on moving people through certification than helping clinicians provide effective patient outcomes. Wherever you fall in that debate, I’m sure no EMS educator wants to be seen this way. Really using these strategies as intended takes significant time and effort for education coordinators, instructors, and students, especially if you’re dealing with individuals or organizations that haven’t been held to these standards before.

For example, the first strategy in the statement is mastery learning and deliberate practice. This means more than just practicing or even practicing a lot. It means students must be completely clear on performance expectations before they begin practice. It requires that student performance be evaluated (not tested) so progress can be charted and feedback given. It requires that feedback be provided not as instructor commentary but within a structured format where students focus on improving their performance.

The AHA is not releasing new teaching tools right now to go along with these strategies and recommendations. That’s where we come in. In the coming months we’ll focus articles on each of these strategies, breaking down how the recommendations can be applied in effective and practical ways in any EMS classroom environment without breaking the students, the instructors, or the bank.

If you’re a registered American Heart Association instructor, you can find a summary of the statement here, with a list of frequently asked questions here

This statement was released with little fanfare. It would be easy to give it a brief overview and conclude it’s not important because it doesn’t demand any immediate changes to classes being taught and makes many recommendations instructors have heard before in some form. This would be a mistake. While not immediately obvious, the recommendations in this statement not only provide a road map for individual EMS programs as varied as CE classes, EMS refreshers, and initial EMT and paramedic programs, it describes the educational practices we must adopt as a profession if we’re to stay relevant in the rapidly changing healthcare and emergency services industries.

Rommie L. Duckworth, LP, is a dedicated emergency responder and award-winning educator with more than 25 years working in career and volunteer fire departments, hospital healthcare systems, and public and private emergency medical services. He is currently a career fire captain and paramedic EMS coordinator.



Submitted bygheigel on 01/30/2019

Thanks for providing a concise explanation of why these seemingly basic recommendations are worth noting and taking action on within our programs.
Gary Heigel

Submitted byromduckworth@n… on 02/26/2019

You are welcome. Basic yes, but properly implemented everywhere? Sadly, not yet. Hopefully this will prompt more educators to think, "Hey, I really SHOULD back up my evidence-based medicine with evidence-based education techniques."

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