aussiephil Posted April 15, 2008 Posted April 15, 2008 I read with interest the thread http://www.emtcity.com/phpBB2/viewtopic.php?t=1462 My intention here is not to enter the duration of education, more so, should all EMS training in its initial phases be purely didactic, or should they contain some form of hands on training & assessment as well - ie. with real patients, under supervision. Further, should this be repeated as each clinical level is obtained? Consider you answer very carefully, because if you are in favour of more education, do you then think that EMS should be recognized as a medical 'specialty' & if so should it be removed from fire completely, as they are 2 separate & distinct professions. Should EMS be in charge of rescue, should it be fire? If it is medical, not mechanical, should it be incorporated as part of your initial training, or be a stand alone sub specialty? I will read your replies with keen interest
JPINFV Posted April 15, 2008 Posted April 15, 2008 My intention here is not to enter the duration of education, more so, should all EMS training in its initial phases be purely didactic, or should they contain some form of hands on training & assessment as well - ie. with real patients, under supervision. IF properly implemented and IF properly supervised, this would be a good thing. To use an example from a medical school, the school I'm currently getting my masters degree at has their med students in the hospital talking to patients the first semester of their first year. The problem, though, is that I can also see something like this back firing big time. Further, should this be repeated as each clinical level is obtained? Yes. Consider you answer very carefully, because if you are in favour of more education, do you then think that EMS should be recognized as a medical 'specialty' & if so should it be removed from fire completely, as they are 2 separate & distinct professions. Yes, EMS should be separate from fire suppression. Th most fire suppression training EMS should have is how to use a fire extinguisher. Should EMS be in charge of rescue, should it be fire? If it is medical, not mechanical, should it be incorporated as part of your initial training, or be a stand alone sub specialty? I will read your replies with keen interest The basics of extrication should be taught. Yes, it is mechanical, but it is still very pertinent to prehospital care. If a system wants to take over extrication completely, then they can always train up more themselves.
aussiephil Posted April 15, 2008 Author Posted April 15, 2008 One of the biggest problems, as I see it, & I know a number of those in the chat feel the same, is the number of 'medics' who are paper medics, cause they have the pice of paper that says they are, try to argue BS. They have minimal understanding of the realities of working on the street & for the most part, the scenarios proposed are unrealistic (how many codes do you save while studying & in your pracs in class??????) I have seen people trying to argue that we should be closley monitoring pt's for the amount of saline we infuse so they dont get an electrolyte imbalance (classroom thought). Reality tells us if we have a pt that we need to infuse thatmuch fluid into rapidly, well, they are damn sick & close to meeting their maker & the electrolyte issue is a nonsense. It seems that we learn a lot of nice to know stuff, but how much is really practical for what you do?
Just Plain Ruff Posted April 15, 2008 Posted April 15, 2008 I agree fire should be out of patient care and EMS should be out of fire suppression. If I need my patient put out then I'll call the fire guys. If the fire guys put a patient out then they should call me. anything else is semantics.
JPINFV Posted April 15, 2008 Posted April 15, 2008 Whats "[s:f27ae2a2c5]T[/s:f27ae2a2c5]hands on Training"? Better?
Dustdevil Posted April 16, 2008 Posted April 16, 2008 Better? Hey, he wasn't just being a smart arse. I too actually thought Phil was quoting some court case or something at first. You know, like Brown v. Board of Education.
Timmy Posted April 16, 2008 Posted April 16, 2008 Even though I’m only doing my diploma, I’ll put my 2 cents worth in if I may. I’m the first one to admit I’m no academic and find learning theoretically quiet difficult. I can read over a text a thousand times and still know none the better. Now, if it’s practical or visual I’m all guns. The course I’m doing mostly involves sitting in a lecture theater for 8 hours every Friday watching hundreds of PowerPoint slides and having the lecturer read them out, this type of learning for me is completely useless. Occasionally we have a full week of this. In this week we were taught the 11 body systems, we then have one week to study at home before our exam which I need to pass with 80%. The exam I think consist of 80 Multi choice questions, 40 short answer as well as diagrams. I’m not quiet sure how many times I’ve hear different lectures say ‘this is a nice to know, but you don’t need to know, just learn it for the exam’ I pose this question, why teach it? Having spoken with many paramedics, health professionals and even members of this site the general impression/feedback I receive is most only remember about 40% of what they learn in school. Why not teach this 40% well so everyone has a sound knowledge of the ‘need to knows’ instead of wasting our time on silly microbiological/microchemical and bioscience stuff we only need to know to pass the exam. I might add, after the exam it’s assumed you know it all, we move on, never to revisit most of it again. As for practical’s, yes we do a little, not much. Even then there are 35 people in the class and 1 teacher. We also have clinical placements which involve riding with both emergo paramedics and non emergo transport services, depending on what sort of crew you get you may not even get to touch a real patient. Just to save time they cancelled our aged placements and replaced it with an 800 word essay. If and when you graduate and your employed with a state service you get Clinical Instruction hours which involve working under a senior paramedic. What if the branch you’re working at has little work load? It’s just merely hours not experience. After these hours they stick you on a truck and off you go. Australia only recently moved from having a mix of on road and theoretical training to the 3 year degree. Having spoken with some high up people who have been in the job for years they say this move was merely just for money. The state services would rather recruit from a uni course (that the participant pays quiet a lot for) than pay for in service training program, some states still have this but it will eventually be phased out. In a heated discussion at one of our lectures we were pretty much told that not many paramedics or even some lectures supported the degree. There’s major debate at the moment about graduate nurses. Straight from uni and straight into the workforce, I’ve witnessed this first hand many times and can say I’ve never seen such clinical incompetence and cluelessness. Having a 3 year degree means Jack if you can’t put it into practice. You can’t blame them for being incompetent it’s just the way they’ve been taught. I fully support the suggestion to move back into hospital bases training. In conclusion, I’d much prefer to be doing an on road traineeship and I’d defiantly benefit from it but unfortunately my state doesn’t offer it. Anywho, enough of me carrying on. I need to study for this exam!
emtannie Posted April 16, 2008 Posted April 16, 2008 should all EMS training in its initial phases be purely didactic, or should they contain some form of hands on training & assessment as well - ie. with real patients, under supervision. I definitely feel all education should have some hands on training and assessment. From Basic to Medic, there are always things that can be learned from hands on that can't be learned in a purely didactic setting. Hands on should not be limited to the scenarios that are in the classroom... you know the ones "you are called to a single vehicle rollover... yada.. yada.. yada.." That isn't hands on. I do feel that the classroom education is the basis for the hands on. Students should be learning the why, and the reasoning, not just "the textbook tells me I have to do this." Students need to see the practical application to their learning. For example... I am currently teaching an EMT course with several other instructors (EMT here is the approximate equivalent to EMT-I in the US). The students had completed a lecture portion on MCI's earlier in the week. On Friday, we set up an MCI scenario on a back lot of the college, complete with injured and dead patients, and hazards. We have two complete ambulances at the college for training use. The students were assigned jobs, so we had 4 EMT's (2 per ambulance) and the remaining students were considered firefighters and EMR's. We started the scenario across campus so they had to arrive on scene, evaluate the situation, assess the patients, and delegate and deal with the patients as best they could, including transport back to the "hospital" (an area we had set up somewhere else on campus). A two hour hands on brought to life the lecture portion, and brought understanding to a topic that the lecture alone could never have accomplished. Further, should this be repeated as each clinical level is obtained? Absolutely. Each level has its own increased demands on your understanding, so that has to be tested in a field environment. For example... starting an IV on a practice arm is easy... starting one on the 86 year old female who is diabetic and dehydrated may not be. Students need to see that to respect and understand it for fully. Now, for the downside of this..... We all know medics/nurses/doctors/medical "professionals" who should never be put in charge of another person's learning experience. Finding quality placement of students can be incredibly difficult. Some of the best medics do not make the best preceptors. Colleges and universities have to walk a fine line in finding quality placements for those students. Overloading EMS services with students causes stress for the preceptors, burnout (aarrgghh... I can't take ANOTHER student"), and does more harm than good to both the service and the student. In our region, almost every service is in dire need of more medics. One of the problems we are facing is that colleges can't find enough quality placements for practicum rotations, and although we need more medics, we can't increase enrollment into programs because there just aren't enough places to put the students for their hands on portion of their education.
Timmy Posted April 16, 2008 Posted April 16, 2008 The students had completed a lecture portion on MCI's earlier in the week. On Friday, we set up an MCI scenario on a back lot of the college, complete with injured and dead patients, and hazards. We have two complete ambulances at the college for training use. The students were assigned jobs, so we had 4 EMT's (2 per ambulance) and the remaining students were considered firefighters and EMR's. We started the scenario across campus so they had to arrive on scene, evaluate the situation, assess the patients, and delegate and deal with the patients as best they could, including transport back to the "hospital" (an area we had set up somewhere else on campus). A two hour hands on brought to life the lecture portion, and brought understanding to a topic that the lecture alone could never have accomplished. Oh my lord! Now thats what I'm talking about lol!
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