lowest common denominator

[akroeze]

We hire anybody with a pulse

So the discriminate based on if someone has a pulse or not?! :evil:

[AMESEMT]

People blame the "quick programs" quite often. However, both 2-year and 4-year programs have their downsides as well. We need to look at are these programs accredited? What sort of qualifications are needed to get into a program? What standards do the programs have of the student, while the student is in the program? I know of a program that gives you your AAS but is HORRIBLE at educating paramedics. The doctors and nurses in the hospital they do their clinicals in (the same hospital has the school) complain that the medic students are unable to do the simplest of skills that are required of a paramedic.

Whereas the program I went through, is a "quick program" of sorts. We don't get an AAS. We went 3 1/2 months of full-time schooling. We had tests weekly which we must get at least an 80%, and quizzes daily to test us to make sure we were retaining what we were learning. Then after a practical test and a comprehensive final we are sent to clinical and field time. From the people I have talked to that know both medics that went through my program vs. another program, they take the medics from my program due to them being competent medics that know their stuff.

We need to focus on the programs that are not turning out quality medics, part of that could be mandating all paramedic programs need to be accredited. From my understanding (showing my ignorance of how they become accredited, sorry) there is a fair amount of monitoring of the programs that have and maintain an accreditation. Having more monitoring of paramedic programs, the poor programs could be weeded out, thus hopefully increasing the quality of medics produced by any length of program.

Just my 2 cents

Ames

[Dustdevil]

Absolutely. As Spenac reminds us with his signature, more education alone is not the answer. It has to be more education and better quality education. But seriously, no matter how you slice the equation, you cannot pack two years of quality education into four months or less. If it were possible, we would be turning out doctors in one year instead of four. Instead, we have PAs in one year, not physicians. And the only reason we can even do a PA in one year is because he has three or four years of prerequisites and experience. Do the math.

Indeed, I do see some really, really competent medics coming out of four month progammes. No doubt about that. But it's a facade. Their competence is limited to the bare bones basics. They know there are 206 bones in the body, but they can only name twenty of them. They can recite protocols with the best of us, but can rarely cite the pathophysiology behind them. They know nothing of pharmacology beyond the twenty drugs they were tested on in their system. They know nothing of the psychosocial aspects of patient care. They function quite well in whatever urban system is employing them to follow their protocols. However, they are not given the scientific foundation, nor the critical thinking skills to function otherwise. Stick them in another system or a clinical environment and they are lost, without the skills to rapidly adapt.

That's the problem with considering "the needs of the community." That is exactly what results in dumbing down the profession.

I can take a mature, intelligent student with a couple years of pre-requisite, foundational education, and turn them into uber medic in about six months (about twice what your accelerated school is offering) of full-time schooling. That's 960 hours on top of A&P, Psych, Soc, at a minimum. That's not even including what else it takes to earn an Associates degree. Anything less, whether it be the pre-requisites or the medic school hours, makes you less of a medic, without a doubt.

Being a medic is not about being as good as the next guy. It's not even about being better than the next guy. It's about being the very best that you can possibly be. And, any course, regardless of quality, is shorting you valuable education, if it shorts you on time. Too many people are suckered into believing that a patch is a patch is a patch. Sure, it may seem like it in an urban area where any patch gets hired. However, getting the same job as the next guy does not in any way make you as good as him. And any medic who thinks that more education would not make him a better provider is a complete idiot.

[Scaramedic]

I personally feel that since Paramedic is quickly becoming a Degreed program that we should join the other degreed programs when it comes to pre-reqs. Maybe it's time to quit having set pre-reqs for each program. A universal set of pre-reqs for Healthcare Professional could be in order. That way RN, RT, EMT-P, Ultrasound, etc could all come from the same background and have the same basic knowledge. Math, A&P, Chemistry, English, etc. Only after you finish these then you can move onto your program.

Or maybe I am just rambling because I have strep and feel like I am dying. :roll:

[AMESEMT]

I had a long post in response do your post Dust, but I am going to have to say we disagree on things. I acknowledge I am still a student and don't have a fraction of the experience you do Dust (which I hope to get in time), but I am looking at things from the other side of the track and from a completely different geographical location. I disagree with you on the idea that the competent medic from a 4 month program is just a facade. Like any program, it highly depends on the quality of education and the devotion of the student to make sure they are learning and understanding everything, as well as the quality of instructors and facility. Being a graduate from a 4 month program (technically is more like 9-10 with clinical and field) I am biased, but the program I am from is known for turning out quality and educated medics. Maybe where you are from, the shorter programs turn out not quality and educated medics and the longer courses do, I don't know.

I agree with every medic should have a degree (I am assuming that is what you are alluding to with the 4-year program). Personally, any degree that could be applied is good (i.e. business, psychology, biology, chemistry, etc...). The saying that all 2-year or less programs are bad is what gets me. You need to look at each program and what they do teach.

Thats my 2 cents. We can't all agree on everything.

Ames

P.S. Dust, can you name all 206 bones in the human body by chance?

[DwayneEMTP]

AMESEMT, not sniping at you, honest. But you're program is known to turn out quality and educated medics...By who? Based on what standard? Can you put a link to your school so we can compare prerequisites?

If your school doesn't have strict prerequisites then the average medic coming from it is not well educated. See what I mean? They can't teach you anatomy, physiology, cellular biology, psych plus all the necessary, required DOT info in four months. It's just not possible...

I'm not doubting you flat out, but we'll need some objective data to substantiate your claim before it can be accepted to be factual enough even for the sake of argument, much less adequate for the proof necessary for the rebuttal you're attempting.

Dwayne

[ccmedoc]

I'm not doubting you flat out,...Dwayne

I kinda do...I have not seen many good outcomes from short courses, thats all. :wink:

Medic mills around here have put a bad taste in my mouth..

I can name all 206, by the way!!

I personally feel that since Paramedic is quickly becoming a Degreed program that we should join the other degreed programs when it comes to pre-reqs. Maybe it's time to quit having set pre-reqs for each program. A universal set of pre-reqs for Healthcare Professional could be in order. That way RN, RT, EMT-P, Ultrasound, etc could all come from the same background and have the same basic knowledge. Math, A&P, Chemistry, English, etc. Only after you finish these then you can move onto your program.

This is what I would like to see...for starters anyhow

[Dustdevil]

[EDIT: Sorry about the length! It got away from me. :oops: Much of this is redundant, so feel free to skim or skip as you see fit. This stuff is just too important to not address completely.]

I disagree with you on the idea that the competent medic from a 4 month program is just a facade.

First, let me say that I was not and am not sniping at you personally either. You've always seemed to be a good guy, whose input I enjoy here. But see, you disagree based solely upon your desire to disagree, and nothing more. You have a vested interest in disagreeing, just like a guilty defendant in a courtroom. Admitting that you could be a better educated medic than you are is not a stroke to your ego. Right now, just like I was, the only stroke to your ego is having a paramedic patch, and having been able to do it the fast and easy way. Been there. Done that. I too was wrong.

As Dwayne properly points out, it's all in the math. Quality cannot compensate for incompleteness anymore than completeness can compensate for poor quality. They must co-exist. Alone, either of them is invalidated by the absence of the other. No matter how much quality instruction you pack into four months, you still aren't packing the full picture in there. Anybody who says that it is only quality -- or only quantity -- in medical education that is important is simply ignorant of the realities of medical practice and education.

Come on, man, this really isn't a difficult concept if you open your mind. I know it's not what you want to hear. And I know it's not the smoke your school is blowing up people's arse because, like you, they have a dog in the fight. I don't. I too went to a three-month school. I thought it was teh aw3some. I thought I was teh schitt for getting my patch in one-quarter the time as the losers in the next county. Then I worked with them and realised I didn't know dick. Sure, I could start a line, drop a tube, and give two amps of the red box just as well as they could -- which is what most of the idiot drones in EMS seem to base competency on, even still today -- but I couldn't hang with them in intelligent medical discussion until after years of experience and a college biology education. You won't either.

I've got fifty-bucks that says Dwayne -- who graduates with an AAS at about the same time you graduate -- has a significant edge in medical knowledge over you right after graduation. Even if you are twenty IQ points above Dwayne, the only hope you have of competing with him right after graduation is strictly on monkey skillz. He will have you seriously outclassed in diagnostic and problem solving abilities. That is the simple result of better education, not him being a better man than you. Again, this is simple math.

I am biased, but the program I am from is known for turning out quality and educated medics. Maybe where you are from, the shorter programs turn out not quality and educated medics and the longer courses do, I don't know.

So far, you have been unable to qualify the term "quality" for us, so we really have no idea of understanding what you are trying to say about them. But again, in EMS today -- especially in areas where the quickie schools proliferate, like Kalifornia -- competency is judged only by monkey skills. I'd be willing to be that the accelerated school here is one of the best in the country. I know, and have worked with, much of the staff there personally over the years. And, since the major patron (the Dallas FD) requires a year of college before they'll even hire you, most of the students at least have some record of academic success before entering, unlike most medic schools. Still, they turn out medics who are good only for one thing, and that is providing the absolute bare minimum of care skills in a system where the hospital is rarely ten minutes away. You simply can NOT teach any more than that in four months, period. Doesn't matter how awesome your instructors are. Doesn't matter how smart your students are. Your students are only as smart as the dumbest guy in the class, because you have to pace the class to his level.

I agree with every medic should have a degree (I am assuming that is what you are alluding to with the 4-year program). Personally, any degree that could be applied is good (i.e. business, psychology, biology, chemistry, etc...).

I can't agree with that. Yes, all education improves you as a provider. No doubt about that. Every bit of intellectual exercise your brain gets is a positive thing that builds you knowledge base and your critical thinking skills, which are the most important skills in EMS. But not every degree contributes to the scientific knowledge base necessary to help you assimilate medical concepts in your brain. And if you don't even get that until after medic school, it is really of almost no value to you. Education that occurs after medic school does little to contribute to your foundation. That concrete has already hardened. Now you're just adding another story onto a house with a weak foundation. This is one place that does demonstrate where you are absolutely correct though. That is, that quantity is not everything. That quantity not only has to be quality, but it also needs to be in a logical order to contribute optimally to your professional development. Education as an afterthought is about half as effective as education as a foundation.

The saying that all 2-year or less programs are bad is what gets me. You need to look at each program and what they do teach.

I didn't just fall off the turnip truck. I've been around a good while, and have examined the issue pretty darn thoroughly. I don't need to look at more programmes (although, I plan to). You need to simply look at more math. But I will cede one thing, and that is that the students who CHOSE paramedic school do tend to come out better practitioners than those who are there just because they want to be firemonkeys. You do have that plus on your side. But at best, it only makes you better than the lowest common denominator, which is really nothing to be particularly excited about. But that's a hollow victory, sort of like having the nicest trailer home in the neighbourhood.

P.S. Dust, can you name all 206 bones in the human body by chance?

Nope. I'm not afraid to admit that. Hell, yesterday I couldn't even remember the generic name of Atrovent for a few hours. I'm old, and I've started to reach informational overload. It eventually happens. And I had been in EMS for three decades before Atrovent even entered the field too. But I could have twenty years ago. I DID learn all 206 bones at one time, and I CAN still show you exactly where each and every one of them are, as well as describe their structure to you. That's simply all part of that foundation that is necessary to be a medical provider -- of any kind -- that is something more than "adequate."

I'd like to know if you really think none of that education is really important to ever have, or if you just think it's not important to have before starting to take human lives into your hands.

[DwayneEMTP]

I'd like to know if you really think none of that education is really important to ever have, or if you just think it's not important to have before starting to take human lives into your hands.

See. This is the part that EMTCity brainwashed me with before I decided on my path in EMS.

I can accept that I am going to lose patients. I can't accept the fact that I didn't do what I could to save them, and then they died. And education is part of what I CAN do.

And During my clinicals, people died without my preceptors intervening. The only thing that helps me sleep, is that I'm truly confident that I gained the education required, plus X, and they died anyway.

There were a hundred times during my AAS in EMS experience that I cussed Dust and AK and meant it, as they were the ones that convinced me that this was the correct path! But when people died under my hands, I slept like a baby, because I knew that I had done all that was realistically expected to provide the care necessary to save their lives.

Then=not a big deal. Now=pretty big deal.

And trust me. When/if you ever get the chance to sit down with the types of people that Dust and AK are, you don't want to have to explain that people's lives are not worth the few extra semesters of school...or that..."the volly's don't do it!"

Honest.

Dwayne

[Don1977]

NO TO UNIONS!