Precepting New Medics

[DirteMedic]

Hey guys,

I'm looking for some insight on helpful ways to make a new medic feel comfortable but still make sure he gets everything done that needs to be done. A major issue is a set routine for each patient contact. Also, working with him on pathophysiology of a number of disease process and our treatments.

any advice is greatly appreciated.

thanks again,

DirteMedic

[stcommodore]

I would say set specific standards as to what you want to see from them. Set target completion times, and be open and honest with them at all times. Let them know that you won't broadcast there struggles across the department, but broadcast there sucess.

[Eydawn]

The perspective of a student type...

What I find useful from a preceptor:

Engaged discussion, an accurate review of performance, enough space to develop my own comfortable system with critique to improve it, someone who's not afraid to totally check me when I'm about to do something dumb. Poking me to think more about the pathophysiology is great! Allowing me to put theories and connections out there without being chastised is also nice. Teaching me to develop good working relationships with a variety of personalities. Someone who isn't afraid to ask me what my learning style is and change their teaching accordingly.

What I do not find useful from a preceptor:

Someone who's hell bent on making me learn their way because it's the ONLY correct way and marks me down for not thinking/acting the exact same way (no Mini-Me attempts, please), someone who doesn't care to engage with me or actually teach me and frowns upon independent thinking. Someone who doesn't understand the concept of a learning curve. Emphasizing short scene times above good care.

Does this help at all? This was great for me to think about, as I'll be in nursing clinicals soon... when my preceptors ask me what they expect, I'll be able to think back to this!

Wendy

CO EMT-B

[brentoli]

Do you have any standards set by the company/school?

I work as an FTO in my full time job, and I can tell you that not having goals and standards makes it very hard to measure preformance.

At what point are you getting them? Is it medic students, new hires, or something else? That can make a huge diffrence in how you go about it.

With out knowing more information, my suggestion would be to set goals for each week. Get with your newb at the start of the week and tell them what you are expecting from them. Its just as hard on them when they don't know what is expected of them also.

Give us a little bit bigger of a bite here, what do you have to work with now?

[PCP]

First of all I would like to add that it is very nice to see that you care enough about the new medic that you are going to be precepting. I have found through being precepted by a couple different medics that some still enjoy their job and actually take the time to help the student out and others just didn't care. So good for you for caring enough to ask this question!

I have to say the biggest thing I found helpful coming from my preceptors was getting the feed back from them on what I could have done better or what I did well on the call. Without that feed back it does not give the student a chance to learn from their mistakes or give them the confidence that they are looking for, which helps them be a better Paramedic.

Talking about the Pathophysiology is huge as there is lots of that to learn in school and I found by talking to my preceptor about it helped me understand it better. Let the student do as much of the call as he/she can, then when he/she gets stuck that is when you as a preceptor I feel should jump in and prop them in asking more questions or do certain procedures.

I am sure you will do great at precepting, just remember the students are going to be very nervous so be understanding when they make mistakes or don't know the answer to something.

Brian

[Just Plain Ruff]

All the above but I'm going to go out on a limb and say that most preceptors out there do not have a truly firm grasp on the physiology and many don't even have a grasp on the anatomy and biology.

To expect them to teach anyone about physiology or other stuff is a pipe dream.

I had many preceptors because the service I was riding out at was so big. 40 ambulances on at a time. not a guarantee you would get the same preceptor twice.

I had one preceptor, Michael Spuehler. His grasp of EMS was phenomenal. I learned so much from him and he made arrangements to get me to ride with him for the remainder of my time.

Many of the preceptors didn't know enough about phys and anatomy and although they were good medics, I didn't learn near as much as I did with Michael.

So when you find a good preceptor, stick with them throughout. That's my advice.

You will know a BAD preceptor, trust me you will. They are the ones who don't help you learn, who are doing it only because it's a 40 cent an hour raise or they were told to do it. STAY AWAY from those people.

But seriously, the education that we give the medics these days they are lucky if they get the basic pathophysiology taught to them. To expect more from most preceptors is asking like asking for a tax break from a liberal or a tax hike from a conservative.

[armymedic571]

Hey, if this guy is a certified medic, treat him/her as such. Value their opinion and discuss issues. By allowing them to talk through the calls, and not interjecting your opinion or ego, will let them know that you are there for them.....

Cheers

[DwayneEMTP]

Simple, decent human respect.

I was 40 years old when I was going through clinicals, and I can't tell you the rage I felt when some 20-30ish something medic would point at a chair and say, "Sit, and wait there until I get back." I would never, ever put up with such shit again.

Let them know as much as possible what is expected. In my first stage clinicals I wasn't spoken to unless we were on a call. If the crew went in to eat somewhere, I wasn't welcome to come. If they went back to quarters to watch tv for a few hours I had to stay in the truck. Not just nonsense, but very destructive nonsense.

"We're going to stop and grab something to eat, you're welcome to come in with us if you'd like, or if you'd rather stay in the truck and study, that's ok too. I'd just ask that you don't lay down and sleep while on duty." That was my thing, you may have no problem with that of course.

Remember that mistakes are much more valuable than successes. We may learn 1 or 2 things from a success, if we're luck, sometimes 50 from a mistake. Allow your student to make mistakes if possible, then teach the mistakes away instead of trying to punish them away. In my opinion the most productive, as well as kind thing that you can do for a new student is to teach them that you understand that mistakes are inevitable and part of the learning process. That you expect them and are not waiting to pounce when they occur. This allows them to be very brave, and aggressive as they know they are free to try anything and to learn as opposed to spending all of their time feeling like they're tip toeing through a mine field.

Not long ago we had a new hire that was starting an IV on a pt that I thought looked challenging. She got the IV on her first attempt, was excited, and I gave her a smile and an 'atta boy, but inside was thinking, "Dang it, too bad she hit that, first try. That would have been a great patient for her to locate secondary sites on." Revel in successes, but revel even more in failure! Teach the way to accept failure and learn from it instead of allowing students to be so timid so as to never have to face it.

It sounds to me like you're off to a good start. Helping them develop a routine for pt contacts, priceless! As long as it works for them, and not just for you. From your few posts here it sounds as if you'll do really well! Be kind, be patient, be realistic...the rest you'll get figured out.

Dwayne

Edited December 15, 2010 by DwayneEMTP

[uglyEMT]

Simple, decent human respect.

Couldn't say it any better!!

Remember that mistakes are much more valuable than successes. We may learn 1 or 2 things from a success, if we're luck, sometimes 50 from a mistake. Allow your student to make mistakes if possible, then teach the mistakes away instead of trying to punish them away. In my opinion the most productive, as well as kind thing that you can do for a new student is to teach them that you understand that mistakes are inevitable and part of the learning process. That you expect them and are not waiting to pounce when they occur. This allows them to be very brave, and aggressive as they know they are free to try anything and to learn as opposed to spending all of their time feeling like they're tip toeing through a mine field.

Can you be my teacher? Your better then some of the shitdicks I work with. This is huge, from a students perspective we are uncomfortable enough and nervous as it is. Pounce on the little tiniest mistake just makes us more on eggshells and distracts us from good patient care. We are more worried then about all the details then listening and treating the patient. Let us have some room and give constructive critisim AFTER the call and what we need to work on. Of course if your student is about to kill someone jump in and correct the situation.

Not long ago we had a new hire that was starting an IV on a pt that I thought looked challenging. She got the IV on her first attempt, was excited, and I gave her a smile and an 'atta boy, but inside was thinking, "Dang it, too bad she hit that, first try. That would have been a great patient for her to locate secondary sites on." Revel in successes, but revel even more in failure! Teach the way to accept failure and learn from it instead of allowing students to be so timid so as to never have to face it.

Excellent example. I learn more when it doesnt come easy and learn to adapt. Doing it right the first time usually leads to complacency because you think you know it all.

[paramaximus]

It appears you have got some great, broad, ideas to begin.

I would only add along the lines that have already been mentioned, it really depends on who you are a preceptor for. If it's a student, you will probably need to focus more on basics. If you have a new hire that perhaps worked elsewhere before, you want to focus more on your policies and procedures.

The thing to remember is many services out there suffer what I call intellectual inbreeding. It might be something you and your co-workers don't even recognize... typically you don't in fact. But you continue to do something just because "that's the way everyone does it". Try to get out from under those paradigms and offer instruction in such a way that you never forget there are several ways to get a desired result, and the fastest isn't always the best.

As for R-E-S-P-E-C-T... never lose sight of that. Dwayne made several great points. Use a mistake as a teachable moment. No reason to berate or belittle (although there is a time and place for that... think knuckle draggers who need to be policed and ran off).

And finally... patience. It's hard for me to sit back and observe/assist but that is often what needs to be done when evaluating where someone is at. Get involved the second you need to, but allow them to grow. And growing is a process. Your humble Paramaximus wasn't born great... it took time.