How would you describe students today?

[EMS2712]

Generally, how would you describe the EMT students that are currently entering your programs? Tech-savy? Lazy? In addition, Are you happy with the students we put out, or do you think we basically teach to pass the exam and that is it?

[Lone Star]

Generally, how would you describe the EMT students that are currently entering your programs? Tech-savy? Lazy? In addition, Are you happy with the students we put out, or do you think we basically teach to pass the exam and that is it?

Having personally taken the EMT-B course twice (fourteen years apart), I can honestly say that I've seen a decline in the information being presented to the students. There is far less emphasis placed on the medical knowledge of WHY we do the treatments and interventions that we do, as opposed to an emphasis on 'the book says'. In my opinion, this only produces 'cookbook providers' as opposed to CLINICIANS.

Teaching 'pass the exam only' is how we got to this state in the first place...

I've advocated higher educational standards for a while now, and I'm more convinced than ever that the students that are being turned out now are far less educated than us 'old dogs' were back in our days of EMT school.

There's been amazing advances in medicine, but yet EMS still sticks to the old anecdotal 'Golden Hour/Platinum 10' rules that have been disproven time and time again.

If EMS in general wants to be taken seriously as a 'profession', then those in positions of being able to change the educational policies and requirements NEED to realize that by hanging onto the 'old ways' is not only cheating the students out of beneficial knowledge and opportunities to practice evidence based medical techniques, but it's doing our patients a MAJOR disservice because we're still practicing 'medievil medicine'. (High blood pressure? You've got too much blood in your body, so lets let some out!)...

It's been pointed out many times that EMS education caters to the 'lowest common denominator'; it's time that we start raising the 'educational bar' to establish a new 'higher level of lowest common denominator'!

You won't see nursing programs accepting any 'low achiever' into their programs, you must meet certain academic standards to even apply...let alone be considered for admission. I'm presuming that medical school does that as well, so they don't turn out substandard doctors...

Since other professions are able to prevent just any 'knuckle dragger' with a pulse from entering their programs, why should EMS continue this practice? Not only does EMS continue this deplorable practice, but gears its education toward them!

In no way am I implying that ALL of the students successfully negotiating their way through the EMT courses are 'substandard', ther ARE some very stellar exceptions to the rule. Unfortunately, there are too many substandard providers that are being turned loose on the general public as well!

[EMS2712]

Lone Star I fully agree with your view on this. I was hoping to open discussion on this. I think we have lost our ability to think. In addition, I think that we rely too much on technology on the truck. A new tool is great to have, BUT a tool is only as good as the person operating it. In Ohio, I think there are too many programs in the state, and because of that the quality of product being put out is gone down as well.

[Lone Star]

Lone Star I fully agree with your view on this. I was hoping to open discussion on this. I think we have lost our ability to think. In addition, I think that we rely too much on technology on the truck. A new tool is great to have, BUT a tool is only as good as the person operating it. In Ohio, I think there are too many programs in the state, and because of that the quality of product being put out is gone down as well.

We can only hope that these 'patch mills' are denied accreditation and be driven from the field of EMS education. They seem to only focus on enough information to pass the test, as opposed to truly EDUCATING their students.

Unfortunately, this is a very touchy subject. Those of us that have actually expended the effort to become truly educated have a hard time convincing those that only want to become 'trained' that there IS a difference between the two.

Yes, a 'new tool IS great to have', but not only is it as good as the person operating it, it has it's inherent limitations. This is why we must become more proficient in evidence based medicine as opposed to treating what we see on the monitor.

There are too many 'grey areas' in medicine, and just because your pulseoxymeter says that the patient has a SPO₂ of 98% on room air, DOESN'T mean that they're in good shape. CO poisoning will also show a great SPO₂ reading as well. Too bad for the patient that the oxygen attached to the hemoglobin can't be released at the cellular level where it is so desperately needed.....

We're indoctrinated from EMT-B school on through Paramedic that the "You call, we haul" mentality is the ONLY way to do business, but yet we bitch about that 'stubbed toe last week' call at 0345. Not everyone however, wants to take the time or give the effort to be able to'treat and realease'...

[flamingemt2011]

Sorry, you got it backwards. The reason for teaching to pass is that the test became harder. In the old days, the test was easy. It is the responsibility of the employer to "orient" new employees, there is no way that any school can teach someone everything they need to know in school.

[Lone Star]

Sorry, you got it backwards. The reason for teaching to pass is that the test became harder. In the old days, the test was easy. It is the responsibility of the employer to "orient" new employees, there is no way that any school can teach someone everything they need to know in school.

If your statement were true, don't you think that making the test harder is a good thing? Medicine has made great strides even in the time that elapsed between my first EMT-B class and the last one.

The proliferation of the 'patch mill schools' and 'teach to pass the NREMT only' concept came from nothing more than the idea to churn out as many mediocre providers as possible.

These so called 'schools' charge just as much as the colleges do, but can churn out twice to three times as many 'students'. Most are neither educated, nor given any tools/skills other than to follow the cookbook methodology.

Orientation IS the responsibility of the employer but its the STUDENT who has the responsibility to seek out the best education possible, and the SCHOOL has the responsibility to EDUCATE their students so that they can be 'oriented' into the field of EMS.

Orientation is not education!

Since I have taken the EMT-B course twice, I'm in a better position than you to know what went on in 'the old days', and therefore better qualified to compare and evaluate the curricula from 'back then' as compared to 'now days'; and believe it or not, there are some on this forum that are even more qualified to speak on this phenomenon than I am....

Remember, a quality education yields a quality clinical provider; and a 'patch mill school' that turns out warm bodies with a 'pass the NREMT only' training to fill uniforms is NOT 'quality education'!

*Edited to correct spelling error, no contextual changes were made*

Edited May 21, 2011 by Lone Star

[hatelilpeepees]

I would have to argue that EMTBs are not medical providers, but are really first responders. I am not sure what flamer meant, but I know that there were just as many dumb asses in the old days are there are today, but the difference was that in the old days, you had to call for all orders including starting an IV, and you were denied 60% of the time. Today, EMS people are pretty free to do what they need to do, within reason, so there is a greater opportunity to screw up. It is kind of like if you work on an automotive assembly line, and its your job to put the knobs on the am/fm radio in the old days. But today, its your son's job to run the wires from the radio, to the blue-tooth, and make sure the synch-voice commands work. It is totally different ---- but I am sure the 40 year vet would say all the new people on the line are dumbasses.

[HERBIE1]

I think HOW we approach education has changed over the years- especially recently. Technology has become such an integral part of our life, and kids know nothing else. Technology is more than just a tool, we also need to understand how all the bells and whistles apply to what we do. In the case of medicine, technology and knowledge are inseparable. You need to understand the technology so you can appropriately apply it to our job. Think EKG's. What we see displayed on the screen is a visual representation of what is happening with someone's heart and it's conduction system. We understand those electronic lines and bumps represent specific activities of a heart's function. In other areas, technology may or may not impact what you do- it may make your job easier, but is not necessarily bound to what you do. If you are a philosophy teacher, technology may help you access the material easier than grabbing a book, but other than that it's low tech.

That said, there is still a basic level of didactic knowledge we must have- A&P, biology, physiology, pharmacology, etc. Technology may assist in amassing/consolidating the knowledge for you to learn, but committing it to memory is generally still old school.

In the end, I think we need to appreciate the fact that kids are tech savy at a very early age, and we need to acknowledge that when we teach. Technology is a tool, and we use it as an alternate/adjunct method for imparting the information to the students. It's still us to educators to integrate the tech with old school instructional methods.

[kbrozenick]

Generally, how would you describe the EMT students that are currently entering your programs? Tech-savy? Lazy? In addition, Are you happy with the students we put out, or do you think we basically teach to pass the exam and that is it?

I think that this depends completely on the instructor and the training institute that is providing the education. Like all programs there are both good and bad. I think that you must tailor your classes to meet the needs of your students. Based on the fact that medicine is an ever evolving process, we currently are teaching based on a curriculum that was implemented in 1994! (Very happy that the new curriculum is in the process of being implemented)

I think as educators we do have to use technology more frequently to keep up with the learning styles. Of course we have to base this technology use on your audience. I hear a lot of negativity about technology. Technology is not meant to replace knowledge. Technology is meant to assist the provider to provide excellent care.

We need to continue to have high standards in our courses and turn out excellent providers! In doing so they will pass the test.

I do wish however that the programs in the area would raise their standards on the students thats are accepted into the programs. It would maybe help a little bit.

I think we just have to keep doing the best we can, and set the bar high and keep it there. Bring the students up to the bar not lower it for them.

[chbare]

You still have a full range of students, from mature and highly motivated to sandbaggers, and everything in between. This will never change and has been consistent throughout the ages.

However, what I find to be rather significant are the demographics and abilities of students:

The demographics have changed somewhat. Where I teach, the "traditional" student is no longer definitively dominate in the classroom. The older, "nontraditional" represents about half of our student body. This appears to be a function of the economy as people loose jobs or find themselves back in school later in life to either be more competitive or redefine their career altogether. Clearly, the health careers are one of the biggest draws. Even programmes such as respiratory therapy that typically have had fewer students enrolled than say nursing school are now dealing with an excess of candidates. Somewhere around half of the students who apply for acceptance into health programmes are turned away because the pool is so large and often competitive.

However, I find (n =1) some of these older students can often be a real asset to have in the class room. Many have relevant life experience and maturity. With that said, there are still all types of students and I am not about to make sweeping generalisations. Additionally, I find the gender gaps in health care programmes that have been traditionally dominated by one sex or another are closing. Nursing programmes typically have several male students in each class and our respiratory programme that has been overwhelmingly female dominated just graduated a class of half men and half women. I find a similar trend in the EMS programme as well with more female students. I'm not exactly sure how this has changed the classroom, but anecdotally, I find classes with a good mix of students tend to work well together.

The major issues I find are related to mathematics, physical science and writing. I find that people coming out of high school are often weak in mathematics and are not adept in fundamental mathematics knowledge such as algebra, long division, fractions and the metric system along with unit conversions. Even after taking math, students can struggle in technical programmes that are more math intensive. Many student often struggle in physical science pre-requisites. One of the biggest issues is chemistry. About 1/3rd of people attempting to get through the chemistry sequence will not pass with a C. I personally know one of the chemistry professors and she is a top notch teacher and well qualified (doctorally educated organic chemist). She has taken aggressive steps to try and support the students. She has gone to great lengths to maker herself available, to the point of moving her office out to the student commons. There is also an aggressive physical science tutoring programme and an entire student success centre dedicated to tutoring.

Technology has also been a game changer. This is good and bad. Students often have information and resources at their fingertips, but may not be able to identify good resources to reference and may not be able to properly articulate their thoughts in written form. Clearly, this is also a challenge in programmes that require several large, written papers and case studies.

Take care,

chbare.