MedicDude Posted April 8, 2006 Posted April 8, 2006 I'm just finishing up my first year of my primary care paramedic course, and I've been doing quite well on everything (tests, clinicals, assignments, skills testing) except for scenario-based testing. I know my stuff, and I'm near the top of the class, but I find that when I get into a scenario test, my brain goes on vacation. The funny part is, I do just fine when doing a regular scenario in the lab, being supervised by the medics they bring in as lab instructors. I always do my assessments adequately, and the lab instructors rarely have any negative feedback. This is great, but when I'm doing a testing scenario in front of the program director, I just get nervous and start making stupid mistakes. For example, my midterm had three stations. The first and third were done with visiting medics, and the second was done with the program director doing the grading. Guess which one I had trouble on? I just started rambling and second-guessing all my decisions. I totally forgot the assessment and treatment template we had been using all year. Afterwards, I wrote to my course coordinator about my concerns, and he said that I need to be more decisive and a little less wordy during my scenarios. It's good advice, but how can I do that? Does anybody have any tips for how I can practice being more decisive (and doing better!) during scenarios? Are there any strategies that have worked for you? I'm sure I'm not the only student in this situation!
SooC Posted April 8, 2006 Posted April 8, 2006 No worries. You're not the only pcp student that is getting worried about final scenerios. This whole term for me has been about being confident in the decisions I make and not second guessing myself. Final scenerios are going to be stressful for everyone- even those who appear completely calm- they're just better liars than we are!!!!!! . My approach to final practicals -No second guessing- If I make the wrong decision, dont verbalize it!!! -No sitting on the fence- you know your protocols- follow your gut (more than likely its the right decision) -Walking into the scenerio as if I own the place (even if you arent confident- smile and take a deep breath) -Remember- its all about ABCs....when it doubt- check the ABCs again! -Knowing my protocols inside out, backwards and forwards- chances are less likely that I'll have to stop and think about them -Make sure to ask any protocol or treatment related questions before finals- my techs have said that you shouldnt walk into a final practical with a question still nagging at you (Im sure your techs are as wonderful as ours- there are no stupid questions- and with drug/treatment protocols- so many grey areas!!) -Verbalize everything- verbalize what I see, what I am looking for during assesments- aka "verbal diarrhea" I know that we've been told to just ask for a min to catch our breath during the scenerio if we start to get flustered- Even if they dont allow- sit back for a few seconds- take a couple deep breaths- shouldnt kill your scene time or your pt :wink: . Another "tip" that we've been given is to pretend the evaluator isnt there- easier said then done Im sure but focus on the scene, your partner and your patient. The evaluator will be feeding back information to you but other than that- dont even acknowledge their presence in the room. My program coordinator posted a message for the students and my favourite piece of advice he gave was "do not throw things, swear or leave during the middle of the scenerio!" Not sure if this helped you at all, but just some things to think about. Try to picture being out on the road and when you're verbalizing all your mistakes- think how the pt is going to feel "wow- doesnt sound like my paramedic knows what he's doing- yikes!!..." I think half the battle is at least making it <look> like you know what you're doing or that you are confident when you arent! Just remember, the techs (school) isnt out to 'get you' in a scenerio. We have been told that the final scenerios are generally medical trauma and that they wont be any harder than our lab scenerios- They want to see sucess with the testing and they dont make money from you if youre not back at their school in the fall :wink: Deep breath- you'll do fine!
cynic Posted April 8, 2006 Posted April 8, 2006 I may be way off base because I am just a student myself, but what I have found that works for me is to look at everything as a scenario. When I am watching t.v. I role play, when I am out driving around, I role play. I also have no fear in asking questions with others whom are higher certified. This is a great opportunity to learn something. It wouldn't hurt to ask the question, "what would you do different?" They will not only see your zeal for learning, but also develop a greater respect for you. Besides, don't put too much pressure on yourself to perform in front of the big wigs. You need to remember that they were once in your shoes. Ask them how they were able to overcome their performance anxiety. Don't just accept that they tell you that you are too wordy. Have them explain what is too wordy and how they would have said it. I hope this helps!
Lithium Posted April 9, 2006 Posted April 9, 2006 Good advice from those so far. I really do understand, as I was never a scenario person, atleast the way they run scenarios in school. Mainly, I don't like the fact that you have to verbalize everything. Yes, I realize that repetition builds memory, and memory is crucial for those high-stress moments when everything around you is falling to pieces. However, I want to be working with people who can think clearly under pressure and not revert to an automatic-pilot-mode "Oxygen, Monitor, Vitals" crap ... now what!??!?! I disagree that you need to verbalize everything in school. Clearly, if you're tearing the flynn kit apart, you're gonna be putting the patient on oxygen, or sticking in an airway, so why do you need to verbalize that? Your evaluators should have enough road experience to see where you're taking things ... Talk to your instructors, because I feel that you really need to learn how to multi-task. When you're riffling through the flynn and you're verbalizing out-loud "im searching for the bvm, here it is, im now going to bag the patient at one breath every 5 seconds for a total of 12 breaths per minute", it conditions you subconsciously to be doing the same on scene. So when you're actually on a call doing this, your silent for that time period because you weren't taught to do anything else. (This would be one of those school world vs. real world things) I believe it would be more prudent to learn how to search and apply equipment simultaneously while acquiring relevant scene and medical history from your patient and bystanders then blatantly stating what you're doing. peace
SooC Posted April 10, 2006 Posted April 10, 2006 Hmmm.........thats interesting Hammer..... lol Another thing I thought of to help improve scenerios might be to try watching yourself on tape. I try to bring my digital camera to practice (nice little video function that tapes 20 min scenerios). That way I can see what it looks like when Im second guessing myself or being indecisive during a scenerio- might that be another option?
MedicDude Posted April 10, 2006 Author Posted April 10, 2006 Good advice from those so far. I really do understand, as I was never a scenario person, atleast the way they run scenarios in school. Mainly, I don't like the fact that you have to verbalize everything. Yes, I realize that repetition builds memory, and memory is crucial for those high-stress moments when everything around you is falling to pieces. However, I want to be working with people who can think clearly under pressure and not revert to an automatic-pilot-mode "Oxygen, Monitor, Vitals" crap ... now what!??!?! I disagree that you need to verbalize everything in school. Clearly, if you're tearing the flynn kit apart, you're gonna be putting the patient on oxygen, or sticking in an airway, so why do you need to verbalize that? Your evaluators should have enough road experience to see where you're taking things ... Yep, that's exactly the issue I have with the scenarios. I'm one of those people who just DOES things, and gets tripped up trying to explain everything I'm doing. For example, I know exactly how to set up my DVD player, but if you asked me to explain it, I'd be like: "umm, you connect this thingy to this thingy, and uhh..." I know they want to see that I know what I'm doing, but still... it's a little annoying having to verbalize everything. But someone gave good advice by saying that I should "talk through it" and say things like "I'm looking for a BVM now"... I agree, that'll help me make it a little more automatic. Still, I'm not too comfortable with talking to myself in front of others! I don't want to look like that crazy guy you see on the bus (you know, the one who mumbles to himself constantly...) Thanks, everyone-- I'm definitely going to put some of these tips to use! 8)
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