Hands on training in the classroom

[Timmy]

I believe hands on plays quiet an important part in ones education and learning.

Australia is starting to bring back the old school nursing training which I’m partaking in a new pilot program. I currently work as a hospital based student nurse so I work 32 hours a week under the supervision of senior RNs in a hospital setting and spend around 8 hours a week in the classroom.

I must say I’ve learn substantially more in the hospital than in the classroom.

I’m one for visual learning; reading something just does my head in. The great thing about being hospital based is you study a certain thing then put it into practice the next day on a real patient under the supervision of someone who has years of experience and a wealth of knowledge. It’s very one on one and everyone I work with is more than happy if I bombard them with questions.

I haven’t been thrown in the deep end as such but it is quiet challenging. They may ask me to go down to room 6 with the wound care nurse and observe how they assess 86 year old Mr Jones who has a decubitus ulcer to his right foot, his a type one diabetic and suffers with PVD. Then tomorrow I want you to go down re-assess the ulcer, devise a treatment plan, re write the wound care, treatment and care plan then present it to us at the wound care meeting on Friday, we’ll look at your plan, compare it to ours and change it to how we think it should be but also explain why we do it this way. To me this is the best way to learn. So I go home that night, read into decubitus ulcer, read into the pathophysiology and how PVD and diabetes will effect the situation and write a draft care plan. I find this type of learning much more motivating than ‘it may be on the next exam’ because I know I’m actually going to be doing it on a real patient.

It’s pretty much the same drill everyday. They may send me home with a whole heap of info on IMI antibiotic, ask me a heap of questions the next day then let me give the injection.

When ever a patient needs vital signs taken or a BGL or similar they always get the students to do it, I might take a blood pressure 7 times a shift or do 12 BGL’s. If something doesn’t seem right the RN may re do it but they always ask questions like if this patients BGL is this then what does it mean and explain what is happening and why its happening. If we don’t know they’ll make us go read up on it and ask again the next shift.

A lot of our module assessments are done in the hospital setting, we only have a few classroom practical assessments. Of course we still have the theoretical side, most things we do in hospital are backed by classroom study, we do a fair few written assessments, essays, exams ect. Every module is assessed in 3 different ways, practical (in the hospital) written (exam, project, essay ect) and oral (class presentation ect) There are quiet a few things were not allowed to do until we’ve covered it in class but on the most part there pretty good.

I love learning this way, nearly everything you learn in class you put into practice soon after.

[Kaisu]

Sounds like a top notch education to me timmy. Just be sure you don't shortchange the book learning. Both are important.

[Dustdevil]

Yeah, it would be nice if we could immerse our students earlier. But EMS just isn't very conducive to that, with our practice being so emergent. However, we should still be working on giving our students a lot more patient contact in school, even if it is in-hospital instead of in the field.

[chbare]

To be honest, this is one concept I really appreciate when looking back at my nursing education. Our practicum rotations started very early in the semester. First, we had to do several hours of preclinical work on our assignment for the week. While not something that occurs in the real world, I think this was invaluable for the learning process. We had to research our patients problems, labs, and hand write comprehensive information about the medications and have a tentative plan of care written up. This was crucial to learning and really forced us to review and research. The focus was on learning and understanding our patient's problems and less about having somebody sign off on a skill like I see occurring all to often with EMT students.

Then, we had to present our findings to our clinical instructor and fellow students prior to the start of our clinical experience the following morning. If we picked up new patients during our weekly rotation, we had to do it all over again.

I simply do not see learning and education emphasized when EMT's enter the clinical environment. They go to their area, get a skill signed off, and head out. I actually rotated through the OR with a paramedic student while I was a nursing student. She came in, intubated, and took off. I was in the OR all day getting grilled about MAC's for different inhaled anesthesia agents and on the A&P of the specific surgery by the surgeon and CRNA. Very different focus of education.

I admit, this may not be the norm for all EMT students.

Dustdevil, it is nice to see you back on the forums.

Take care,

chbare.

[Arizonaffcep]

What makes sense is to exclude those morons who are too stupid to comprehend the intellectual portion of the curriculum, and can only learn from monkey-see-monkey-do. You don't have to pass everyone, you know.

I don't. But I do try to present the material in as many different "learning styles" (kinethetic, lecture, visual, etc.) to give them the best chance of learning the material. No one can fix stupid, but giving the students the best possible chance of making it, then that is part of my responsibility. If they can't make it, the can't make it. If I am wrong in my interpretation of your post, forgive me but it does seem that you indicated that if they don't get it one way, then forget it. That's not what being an educator is about. I know many great pracitioners who learn best by kinethetic, others that are great and learn by lecture. Does it make one better vs the other? No. Just makes them different.

[Richard B the EMT]

Where I have my "mantra" of following local protocols, someone else has a posted mantra which is quite the support of "hands on" training (sorry, i forget who you are):

Kill them in the classroom so you can save them in the streets

[Dustdevil]

I don't. But I do try to present the material in as many different "learning styles" (kinethetic, lecture, visual, etc.) to give them the best chance of learning the material. No one can fix stupid, but giving the students the best possible chance of making it, then that is part of my responsibility. If they can't make it, the can't make it. If I am wrong in my interpretation of your post, forgive me but it does seem that you indicated that if they don't get it one way, then forget it. That's not what being an educator is about. I know many great pracitioners who learn best by kinethetic, others that are great and learn by lecture. Does it make one better vs the other? No. Just makes them different.

Excellent! It seems you are talking about that fine line between tailing your techniques to your audience and actually dumbing it down for your audience. The former is, of course, ideal adult education. The later is unacceptable. It would sure be nice if all adults learned in the same fashion. And quite unfortunately, most medic schools do seem to operate under that theory.

Many judge the quality of a school by how many pass NR on the first attempt. I am more inclined to judge the quality of a school by how many of the originally enrolled students pass NR. If you're not counting the drop outs in that final number, then you aren't really judging the educational capabilities of the school itself. Lots of schools with top notch pass rates maintain that rate buy flunking out a lot of students before graduation. Any school flunking out that many students is either doing a shyte job of applicant screening, or a shyte job of education. Either way, that school sucks.

[brentoli]

On topic but off. The two years of college I went to, we never got a chance to make up a final. If you bombed you final, you bombed it. Sorry boutcha. So why do we let these people who don't pass their tests the first time around take it and take it again until they do? I failed my freshman spanish class, I had to take it again. There was no "well let's go back and try your tests over can we?" It was... YOU SUCK! COME BACK NEXT YEAR.

[Dustdevil]

Well, it is a little different preparing people for a test that YOU wrote, as opposed to preparing them for a test that you did not write, and may not have even seen in years. Not that I have much tolerance for any NR written failure. I still do not understand how anyone can fail that. And I would be very tempted to agree with you that anyone that cannot past NR written on the first try with 85 or better is the definition of FAIL. But because there are so many poor educators out there, students have to be given that benefit of the doubt. There are probably some smart students out there who simply got shafted by a shyte school, which is why the new accreditation process is so important.

[Arizonaffcep]

Excellent! It seems you are talking about that fine line between tailing your techniques to your audience and actually dumbing it down for your audience. The former is, of course, ideal adult education. The later is unacceptable.

I agree, there is really no place for "dumbing down" in this industry. In fact, this is one of the primary reasons that my wife and I have opened our own school. In Pima County (where I work and the school is located) had (until we opened) only one other paramedic program...the local CC. I work in the only level 1 trauma center in southern AZ, and as such, eventually ALL medic students come through for clinical time. I am also one of the hospitals "preferred" preceptors for medic/emt students, and I have watched with much dismay over the last 2 years that the quality and knowledge of the students is FULL of holes. And they have a "great" NR pass rate! This all started (forming the school) over a table top discussion where we were posed the question, "if you aren't happy about the situation, how are you going to make it better?" So...we've opened our own school and are taking some very progressive steps to make the course not only difficult (because the caption is correct, "Killem in the classroom" so they turn out good), but totally different from anything AZ has previously seen. While this will be our first year in operation, I am excited to see how it works. And the nice thing about owning the program...we can change it at will if need be, and not cater to some CC's version of bureaucratic red tape.

In regards to your comment on NR pass rates, we are stuck between a rock and a hard place...so to speak. AZ's DHS (who oversees the certification) does look at the NR pass rate to help determine the success of a program. Although I think that the NR pass rate is bogus (if the program is not great, teach to the test and get a high pass rate, if the program is good, no need to teach to the test because the students will have a high pass rate because they know the material).