Paramedic that Knows Everything Declines Additional Learning

by on August 24, 2010

in Continuing Education, EMS Education Tips, EMS Tips

I feel like I have “read it all” from end of course evaluations … “this was too easy” or “too difficult” or “the classroom was cold” or “breaks were too short” or “the PowerPoint slides were difficult to read” or ” I learned a lot, thanks” and on and on. I actually really enjoy reading student evaluations because they help me, as an instructor, improve my delivery, use of materials, time management, and planning for future sessions.

A recent evaluation from a paramedic really struck me because I had never really read anything like it before. When asked for additional feedback about a continuing education course the student wrote, “Too much information for a paramedic.”

The qualifier, for a paramedic, is the astounding phrase in that short sentence. I would have passed quickly to the next student evaluation if the qualifier had been:

  • too much information for thirty minutes
  • too much information for a single class
  • too much information for the instruction method

But “Too much information for a paramedic.” Really. To say that implies an underlying belief that paramedic school graduation was an end point and not a starting point.

Refresher Education vs. Continuing Education

I define refresher education as review, remediation, and / or competency checks of knowledge, skills, and abilities the student should already have from previous training (original or refresher). Continuing education is learning above and beyond the baseline knowledge. To me continuing education and refresher education are totally different.

Refresher education usually follows a set recipe of hours and skill checks in various categories – airway, cardiac, OB, pediatric, etc. Year after year the content stays fairly similar. In most places the refresher education system is broken. Instead of a 120 hour EMT class an EMT “refreshes” their education in a marathon 24 hours of lecture. Refresher education would be better labeled as really fast EMT class lectures without all the fun hands-on stuff.

A better refresher education program would consider a student’s field experience, successes, failures, and self-analysis. If I could set my own refresher education schedule based on a self-assessment and regularly scheduled feedback sessions with my supervisor I would probably spend 40% of my time on cardiology, 40% on airway management skills practice (0% on airway management lecture), and 20% on everything else. Instead of lecturing me about environmental emergencies, one of strengths, let me teach or guide a discussion with my classmates.

When I seek out continuing education I think of it like I am setting up a new bookshelf or opening a new sector on my cranial hard drive. I am searching, accessing, consuming, analyzing, and interpreting new information. My shelf and sector have unlimited space. There is no such thing as “too much information” when I access continuing education. There may be concepts I don’t understand, words I don’t know, or authors that are new to me, but those are open doors to more information.

Dig Deeper for the Real Issues

Sometimes I think throw-away lines like, “Too much information for a paramedic” are just cop-outs to exploring the real issues that exist in a workplace. If I were able to dig deeper into this comment and explore the context from which it came I might find a paramedic that feels constrained by restrictive medical control and tight protocols that limit options for airway management or pain control. I might find a paramedic that is struggling to maintain the baseline of knowledge in a number of specialties like paramedicine, fire fighting, technical rescue, hazardous materials response, and more. I might find a system that does not offer incentives for obtaining advanced certifications or a college degree. I might find a system that requires continuing education about technologies and protocols and then doesn’t allow people who complete the training to use those technologies and protocols.

Maybe You Have Had Enough

In February I co-led a workshop for EMS educators about incorporating gaming and social media content creation into EMS education. At the afternoon break a participant approached me and heartily thanked me for helping him make an important decision. He explained, “I quit. I am totally done with EMS education. I have been doing this for 20 years. I don’t want to change. I don’t want to use any of this technology. I barely understand it. I am done. Let somebody else do this.” He was sincere and seemed relieved to finally have an out to something that had become a burden. His decision to quit was probably my biggest success of the day. Of the 100 people in the workshop he was the only one that I truly knew I reached.

What’s Next

If you reach the point where you decide this is too much there are really two options. You can quit. Or you can open up another sector on your cranial hard drive. Now more than ever we have an amazing quantity of information at our finger tips.

  • Need more information about a drug, there is an app for that.
  • Want to learn more about heart failure, then Google 10,000+ articles.
  • Trying to understand the mechanism of action for Magnesium Sulfate to treat asthma, ask your Facebook friends.
  • Want to know the best ways to study, call the MedicCast phone.
  • Studying acid-base, schedule a Skype chat.

Which are you choosing?

How would you respond if a student told you, “this is too much information”? What would you say to a co-worker that complains a con-ed class is too much information?

I was so struck by the comment, “too much information for a paramedic” I asked Steve Whitehead of the EMTSpot.com and Chris Kaiser of LifeUndertheLights.com to write on this topic. Please visit their blogs to see what they have to say. If you want to opine on this topic please share the link to your post, audio or video in the comments section.


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  • http://twitter.com/tbouthillet tbouthillet

    This is some of your best work yet, Greg. I expressed similar sentiments in my recent post “McLearning and 12-Lead ECG Education”.

    http://ems12lead.com/2010/08/15/mclearning-and-12-lead-ecg-interpretation/

  • Margaret Keavney

    Great insight. There is so much mediocore, “just check the box and I’m outta here” education, but when you have a teacher or a class that’s a gem – you see what it CAN be..

  • SeanEddy

    Wow that's a first for me too. It's obvious that plenty of paramedics don't care to partake in real continuing education, but I have always attributed this to laziness. I couldn't imagine someone flat out feeling that anything is too much knowledge for a Paramedic. Hell I could take a class on auto repair and somehow benefit as a paramedic.Great post Greg.

    • http://everydayemstips.com Greg Friese

      Thanks for your kind words. As I understand it the engine is kind of like a big pump. Oxygen and gas mix in a chamber and combust which moves a valve to produce energy. A few weeks ago my car battery and alternator died. The nervous system for my car was dead … no cruise, no radio, no AC and eventually no combustion. Dead.

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  • http://thehappymedic.com the Happy Medic

    Blink. Blink.

  • http://www.CarissaO.com CarissaO

    Good perspectives, Greg. I think “digging deeper to find the real issues” is smart. I'd like to think the person who provided the feedback that inspired this post wasn't just lazy or limited by low expectations. Perhaps he or she is struggling with some condition of his/her own professional experience as a paramedic. If that's the case, rather than drawing a line in the sand on learning and professional growth, I'd encourage digging deeper. Dig deeper to understand what issues or challenges are at the root of that comment. Dig deeper to understand what more you could be if you were willing to keep learning. Dig deeper to see what opportunities are available to you once you expand your knowledge base. Dig deeper to realize only you can be the change you want to see…you might not be able to do it alone, but until you dig deeper, you'll never get any farther than a feedback card.

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  • http://twitter.com/JonEMTP Jon B.

    Greg,I couldn't agree more. I've been nauseated by my local EMT school utilizing brand-new EMT's as instructors (especially as skill instructors). So instead of sitting on the sidelines and complaining, I decided to do something about it. So I offered to help. I was told that I am “very intellegent (sic) and tend to talk over the students' heads. This is simply not a good quality for an instructor.”My response? Are the students too dumb? Or do I make the rest of the instructors look bad?I hate it when I hear talk of CPAP “pushing fluid out of the lungs and replacing it with air”… There is SO much more involved. Taking shortcuts just to save time does EVERYONE (Students, Instructors, and PATIENTS) a huge disservice.Add to that that EMS texts and “journals ” (JEMS) aren't written to the same level as my college textbooks and a true peer-reviewed medical journal. The establishment has been dumbing down EMS education for decades. It's going to be a long road to raise that. Every month, when I get my copy of JEMS, I open it to the back and read Steve Berry's column first. That said… if it really is a true “Journal” why is that there? I don't recall seeing a humor column in JAMA.I'm working hard towards a B.S. degree, because I have a dream that one day, little boys and little girls will go to SCHOOL for 4 years to become a paramedic – and their standardized training, education and knowledge base will make them a true clinician and prehospital practitioner. Maybe even someone that can diagnose and treat their patients without strict protocols or online medical direction. Maybe.Or maybe I'm just dreaming.

    • Greg Friese

      Thanks for your kind words and comments. Jon, stay focused on your dream and not the road blocks others want to throw in front of you.

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  • Iwonder

    ” I might find a system that requires continuing education about technologies and protocols and then doesn’t allow people who complete the training to use those technologies and protocols.”I think you hit the nail squarely on the head here. It is a tragic fact that in EMS the slowest runners set the pace as far as protocols & scope of practice are concerned. It's even more tragic that the leaders that should be pushing hard for progress seem to be the primary source of roadblocks.

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  • http://www.facebook.com/profile.php?id=597965131 Brian Lilley

    Greg, this is one of my favorite articles from you.  I come back and re-read it every time I feel overwhelmed by apathetic student complaints.

    • http://everydayemstips.com Greg Friese

      Thanks Brian

  • http://everydayemstips.com Greg Friese

    Unfortunately there is a positive feedback cycle. Poor teaching leads to low expectations. Low expectations lead to poor teaching. I am optimistic we can break that cycle.

  • http://everydayemstips.com Greg Friese

    Thanks Tom! Your McLearning post was also excellent. I really believe it is up to each of us to aspire to high level expertise in at least one area of paramedicine. Your niche is 12 leads. I am reading everything I can find on drowning.

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