Innovative Interviewing Techniques

In an era of the greatest paramedic shortage in history and the largest segment of the population becoming elderly, it's difficult for EMS systems to turn down anyone who has the proper credentials and is willing to work for them.

Take Tom and Steve--two individuals who both have valid and approved national and state credentials, clean driver and background checks, neither test positive for drug use, and (if applicable) credit checks show nothing irregular. Both have the same amount of time in EMS, and both are fit for duty. How do you know which one is the better choice?

The answer is all about the interview: specifically, behavior-based interview questions.

According to Gallup, Studer Group, Mercer and myriad other consulting firms, previous behavior or history is the greatest predictor of future behavior. This means that if you hire a person who historically went over and above what was expected in previous positions, chances are he or she will do the same for your service.

Here's the problem: Most systems follow a mandatory questionnaire, especially those who work for government agencies that are typically required to ask the same questions of every candidate no matter what they are applying for. That's fine, but for EMS it is perfectly acceptable and recommended that you add questions focusing on previous behaviors, so long as every candidate applying for an EMS position is asked the same questions, in the same order and fashion.

Behavioral-based interviews allow the interviewer to ask about specific times in a candidate's career where he went over and above a situation, had to go along with a decision he didn't agree with, and how he handled it. These questions allow for a dialogue and give the system a chance to evaluate candidates based not on objective criteria, like whether they have an ACLS card, but, more importantly, if they are the right fit for the organization.

No one suggests skipping these mandatory objective requirements. This interviewing skill allows the candidate to realize what's expected and the system to evaluate whether the candidate will be an asset or just a warm body filling a spot on the schedule.

This may seem simple, but it takes some work, especially from administration. The first and foremost part has nothing to do with the interview at all. It requires senior staff to get together and discuss what is important to the system, what's expected and what the culture of the system is like. These must be specific and agreed-upon standards for the organization. This is the bedrock from which you are recruiting and the traits you are looking for in future candidates.

Once this step is completed, it is important to craft questions surrounding these core points. For example, assume in a medium-sized 9-1-1 system serving a community of 180,000 citizens, integrity, professionalism and compassion are the three most important areas to administration. The culture is almost militaristic and there is a strict sense of chain of command. Along with those attributes, there is a "feeling" that new personnel have to "earn their place" in order to be seen as equals.

Given these constructs, it would be appropriate to ask the following:

• Tell me a specific time when you did the right thing even if it was difficult or detrimental to you personally.
• Give me an example of a time when you had to act professionally despite your personal feelings.
• Tell me about a time when you made someone better by your actions, and what was the result.
• Tell me about a situation where you had to utilize a chain of command and how you felt about it.
• Give me an example of a time when you had to prove yourself, what was the result and how did you deal with it

The trick is to elicit specific instances. Vague, global or lofty terms are useless. You are assessing the candidates' ability and history, pulling from specific points in time to gauge their ability to fit into your organization. Most individuals are not prepared for this style of interview, and it is perfectly acceptable to guide them if they start out with vague stories or instances. You can say, "That's great, but I'm looking for something specific."

It is also important to know that people coming straight out of class with little pre-hospital experience can use any specific experience they wish. It is about relating, rather than comparing experiences, and who gives the better answers that make them a better fit for the organization.

Remember Tom and Steve? During the interview, Tom can't give specific examples and relies on negatives to describe previous supervisors and systems. He spent time in the military, finds the chain of command bothersome, and believes that an ironed shirt is useless in the 9-1-1 arena. Steve, on the other hand, gives a poignant and specific example of having to tell a doctor about misdiagnosing a patient when he was fresh out of school, even though it didn't change the patient's treatment, and he remained with the patient's family member after dropping him off at the ED. He tells you that the chain of command is an essential part of any organization.

The traditional "tell me about yourself" questions found in most HR repertoires simply don't have the ability to draw out specifics required to judge fitness.

Why is this important? Once done effectively and consistently, it decreases the cost of training, the number of voluntary and involuntary terminations, callouts and turnover, specifically first year turnover, and will increase employee satisfaction and engagement.

You want everyone who works for your system to believe it is an honor to work there, to be proud of their co-workers, and, most importantly, to feel valued. Creating a more specific set of interview questions is a step in that direction, rather than using pay and benefits as the sole enticement for prospective employees.

Patrick Pianezza is a consultant experienced with Studer, HCAPS, Gallup and Press Ganey principles. Along with nearly a decade of experience in the prehospital arena, he has worked for Johns Hopkins Hospital and Studer Group. He currently works as a paramedic crew chief with Lexington County EMS in Lexington, SC. Contact him at ppianezza@gmail.com.