Student-Centered Solutions for EMS Education, Part 2

This is the second of a multipart series looking at the role new technologies can play in improving students’ EMS education experience. Find part 1 at www.emsworld.com/10977815. Author Rommie Duckworth recently presented a webinar on this topic. Click here to view.

EMS educators often have common concerns about deviating from the lecture approach. Here are some answers. 

I have a difficult time getting students to engage and interact during class. Despite this, after class I get many questions and comments on my performance as an educator that would’ve been helpful had they been asked when I was actually teaching.

While it can be more difficult to implement during one-off educational sessions, here is where polling software really shines. A number of free to low-cost solutions exist with an amazing variety of features that can really let your creativity, and that of your students, flow. While polling can be as simple as putting up a multiple-choice question and allowing students to vote, you can increase student engagement through fill-in-the-blank type questions, classroom competitions, anonymous questions for shy students and more. 

Polling also allows students to provide real-time feedback to educators on what they understand, what they don’t, and additional items they would like to share with the class or ask of the educator. Some polling software even provides a real-time graph of students’ understanding of what is being taught. This allows the educator to move quickly through subjects students grasp and spend more time on concepts they’re struggling with.

I would like to bring in special guest expert educators, but it’s difficult to get them to the classroom where and when I need them.

A number of no-cost and low-cost solutions exist for Web sharing and video teleconferencing. Skype is simple, readily accessible and essentially free. You might invite a special guest to speak for all or part of a presentation and Skype them directly in to your classroom. While “miking up” every student might be difficult, the moderator can relay questions from the classroom, and answers from the expert guest will be broadcast. Other similar free software includes Apple’s FaceTime and Google Plus’ Hangouts. Additional features include bringing in or connecting multiple people online who are present in different physical locations as well as screen sharing, recording and text chat. This technology can also be used for study groups to allow participation of students in different locations. 

Document-sharing programs are often used in conjunction with conferencing software. Free software such as Google Docs, Zoho Docs, Microsoft SkyDrive and more allows participants to share and work together on documents without being in the same room. This is also a great way to allow attendees to collaborate on classroom notes and deliver paperless handouts to participants.

There is not enough time, space or instructors, etc., for as much hands-on practical as we want.

Skills and scenarios—Assign some portion of the skill you wish students to perform, then have them record one perfect performance and upload it to a private YouTube channel. Students get to practice until they do it right, maximizing performance and minimizing embarrassment, then receive peer feedback guided by educators either online or in class.

Simulation—While much of what has been discussed so far has dwelt in the cognitive domain, educational technology can also apply to hands-on psychomotor skills and integration. While a high-fidelity, high-cost simulation lab is great if you have one, educators can still take advantage of low-cost solutions with a little time and creativity. It is the educator’s approach to their scenarios, not their $100,000 manikin, that creates a suspension of disbelief and effective education. Many of the techniques used in high-tech sim labs can also be effectively applied to low-tech BLS manikins.

Debriefing—The keys to effective simulation education are good scenario set-up and quality student debriefing. Many educators fail to grasp that most learning, integration and retention occurs during the debriefing session that follows the scenario. Here again low-cost home-brew technology can come into play. It’s very likely most of your students bring their own video recorders to class. While a complete discussion of structured and supported debriefing techniques are beyond the scope of this article, such training is available from a variety of online sources, including the American Heart Association.

Students think they can Google every answer.

This problem requires a two-pronged attack, and the correct approach can turn it into an opportunity. It’s important for students to understand that they will not always be able to look up answers on the Internet, nor will the answers they find there always be the correct ones. It is the responsibility of the educator to help teach students when and how to look things up as well as what to do with information they find. 

An educator can turn a lecture into an engaging experience, delivering not only clinical information but helping to develop lifelong learning skills by implementing the “suddenly searching” technique. Instead of being guided by PowerPoint slides, the educator presents an issue or clinical topic and asks the students to search the Internet for information on it and come back and explain it. The students then get a short time to “suddenly search” for information and discuss it among themselves, preferably in small groups. In the role of coach and facilitator, the educator should reference the lesson’s learning objectives to make sure they’ve been met.

In this way the students stay more engaged, practice peer teaching (a highly effective education technique), and develop important critical thinking skills about information they look up.¹ The same could be done with smart phone and tablet reference apps such as Medscape, PEPID, Epocrates, WebMD and the Informed guides.

Students constantly use their mobile devices for messaging and social media.

Rather than banning social media and devices, educators should harness their power for the good of the class. Effective methods for integrating social media in the classroom include:

• Social media polling programs allow educators to solicit questions, answers and feedback from students either outside of class or in the classroom.
• Students can sign up, like or follow educators for tips, tricks, class announcements and special assignments.
• Social media work groups can be used for assignments and peer teaching.
• Private groups and hangouts allow educators to facilitate and coach students with individualized feedback without losing the interest of the rest of the class.

Remember, not only is social media not going away, it is the language through which younger students send and receive their information. How engaged would you be in a class where the teacher wasn’t even speaking your language?

Sometimes I have to deliver one-to-many education that needs to be in a lecture-style format. Students tend to drift off, not retain information and remain generally disengaged.

There are plenty of ways to bend the standard direct lecture into a more engaging and valuable learning experience. There are a number of real-time collaboration programs available that work across a variety of smart phone, tablet and PC devices.

While features vary from app to app, in general real-time collaboration software allows every student, or at least those selected by the instructor, to have direct access to the presentation being displayed on the main screen. This allows attendees to not only record and take notes for themselves, but also interact live with the main screen and ask questions, make markings on slides and otherwise center the focus of the lecture on the content itself rather than the presenter or PowerPoint.

A branch of this is real-time mind-mapping and concept-mapping software. This allows experienced attendees to develop a “mind” or “concept” map around the central theme being taught. While this is traditionally done on whiteboards or large sheets of paper, the software allows attendees to participate directly and the educator to keep the maps clean, coordinated and recorded for everyone to take home. Here again the educator should have a “cheat sheet” available to fill gaps and keep the discussion on point.

Some students have difficulty with fundamental reading, writing or science skills. Also, students who excel can become bored or disruptive.

The educational term for this is scaffolding, meaning students must build their fundamental knowledge, skills and abilities before they can use them to solve more complex problems. Thankfully there are a wide variety of online educational resources available for free. The key is for educators to identify the needs in students having difficulty with their programs. This is especially important with soft skills like written and interpersonal communication. While this can be a difficult subject to broach, the nature of online tutoring will allow students to pursue assistance independently and at their own pace. Similarly, advanced students becoming bored with basic coursework can be given independent-study projects to enhance their depth of learning and bring that knowledge back to the rest of the class.

I need education resources customized for my agency’s training programs.

The key to the student-centered education concept of “flipping the classroom” is to get lecture-style education resources in the hands of students before they sit down; then class time can be spent engaged in practice assignments and activities. The first step is to not reinvent the wheel. There are so many emergency services educational resources available for free on the Web that it’s likely one exists to meet your needs. Even if the resources you find don’t meet your needs directly, you should see what views other people have taken on the topic you’re covering.

Of course there is great written content available online from EMS World and other sources. Video content is available for free through YouTube, Vimeo and other platforms. Always keeping copyright in mind, graphic images can be obtained through Google Images, Flickr, Picasa and other free public image sites. In addition, there are great EMS-specific image resources like public health image libraries and trauma.org. Don’t forget that in addition to written, graphic and video content, podcasts are a great way to incorporate critical thinking and really spark discussion.

None of this content would be available online if people like you weren’t contributing. If you are developing your own custom content, consider uploading it to the websites we’ve discussed or developing your own training agency-specific podcast or YouTube channel.

Educators need to minimize their administrative time, while students crave immediate and personal feedback.

Learning management systems used to require students with at least intermediate computer skills, a full-size computer lab and costly proprietary software. This is no longer the case. Many options are now available for low-cost or open learning management system software. They all require some amount of computer expertise to set up, but they actually require very little to manage. In addition it is now likely that virtually every student will have access to some kind of tablet, smart phone or computer with an Internet connection.

Once set up, a learning management system will allow automatic assignments and in many cases automatic or assisted grading for your initial or continuing education students. If set up properly, the system can not only tell students what they got right and wrong, it can also direct them to additional resources to explain why and what they can do to improve. While this option requires an up-front investment of money, time and energy, for ongoing programs the payback will be multifold.

Cautions and Barriers

While classroom technology coupled with student-centered education methods can boost engagement, performance and flat-out fun in your program, it can be easy to get distracted from the primary goals of education. Keep the following in mind:

• Don’t use technology for technology’s sake.
• Don’t just use technology as another way to deliver a lecture.
• Don’t just use technology as a game or diversion.
• Focus technology on student-centered aspects of the program, including subject, self and social learning.

While we’ve focused on low-cost to no-cost methods to implement student-centered classroom technology, money, time and energy resources still have to be devoted to implementation, especially when altering established training programs.

Even when individual educators are on board with classroom technology and on target with student-centered teaching methods, barriers may remain. Resistance may come from students, fellow educators and administrators due to fear of innovation, misunderstanding, exceeded comfort zones or institutional inertia.

Finally, a barrier that is often missed by technophile educators is that even when many are on board, not every student (or even every teacher) is technology-literate. This is a perfect time for peer mentoring. It will help with technology and communication soft skills as well as build up the recipient’s technology skills. Remember, a 3-year-old can use an iPad not because all 3-year-olds have suddenly become geniuses; the genius is in the interface design of the technology. Most problems technophobes have stem from simple anxiety about the new and different. This shouldn’t be dismissed out of hand, but it can be overcome.

While the solutions we’ve discussed will take time and energy to implement, you’ll know you are using technology effectively when the technology itself becomes transparent and the learning seems to suddenly just get easier.

Reference

1. Ten Cate O, Durning S. Peer teaching in medical education: twelve reasons to move from theory to practice. Med Teach, 2007 Sep; 29(6): 591–9.

An emergency responder for more than 20 years with career and volunteer fire departments, public and private emergency medical services and hospital-based healthcare, Rommie L. Duckworth, LP, is an internationally recognized subject matter expert, fire officer, paramedic and educator. He is a career fire lieutenant, EMS coordinator and American Heart Association national faculty member.