Duckworth on Education: Check Your Students Like You Check Your Gear

When you check your equipment at the start of your shift, you make sure you have everything you need, that it’s all in date, that it works properly with other equipment, and that it’s ready to be used on a real call. In the role of EMS educator, you need to check your students in the same way and for the same reasons.

Is It There?

Of course the students have to be physically or virtually present, but I’m not talking about taking attendance. I’m talking about the foundational knowledge upon which we must build as we teach the lesson. This must be assessed for each class and even for individual groups of students.

For example, if I’m teaching CPR to lay people, full foundational knowledge of cardiac anatomy and physiology is not necessary to perform CPR on a stranger. For these students what I need to ensure is that there is good motivation. Instructors familiar with the American heart Association’s Life is Why campaign will understand what I mean.

When teaching CPR to EMTs, however, I want to be sure they have an understanding that coronary arteries supply blood to the heart, even if they don’t know all the exact names and positions. This will help me explain that coronary arteries connect at the base of the aorta, just past the aortic valve, and that this positioning causes coronary arteries to fill only when pressure is low in the heart, during the “upstroke” of CPR. We need to ensure this foundational knowledge is present because it’s important for EMS providers to understand that the downstroke perfuses the brain and other organs, and the upstroke perfuses the heart. Thus, 100% effective compression technique is needed for the best chance at patient survival.

Checking for the presence of foundational affective, cognitive, or psychomotor skills can be as specific as administering a pretest or as informal as simply asking students what they know at the beginning of class. Make sure you know the basics are there, or you won’t have much success in your lesson.

Is It Expired?

Knowing outdated information can be worse that not knowing it at all. Sometimes you find experienced providers carrying outdated knowledge that was the best information available when they were first trained. Other times students will pick up incorrect or outdated information passed on as wisdom from working providers.

Assessing for “expired” information can be as simple as asking students what they already know about this topic, or, “If a call like this happened right now, how would we approach it?” Educators can’t just apply new knowledge on top of a foundation of incorrect or outdated knowledge. Simply telling students, “This is how we do it now” will work for very few new students and virtually no experienced practitioners. An effective educator begins by identifying these underlying issues and addressing them with an explanation of why things used to be done that way and what we have learned to get us where we are now, preferably capping it off with a clearly defined benefit to doing it the way it’s taught now.

Does It Work With Other Equipment?

As an educator you must consider if students truly understand how new information works with other information. It is a necessary evil that virtually all education is structured into topics or chapters or classes or sections or modules of some kind. As educators we tend to see the big picture: how all these puzzle pieces fit together and affect each other. Students tend to stay focused on just their current section.

At some point, usually toward the end of the lesson, we must make sure students understand how what they’re studying interacts with and affects other parts of their job. For example, when teaching about ventilations, I might be explaining the benefit of positive end-expiratory pressure (PEEP), showing students how a little extra pressure can help open up closed alveoli, increasing the surface area of the lungs for more effective respirations. However, I’d be failing my students and the patients for whom they care if I didn’t also explain that increased pressure in the lungs can decrease circulation. Thus, students learn an effective new ventilation tool—and also how to balance it with the patient’s other physiological needs.

Is It Ready to Go?

The mechanics of the classroom often cause students and educators to focus more on formative achievements as they go rather than the summative goal of performing patient care in the field. This is not to say students are learning one way to pass the test in the classroom while their real-world actions need to be different. Rather, as educators teach each step, they should help students make connections between what they’re learning right now and how they will put it to work to benefit their patients under real-world conditions. Acquiring new knowledge, skills, and attitudes does not inherently translate into being able to use them in the field. Just as your gear needs to be clean, sharp, and positioned to go, so do your students. It must be clear to educators and students that great test scores are no guarantee of future performance. Educators must focus on setting students up for success when they apply their knowledge, skills, and attitudes on real calls.

If you are a quality EMS provider, you make sure your gear is present, in date, working, and ready to go. This takes a little bit of time in the short term but brings tremendous benefits in the long term. It also helps you avoid enormous headaches and embarrassment. As a quality educator, you can apply the same lessons to your students. A short-term investment in checking in with them will pay out tenfold in terms of classroom test scores and real-world performance.

Rommie L. Duckworth, LP, is a dedicated emergency responder and award-winning educator with more than 25 years working in career and volunteer fire departments, hospital healthcare systems, and public and private emergency medical services. He is currently a career fire captain and paramedic EMS coordinator. The founder and executive director of the New England Center for Rescue and Emergency Medicine, Rom is an emergency services advocate, author, and frequent speaker at conferences around the world. Contact him via RescueDigest.com.