Can't-Miss Lesson Plans for EMS Instructors

Are you a new instructor or someone who has no teaching experience? The first time you prepare a presentation can be intimidating. Some of us borrow a colleague’s PowerPoint presentation or download one after doing a Google search.

Many times these materials are lacking. They were designed for a specific audience by a particular instructor. Sometimes when we use these other resources we find ourselves in embarrassing situations when students start to ask questions. Read on for a better way to plan and structure your educational program.

Preparing for Success

First, a lesson plan will help prepare for your class. Any good instructor is prepared, and that requires preparing a lesson plan. Planning what and how you’re going to present a topic is essential, regardless of whether it’s a new medication, skill, or concept.

The first question I ask myself is, What do I want an EMT or paramedic to walk away with after the class? Think about it as “reverse engineering”—What does the final product need to look like, and then build back from that.

For example, when discussing a new medication, I want students to know indications when to use the drug, contraindications, correct dosage, routes of administration, how to administer, and maybe simulation to evaluate how well they’ve acquired what they were taught. What are they supposed to do if the patient has a poor reaction or we administer the wrong dose?

This isn’t any different than a lesson plan. Example: At the end of the class, the EMT or paramedic should be able to describe the indications for odansetron; describe the contraindications; demonstrate the different routes of administration; and recite the correct dosage.

What additional information do I want you to know? I might speak about the history of a medication. For TXA I could mention its application by the U.S. military in combat. For odansetron I would speak about its use for nausea in cancer patients. This might only be one or two lines of information but can provide greater context.

Your people might ask, Why do I need to know this? Why are we making this change? I might present a graph or chart on the epidemiology of a disease, its occurrence in the community, or the expected opportunities to implement a procedure or administer a medication in our EMS system of care.

Know who’s attending your class. You may want to modify the time you spend on certain aspects of your content to match what they need. If I am teaching a class on needle decompression to basic EMTs, I will spend more time on indications, identifying patients with tension pneumothorax, describing the anatomy and physiology, and how to landmark for insertion than I will if I'm teaching paramedics.

What is the pathophysiology of the disease or condition we’re learning about? Be flexible on scheduling. When we first had to present information on COVID, most of the information was foundational, since everyone was on the same page.

Class Structure

How do you want to present information? Case presentations are best, as they let students see the utilization of the material and afford an opportunity for interaction. Every educational encounter needs facts and figures, but you should also include a story that demonstrates application. A case presentation (the story) ties it all in.

Videos, audio, and photos are important tools. If I’m teaching a class on patient refusals, I would spend considerable time on the differences between decision-making capabilities and capacities vs. competence. A video clip, even if simulated, demonstrating that interaction would be crucial.

Did you ever ask an instructor a question and they reply I am glad you asked that? I always draw up a list of questions that anyone taking my class may ask. I also ask my colleagues and other instructors for questions. Did I acknowledge them in my presentation? This is part of my lesson plan.

Resources and references for teaching could include your organization’s treatment protocol, monographs from the equipment or drug manufacturer, research articles, YouTube videos (from trusted sources), materials developed at other organizations, and the American Society of Health-System Pharmacists (AFHS) drug information. Are they up to date, accurate, and current?

Some reference materials and clinical articles may conflict with what’s in your protocol. When Alameda County EMS first introduced TXA, it had a very narrow application for EMS. Some of the resource materials provided to field personnel had to be highlighted to note when TXA was going to be used and when it wasn’t. Over time, as the safety and utility became apparent, the clinical indications were expanded.

Simulation and Labs

What videos, illustrations, photos, and graphs are available that illustrate what you’re trying to teach? If you’re using other resources, did you personally review them? If you are developing your own videos, are they accurate and do they convey what you need them to?

If there is a lab component, what will you need to pull that off credibly? If you're teaching a program on how to administer blood, do you need simulated blood and tubing? Are you using manikins, cadavers, or actual human subjects to teach new procedures? Practical skills scenarios are meant for participants to learn safely. If they fail we can stop, reset, and fix the problem in real time. Make sure you use scenarios that present the patient or situation in a variety of circumstances, such as stable patients, crashing patients and those who had an untoward reaction to medications or procedures you are performing.

Be inventive and use any opportunity to provide training. When we first implemented 12-lead EKGs in my department, I needed to teach lead placement. I could have used the members who were on duty or sent them to a hospital. Unfortunately there were too many hurdles to make that happen. Instead, I went to the local actors’ equity union hall and assembled a diverse group of men and women to help. It was one of the most realistic training sessions we ever had.

Evaluating Student Performance

Finally, as part of your process, you need to evaluate how well all of the planning, preparation, and final presentation achieved your goals for the education of your staff.

A written exam must reflect what you taught. It needs to include scenarios in which the student must flex their brains. Practical performance exams are essential, either with someone acting out a scenario or using a high-fidelity simulation manikin.

Leverage an assortment of scenarios—one that would demonstrate the indications for the medication, procedure, or protocol that you presented, and one that was a contraindication. It should not be cut and dried; it should be one in which the participant must think—for example, a patient you want to give CPAP but now has a decreasing level of consciousness.

You must present a scenario in which there is an untoward outcome; i.e., you are administering blood and the patient has an acute hemolytic reaction or an anaphylactic reaction. Maybe you are teaching a class on push-dose vasopressors: What would the students’ response be if their partner accidently overdosed the patient?

These are not meant to be “gotcha" moments. They are designed to measure how well we’ve taught the student. They also allow the student to fail safely in a controlled environment. They should be robust and realistic, and those in the class should know there will be a range of scenarios that everyone will be required to work through as part of the final evaluation. This will improve attention and retention of the material.

Summary

The hallmarks of good educational programs require that you plan, prepare and strategize for what you want to present. Always ask yourself, What do you want the student to know when you’re done with the presentation? What do they need to be able to demonstrate? What will they do if something goes wrong?

Preparation is an essential component of the educational process. Every educational endeavor requires a lesson plan in order to ensure success.

References

Foundations of Education: An EMS Approach, 3rd Edition. National Association of EMS Educators, July 29, 2019.

Dan Gerard, MS, RN, NRP, is president of the International Association of EMS Chiefs.