Sunday, February 19, 2012

What Would You Do?

Over on facebook right now, EMS World posted an interesting question:

"If you were designing the EMT-Basic or EMT-Paramedic curriculum, what content would you add that you think is currently missing from EMS education & training?"

There are a whole bunch of comments, many of them with good ideas.

Of course it got me thinking about how I'd answer.

It's not as easy a question as I thought at first glance.

In my opinion, the EMT-B curriculum is both very good, and not very good, at the same time. It's well organized, and covers a lot... but it doesn't cover very much in much depth at all. When I took the class, I already had a background of years of interest in the subject, and years of a strong first aid background. But what if I hadn't?

The first thing I'd change, if it's possible to change it, is to make it much more clear to students that the class is just barely jacks to open. It really is only enough to point you towards all the things you need to learn about, so you know where to start with continuing your education. If the class really covered everything that is in the curriculum, it would take a lot more time, and might screen out a lot of people. That might be a good thing, but it isn't likely to happen.

The next thing I would change is I'd require a lot more ride time. Also, I'd make it more like the requirements for higher levels, where it isn't number of hours, it's what you do during that time. Just requiring hours doesn't make sense. Some people ride with an agency that is not very busy, and don't even have any calls during their shifts. Others might get a high number of calls. I'd want people to see a variety of things in the field before being responsible for any.

Another thing I'd change may have a lot more to do with where I am than with the curriculum, per se. I'd make it more clear what continuing education is required and how to get it. I'd provide students with an outline for the first year post-class, with suggestions for what topics to prioritize. I would give them information about upcoming conferences, and likely a list of bloggers to keep up with.

Now for specific topics I'd like to see given more attention:

1. Talking and listening to your patient. People skills.
2. Call pre-planning and post-analysis: evaluation. DIY CQI.
3. Working as a team, especially with volunteers and not knowing ahead of time who your team will be.
4. More practice with documentation. Not just what goes where, but practice picking it out of the conversation.
5. ALS assist skills.

As for specific medical topics... there are so many, I don't really have a specific list. Instead of a list, I'd focus on teaching people to make their own list, as things come up. I'd encourage and show them how to research topics on their own. How do you find reliable sources of information?

The other major thing I would change would be the state exam. I dislike multiple guess questions, especially poorly written ones, and I did not think the state exam was particularly well written. I know that designing a good test is difficult. I'd like to see more emphasis on actual knowledge than on test taking. It makes a test harder to grade, and more difficult to take, but that just means there needs to be better preparation.

Do you have a list of things you'd add or change?

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