Equipment & Gear, JEMS Games, Training, Trauma

Follow These Guidelines for Effective EMS Training

Issue 11 and Volume 37.

Simple Strategies for the EMS Classroom

Although technology has created many engaging and exciting options for EMS classrooms, you don’t have to have the most cutting-edge technology to be an effective instructor. The following are high- and low-tech strategies for each training tool that can make a difference in the EMS classroom.

White Boards & Student Response Systems

>> LOW-tech option: White boards are laminated 12×12 boards that can purchased at any home improvement store. They should be used with an erasable marker and should be available to the student during lectures. The instructor can have the students go to their boards to answer questions every 10–15 minutes to increase interaction with the lessons. The students have five seconds to answer the question or put a question mark on the board … at the end of the five seconds the students hold their board up and look around the room. White boards are a great low-tech solution to get students involved, thinking, and to give the instructor and others in the class the feedback and the chance to fix what they didn’t know.

>> High-tech option: The remote student response clicking system is a fun and novel high-tech approach to answering questions and getting immediate feedback by seeing how the rest of the class answered. The clickers and system can cost a little money, but once they’re in place, they can help the gaming generation answer questions in a manner that they feel comfortable with during class.

Peer Tutoring & Mentoring

>> LOW-tech option: A wealth of research indicates that students who work collaboratively on projects during and outside of class learn and retain more information.

This strategy of putting folks in groups—giving them jobs (e.g., squad leader, homework officer, time management officer, equipment officer) gives them instant peer tutors, mentors, and a sense that they’re stakeholders in their learning and not tourists in the classroom.

We need to belong and we need the support of our colleagues. This is also an effective way to have them work together to solve problems and work through social issues, much like they must do on the streets.

>> High-tech option: Computer games that put students into groups and have them cooperate and work together to solve problems and generate solutions. The market is filled with all kinds of games that can be used for a generation who have grown up with games.

Research-Centered Activities

>> Low-tech option: Restrict the PowerPoint presentations and engage the students in more case studies, discussion, role play and active learning exercises that excite and challenge their brains.

In my opinion, the brain wasn’t built for formal education—it was built for survival, and it needs novelty and a challenging environment to make learning happen and stick.

>> High-tech option: Classroom chatboards and interactive presentations that the group puts together to help teach critical topical areas (e.g, cardiology, trauma, etc.).

A Stimulating Environment
It’s important to create an environment for real learning to take place. Color is important for the brain. Bright colors are best. Stay away from dark colors; they sedate the brain. Putting positive messages around the classroom, such as values and encouraging messages, also make a difference. Arrange the classroom to promote discussion and inclusion. Move away from the traditional outdated and restrictive rows and try a U-shaped setting. Other elements such as the temperature of the classroom are also important. Studies have shown that 70–72° F is the best temperature for a learning brain. Use every strategy you can to increase student learning.

A Passionate Instructor
Although numerous teaching tools are valuable, there is no substitute for an enthusiastic and caring instructor who takes pride in their craft. I like to use the equation: passion + pride = productivity. When a teacher is excited and cares about student learning, this type of enthusiasm is infectious.

The students can find all the high-tech and innovative sources at their fingertips, but a master instructor breathes life into the classroom, and their greatest tool is their love for the profession and creating the next generation of EMS professionals.
—Chris Nollette, Ed.D, NREMT-P, LP

‘Must-Haves’ for the Modern Classroom
As EMS and education both enter this new generation of technology, it’s important that educators become familiar with what’s available. Although some of the technology available may seem intimidating, many resources are available to ensure everyone can utilize them in the classroom. Following are my top 4 recommendations:

1.  Moodle is an open source learning management system (LMS). Moodle can be used for monthly CEU reviews or it can be integrated into initial education. Moodle allows the instructor to post interesting articles, links, files, etc., as well as assign quizzes, discussion boards, and various other assignments. With the click of a button, instructors can monitor student activity, how often they have been on which part of the LMS, as well as student academic progress from graded assignments.  For the price, free and included in many web hosting packages, this feature-packed LMS can’t be beat.

2. Mobile technology is a must for today’s millennial generation. These students are always utilizing smartphones or tablets, so why not take advantage of their technology habits? Many LMS have a mobile app on both iOS and Android. Speaking of apps, there are hundreds that can be beneficial to educators trying to explain A&P, procedures, or anything else you can imagine. Beyond using apps on smart devices, you could purchase Apple TV, MSRP $100, and wirelessly stream any video from your iPhone or iPad directly to your television or projection device. There is even a feature that allows you to mirror the device you are using so you can use the app to demonstrate what you’re discussing.

3. 31% of people age 18-22 update their Facebook status daily. Why not wield this into a tool to be beneficial to your students? If you incorporate a group configuration, your public information officer can update the Facebook page of your class with interesting articles, upcoming events, and graduation celebrations. Beyond utilizing it as a means of promotion, students can gather valuable information about current events. Approximately 48% of millennials get their news from Facebook. Why not allow them to use this to add to topics of discussion within class?

4. Beyond continuing education, how do EMS providers maintain knowledge of current issue? Many choose to follow current events and medical practices by subscribing to trade and medical journals. Many allied health education programs incorporate journal clubs. Even if you don’t incorporate a journal club, students can look up current research or operational issues in EMS by using EMS-related websites or articles and discussing them in class.

Although these ideas don’t work for every educational situation, they most certainly will work in some. Hopefully, they will get your students involved and hopefully help them retain some of what you are trying to teach them.
—Keith Widmeier, NREMT-P, CCEMT-P, EMS-I

Simulation Success
EMS has used simulation for decades in the form of CPR manikins, task trainers and standardized patients (i.e., real “victims” moulaged and simulating illnesses and injuries).

However, with the advancement of high-fidelity (HF) manikins and the use of standardized patients in critical-thinking exercises, we’re now capable of offering scenarios that immerse students and providers in real-world exercises. And it’s had great results in improving the educational process and changing a lot of the traditional behaviors.

Case in point: the 2012 JEMS Games. The use of HF manikins proved essential in providing a scenario that simulated a deteriorating patient and provided the participating teams a platform to perform all necessary treatments in a realistic environment.

The Laerdal/JEMS folks strategically designed and implemented an integrated educational approach by creating an article about asthma and announcing that asthma would be seen in the competition.  A similar integrated  approach will be taken for the 2013 competition, with three coinciding articles on topics that will test participants’ knowledge.

The Theory
Simulation in healthcare is used for education, evaluation, research and system integration. The goal of this article is to assist the instructor in building a relevant scenario and providing a positive learning experience for the student. We can divide the simulation experience into the four “Ps:”
>> Prepare;
>> Practice;
>> Present; and
>> Post-review.

Learn your simulator’s capabilities: Many institutes and departments have purchased HF manikins to augment their training program. Their use ranges from critical-thinking exercises to using the simulator as an advanced “task trainer.”

Although all positively enforced training is good, it’s recommended that the instructor participate in training sessions offered by the manufacturer, and simulation-based training offered by such recognized organizations as the Society for Simulation in Healthcare (, to understand the components of a successful simulation program.

Skilled educators and technical consultants are also available to assist with planning and developing simulation learning. EMS conferences now regularly have simulation as a topic, so this can help the operator keep current on trends.

High-stakes risk assessment: Every training institute and department has its own unique risks and encounters. A primary goal of your simulations should be how to address the high-stakes situations that your students/EMS providers encounter. Is there a trend your students are struggling to grasp? Is there a new method or protocol you want them to learn? Has a problem been encountered that affects crew or patient safety?

You can gather the information from classroom and exercise performance, patient charting/documentation, crew reports, hospital/command feedback and any stakeholder resource. Once the risk is identified, you can begin to plan your strategy for a simulation exercise.

Critical-thinking points: No matter the exercise, critical-thinking points should be limited to the main point of the exercise.

The Practice
Skills: Simulators are also valuable because they can be used effectively to develop, maintain or augment various lifesaving skills. This can include the administration of drugs, advanced airway care, medication and most BLS and ALS skills.

Simulators allow instructors to log skills in real time as they occur, and some skills are automatically logged by the program. The instructor can also log in during the scenario run and make comments that may aid in instruction after the scenario is complete.

Pre-programmed scenarios: Many simulator manufacturers have common, frequently seen (and seldom seen) simulations for clinical (medical and traumatic) cases, to get you started.

Student debriefing (review) should be accomplished immediately after the scenario is concluded or as soon as feasible. Debriefing is the process by which students interactively review their performance after completing a simulation exercise.

Healthcare HF simulation is advancing and has joined the ranks of aviation, space flight, military and other high-stakes roles. With the continual advancement of computer science and simulation design, we can provide a safe learning environment for EMS providers and produce a more effective and efficient EMS system.
—Al Kalbach, EMT-P