Experience & Distractions

In the past month, I received the following two letters. I think both are important aspects of education to share with other readers.

Dear Paul: I m a new EMT living in Vermont. I m very interested in becoming a paramedic, but there are no paramedic training programs within the state. I have called around and found several in other states, but many of them require one to three years of experience as an EMT prior to being accepted to the program. What are your thoughts on this, and does your program require this? J.R., Burlington, VT

Thanks for asking a great question. The thing to ferret out here is: Do you need to be an experienced EMT to be a good paramedic? My take on the subject is that I accept folks into my program who have years of experience as an EMT as well as newly minted EMTs. It simply depends on the individual. Why a program director would want to paint themselves into a corner and say that inexperienced EMTs need not apply is simply beyond me. I don t believe that experience alone makes you a good provider.

In fact, the role of experience is a slippery concept in EMS. What is experience? For example, is a year of EMT experience in a rural EMS service the same as a year of EMT experience in a large metropolitan area? As you can see, the concept of experience simply based on time is a difficult concept to quantify.

Let me ask you a couple of questions: Do registered nurses have to be LPNs for a specific amount of time before going to nursing school for the RN? Do physicians have to work as a PA for a period before medical school? The answer on both these rhetorical questions is no. So why should paramedics need to be EMTs in order to take a paramedic course?

Before folks go wild, let me say that I believe paramedics need to know everything that EMTs know. However, properly structured and accredited paramedic programs can do this, and in fact, many already do. It should be noted that this concept of EMT before paramedic is an open question that has been discussed privately among EMS educators.

It has been my experience in teaching paramedics for the past 15 years that I ve had folks that came in with virtually no experience and did very well; they weren t subject to the preconceived ideas about certain topics as many of their highly experienced colleagues. I ve also found that many students with years of experience are good learners who absorb new material and don t suffer from the you can t teach an old dog new tricks modality.

In short, I ve been pleasantly surprised by both new and experienced EMTs. This is why I keep my options open and interview and test all of the EMTs who apply to my program and don t have a requirement on experience.

Dear Mr. Werfel: I would like to know your thoughts about cell phones in the classroom. Everywhere I go, people are talking loudly on their phones in movies, restaurants and now even in my paramedic program. We have several officers and administrators who insist on taking phone calls in class, and it s getting way out of hand. I think an instructor should restrict the use of cell phones in the class. I just wanted your thoughts on this. A.D.R.

Thanks for the question. I agree with you that the instructor must take a more active role in restricting the use of cell phones. A faculty that allows poor behavior and a lack of professionalism in the classroom is actually tacitly approving the poor behavior. It should be noted that opera houses, restaurants and theaters worldwide are looking into purchasing cell phone jammers that will prevent phones from going off at inopportune moments, such as during an aria at the Metropolitan Opera House in New York City or a private dinner with a spouse. To me, it s simply amazing that such things even need to be contemplated, much less enforced.

As a too-frequent flyer, I ve been stunned by people who will have a loud, and daresay intimate, conversation in which they convey the most personal information in front of a group of strangers. I try to employ discretion when I have to speak on the phone in public. In fact, I use a Blackberry to cut down on my cell usage.

In addition to the disruption, phones/pagers and other data devices carry other educational pitfalls. Students have been known to take photos of exams with discreet, built-in cameras and share the exams with other students. The memories of these phones can also be used to store crib sheets to be recalled during an exam. Academic dishonesty is a hot button everywhere, and these devices only add to the concern.

As for my paramedic students, I ve instituted a creative plan that actually has students confirming that not only are the phones off but the batteries are removed from the phone. How do I do it? Students are warned that if a phone goes off in class, the owner of the phone is penalized 10 points on the next exam. Plus, the students who sit on either side of the offender are also penalized five points each. This tactic isn t without precedent; in the real world, if you re working with a partner and something goes wrong, both partners are cited for the infraction. Although this fix sounds draconian, it has helped control the presence and use of these devices in my classrooms.

Thanks for the great questions this month. Keep them rolling in.

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