Paramedic training and education

Paramedic Education How to Become a Paramedic

I have a love for education and adult learning, but I needed to grow up to grow into it. The excesses and exuberance of my youth had left a young man with a strong ambition but lacking guidance, support and in need of mentoring. As a Young Ambulance Officer with The Ambulance Service of New South Wales here in Australia (ASNSW) I read an early paper on Paramedic training by Dr Bob Wright from St Vincent’s hospital in Sydney. It gave me a sense of where I needed to be and how to get there. Dr Bob Wright developed the early Paramedic system and its protocols. I think all paramedics in Australia owe him a debt of gratitude.

“Great maturity, an ability to think clearly under extreme pressure, teamwork, critical time management skills, dedication focus and commitment are just some of the personal qualities and characteristics that Paramedics must have to work in continuous life threatening situations that are their daily work. Wright (1979)

The truth is however, in many remote places I worked as a young ambulance officer, inspiration and productive learning experiences were hard to find. It existed but you had to seek it out, not wait for it to come to you. I learnt that everyone can teach you something, you just had to understand what that lesson was. As an Intensive Care Paramedic (ICP) trainee in Sydney, I was lucky to be guided by a handful of excellent clinical mentors along the right (Wright) path.

In training as an Intensive Care Paramedic I was supported and mentored through an apprenticeship type of process, learning and being supported by very generous senior clinicians in medicine and emergency care. I was amazed at how the people around me were so willing and able to share their clinical and life experiences and help a young inexperienced, driven but unfocused youth find simple solutions to what had previously seemed insurmountable obstacles, beyond my meagre scope and abilities. Their patience and ability to drill down the complex to the simple left a lasting impression about the importance of keeping it simple and explaining things simply.

Their generosity of knowledge and an impressive ability to impart that knowledge into useable chunks makes you want to pay it forward, to lob that chuck of knowledge into the pond to create the ripple effect of producing better clinicians and with altruism in full bloom, a better world for sure.

Educational guidance or understanding how adults learn came to me from one educator, a principal of a local community college. He instilled a passion for lifelong learning and a methodology of how to hand that knowledge over, not in a lecturing way but in a way that makes a reasoned argument that puts you alongside, not in front of the learners and adapting to that individuals person’s needs, depending on the vibe from them.

How to become a paramedic

In the caring professions you have to start by wanting to make others better, as a paramedic educator I am driven by the desire to make my trainees and colleagues better than me. I can only do so much in one career. But as a mentor I have an opportunity to influence patient care in regions of space and time beyond my moment.

Taxpayer’s money funded my education as a paramedic through the NSW Ambulance Service. I was paid to work and learn, the cart was not before the horse like students who have to spend 3 years at university studying a Bachelor of Paramedic Science degree before applying for work as a paramedic in Australia. You graduate now with a paramedic degree and a HECS debt. There is a lot to be said for the vocational pathway that delivered you a Diploma of Paramedical Science. I have since returned to university to complete a Paramedic degree through Charles Sturt University as I felt it was important to keep up with the new paramedic students graduating from university.

So having funded my initial learning, taxpayers really deserve to get some value for their money invested in my medical and paramedical education. Taxpayers’ money paid my salary as I trained as an Ambulance officer and Paramedic, but more importantly, thousands of patients put their trust in me as I did my best to learn my trade by treating them, sometimes getting it right, but always learning along the way. I owe all of them. I owe it to them, and to myself, to make it all count as much as possible.

Creating a spark, a lightbulb moment inspires us all. If I share a memorable clinical tip or plant a seed through a story that gets recalled and applied at a critical case in a resuscitation months or years from now, then all that investment, all that sacrifice, is so worthwhile.

Here’s a list of the principles I try to apply, especially when running paramedic training courses. To paraphrase a Guy Clark song, it’s got to come from the heart if you want it to work. Learning must come from the heart, training that comes from a genuine concern to help others, not to profit by them enriches us all.

10 Paramedic Clinical Teaching Tips

Know thyself, understanding how you learn makes you learn better

 

Be ethical

Paramedic education should develop decision making skills and judgement, two important clinical skills in the field.  You are given your skills and training to use judiciously, to intervene, when a patient’s condition is such that they may not make it to hospital without that intervention. Intervention itself has its risks and rewards. Finding the balance, requires judgement. You can read more about how to find that balance here

Focus on Clinical Cases

People with different skill levels can learn together better when you keep the learning on clinical cases. They can see the treatment modality from their own clinical perspective. When we’re considering patients, everyone can learn something that is relevant to their scope of practice.

Adults as learners

Two theoretical thinkers who taught me a lot about adult education of paramedic students were Paulo Freire and Jack Mezirow.

“Problem-posing education affirms men and women as beings in the process of becoming. “Paulo Freire (1972)

Understanding Freire taught me to respect the learner, to learn through action and reflection and apply this in equal doses in all learning activities. It is particularly powerful in “trial and error” practical activities.

Mezirow believed that “adult educators must be aware that helping adults learn how to move from an argumentative mindset to an empathetic understanding of others’ views is a priority.”

This educational methodology is vital in developing the “bedside manner” and empathy, the “street smarts” that paramedic students need in a dynamic street environment. Creating a perspective transformation in adults returning to learning makes better paramedics.

Make it fun

Learning is great fun. We should have a good time together. If you’re bored, you won’t learn effectively. Funny or unusual stuff is more memorable, too.

Connect emotionally

Paramedic treatment and patient relationships stir emotions in us all, we are all human. During patient contacts we have powerful interactions with ourselves and our emergency response colleagues, sometimes negatively. Learners who are experienced clinicians have all felt pain or frustration of a case that has, for whatever reason, not unfolded as it should. Being real and working through these issues in a training environment creates a powerful reflective learning environment. Addressing these issues, by focusing on what could be done better, from a self, team, environment, or systems point of view.

When we share our own feelings about cases it demonstrates we have all worked in those shoes, we have all come on a similar journey. You can better equip learners when you understand their concerns, needs and drivers. It is the reality of our human experience that enhances our knowledge.

Make scaffolds and connect the webs

Adults as learners need a framework to add new knowledge to existing knowledge and build upon it. Sir Isaac Newton is credited with the expression “If I have seen further it is because I have stood on the shoulders of giants” We build knowledge upon knowledge as adult learners. We need the linkages; we can’t recall the islands of knowledge. Build webs and layers for your learners not islands.

Tell Fables 

This helps to connect emotionally; Humans have communicated information and ideas through storytelling since the dawn of civilisation. We are hardwired so that our attention is captured by stories. However, the stories must have a learning point to them, a way to craft the language so that in an emergency it can be retrieved

Use mnemonics songs or rhymes

Mnemonic tools like DRSABCD, SAMPLE History or PQRST in chest pain give students the prompts and flow in their routines

Create lightbulb moments

I love it when you see the penny drop, the moment when they just get it. I love the look on their faces when their minds have joined the dots and they see the conceptual framework.

Practice routines

Any sports psychologist will tell you when you are under the pump at a critical incident the routine is your friend. Practice it so when you need it it’s there. Don’t try to life your game on the big days but practice it on every case so when you need it, you have that automated response that helps calm you and the patient.

References:

Wright, R. C. (1979). Patient Management: A symposium page 39-42 August.

Freire, P. (1972). Pedagogy of the oppressed. New York: Herder and Herder.

Mezirow, J. (2006). An overview of transformative learning. Lifelong learning: Concepts and contexts, 24-38.