How Do You Teach Assessments?

[AnthonyM83]

I know we all complain about how EMT schools teach such linear assessments or cookbook assessments.

So, I want to know, how do other instructors teach their assessments? How do you think it should be done? Does it work? Do they leave the class knowing what they need to know? Do you require additional hours or do you fit it into the minimum hours (if you extend it, does that affect your teaching program financially?)?

[Ridryder 911]

Ironically, this is brought up. I have been contacted by three Paramedic schools for this fall to teach. One of the reasons is my "famous or is it infamous ?" assessment lectures and lab. Something I have found majority of those in EMS lacks is the skill to truly perform a thorough assessment.

I teach a very thorough assessment technique over several days. Everything from hair growth patterns to use of opthamalscope and detailed Cranial Nerve tests. With this is an accompanying lab, to place and repeat it over & over.

Now, I realize many of this is not always practical in a prehospital setting... or is it? Alike myself, I have found and developed an abbreviated or use portions when necessary according to history and situation. Does one always check for Chvostek's sign? No, but I have seen it first hand in patients in distress that were immediate post-dialysis. Again, having the knowledge and skill to perform a more thorough assessment as necessary. Can one not assess heart tones prior to that critical care transport? Seriously, how long does that take? ... Just alike any of our skills, we must be able to adapt it when and where appropriately.....this does NOT mean for us to excuse not knowing or even performing it if and when necessary.

If one does not know normal from abnormal, then one cannot determine there is a problem. If one does not even assess or evaluate. then one is definitely not going to be able to find the abnormalities, determine the etiology and associated findings.

Time those in EMS recognize the weaknesses and assessment skills is usually one of them.

R/r 911

[firedoc5]

I find that it depends on what level you are going to be teaching. For me it was always harder to teach a Basic class, especially from day one. I constantly had to remind myself that I had to slow down and simplify things sometimes.

Now if I had an EMT-I or Paramedic class, especially if I knew most of the students, I could cruise along and possibly get into some of what I called "extra stuff". It would be more or less Q & A, but anyone could answer any question. Spread the wealth of knowledge.

A few things to remember for any class, encourage questions. There are no stupid questions. If someone challenges you and says you're wrong, give them the chance to prove it. Most of the time they just hang themselves in the end. If you are proved wrong, chalk it up to a good student (even if they are obnoxious), and that it's something you learned, then move on.

I know these points are pretty basic, but my coffee hasn't got to my brain yet.

[emt~ff~82]

We were given the practical sheets day one. we learn them step by step. and then now I am a special topics instructor for emt-b. I teach that pt assessment is key to survival or your critical pt. Always look listen and feel, always go through your abc's and ALWAYS get you sample. a chest pain pt who has had more than 1 heart attack in the past is more than likely gonna have nitro. and if they have already taken it they are a load and go. We make them learn the pt assessment chart. start with asking whiile you are observing keep moving rapidly but efficiently!

[brentoli]

We were given the practical sheets day one. we learn them step by step.

I hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate that.

If I ever become an instructor, you won't see those sheets until the day of the test. Why?

I protcored a practical recently, and you can tell, these students memorize the practical sheet. They are robots in that room! It shows absolutely NO learning, only memorization skills. If you know the "why's" behind what you are doing, the "how's" will come natrually.

[emt~ff~82]

Gee i proctor as well as instruct and every student that we have had has passed our course with a 90 or above. as well as first time nremt pass rates. I see it as some are audible learners, some hands on, some read. and it intigrates all in one. and um lets see nremt dictates the testing sheets, as well as the requirement for students now to have them. Not my choice but you are one person and others may not agree with you and as for your wording hate is a very strong word. as wella s doesn't need to be around this profession.

[towheadedmule]

:happy1:

Ahhhh

Some Mike Ikes and a large coke please.

R

[brentoli]

I understand who makes the sheets. You don't have to memorize the sheet to pass the practical. Practicals are the things we do everyday in the field. If you know WHY you are doing what you do, you will know HOW to do it. If you know WHY you are doing a SAMPLE, a QPRST, listening to lung sounds, or taking vitals, you will know WHEN they are an important role in your assessment. When I was in my EMT course 3 years ago, I was very frustrated with my classmates, some of them just didn't GET it. You know why? They had piss poor memorization skills. Three years later I am realizing, thats all an EMT-B course is, memorization. "Here is the practial sheets, know them and you will pass." "Here are the test banks, know them and you will pass."

That is what Anthony is getting at, by teaching the test, you are setting people up to pass the test, and FAIL at the real world. Life is more than a cookbook.

Example:

Trauma station practical: 70 year old man who fell off a ladder is unconcious.

Everyone made it up just fine to the ABC's, got to C, the answer was none.

75% of the class failed that station. They said ok, no circulation? Alright, let's C-Spine, roll check for injuries blah blah blah.

CPR wasn't on the practical sheet, no one thought, "Hey maybe we should do something about that."

[brentoli]

Noun

S: (n) hate, hatred (the emotion of intense dislike; a feeling of dislike so strong that it demands action)

And yes, the word hate is perfectly applicable here, because I have such a strong feeling of dislike for the practice that I am demanding action. As many other people do.

[mobey]

Gee i proctor as well as instruct and every student that we have had has passed our course with a 90 or above. as well as first time nremt pass rates. I see it as some are audible learners, some hands on, some read. and it intigrates all in one. and um lets see nremt dictates the testing sheets, as well as the requirement for students now to have them. Not my choice but you are one person and others may not agree with you and as for your wording hate is a very strong word. as wella s doesn't need to be around this profession.

I am far from anyone to comment on your course.... but I am not one to keep my mouth shut.

If you exams are designed for robots and step-by-step then they should do great! 90's should be the low end, hey we all know the NR exam is all about the ABC's and the "sheet"

If you teach the cookbook, then test the cookbook, they should be pretty damn good at that recipe, (if given the right ingredients), now just take thier paprika away! (Ya I know bad analogy)