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AnthonyM83

How Do You Teach Assessments?

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Good ideas there, guys.

The problem ends up being having enough time to teach this stuff. You need sound pathophysiology, then a lot of time for group work (which ALWAYS ends up taking longer, especially if we make sure everyone is included in discussions). It's hard enough getting enough practice time for manual skills like traction splint, KED, rapid trauma assessments, and proper assessment of ABCs.

Reasons why my wife and I started an EMS education company!

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The problem ends up being having enough time to teach this stuff. You need sound pathophysiology, then a lot of time for group work (which ALWAYS ends up taking longer, especially if we make sure everyone is included in discussions). It's hard enough getting enough practice time for manual skills like traction splint, KED, rapid trauma assessments, and proper assessment of ABCs.

That's only a problem if your school is 13 weeks long, and has no prerequisites beyond EMT school and transfer "experience".

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I'm talking EMT school.

So was I.

j/k :D

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Well now you have my interest stirred up. I teach mostly by scenario forum, I try to create an environment similar to the scene and try to use props and make up often. But clues are linear because you are leading the students in a particular direction I don't know how you could avoid that. They don't get the clue until they ask the correct question. I would be very interested in any direction you have.

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I think the key (unless you can make classes smaller, hire more staff, or make course lengths longer and thus fewer per year, and still survive financially) is to ingrain the flowsheet/outline in their heads the first week. Absolutely memorized. Absolutely able to do a linear non-thinking assessment.

THEN, go heavy on the drills where you teach them to interact with patient and findings and critical thinking. Best idea I can come up with. Because without the flow chart, it's almost impossible to teach every individual in the class how to do even a semi thorough assessment...you wind up all over the place and so many things get skipped.

You need experience to skip around in your assessment...classroom-only experience is sufficient! just almost impossible to fit enough of it in before the end of the course.

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I agree that when in the classroom you have to start by using an outline. Yet I have noticed during actual patient contact that the newbies are so busy trying to follow the outline that they aren't paying attention to patients answers. I often tell newbies that they have a very short time to build a relationship with a patient. They are going to ask questions no stranger normally has the right to ask and touch where no stranger would put his hands. I think the patient (and family) interview is extremely important.

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Usually our first skill day is going by the flow chart step by step, then as their knowledge base increases as far as signs and symptoms and understanding of general A&P increases, we advance them into scenarios and coming up with a diagnoses based on there findings. But I agree that it is a cookbook way of doing things, I have noticed that if they dont have the basics down first they tend to be all over the place and miss simple things like checking patient responsiveness and pulses. They tend to focus on the distracters and miss the big picture.

As far as there diagnoses goes they are required to tell us what is going on with the body to cause that problem. It seems to work fairly well, although our classes our always perfect till the next one, meaning we are always changing something trying to imporve it.

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New York State issues a student manual which has a comprehensive breakdown of the assessment. I tell students from day 1 to read and reread these steps and practice using this as a guide. If you get this down , you'll have no problem with the skill sheets. Besides, the skill sheets are bare minimum.

I also try to reference each topic I teach back to the assessment. This builds on the assessment with every new topic. It reinforces the assessment as well as the material being covered.

I believe that students retain more if they learn the reasons behind why they do things rather than learning by rote. That may sound basic but I see many instructors who never grasp that concept.

Finally, I have my students learn the main elements of assessment - sizeup, initial, etc.- and what is to be accopmlished in each.

Then I have them kind of dissect each element. Repetition is so much more effective when it's accompanied by understanding.

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Everyone is going to give you their ideas on how to. What it comes down to is how far you are willing to take it. You can take the easy route and just do the registry sheets or you can go further. Personally I believe in a fast head to toe after the initial ABC's and rapid trauma. I have found over the past 15 years of teaching that the best way is to show one, have them do one and then have them teach one. We are all the typical class A personalities. But tests have shown the most effective way for the students to retain the information is to have hands on that is reinforced with instruction. Soooo, I show all my students how I want them to do the assessment, there are a ton of ways that you can do this be it ITLS, Brady, Mosby or any of the others. You have to find out which one is for you and then practice it until it becomes second nature. If you are not confident in your assessment skills then how can you sell it to new students? Plus you will encounter students that someone else has screwed up and now you have to fix them. So the show them one, let them do one and finally let them teach one works great. But a word of advice for this to work you must be there to interject when the fonder in their instruction. This will also help reinforce what they are doing. Hope this helped. RC

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