OTJ Learning

[hammerpcp]

Hello all...........I've been thinking about our profession and how much is actually learned on the job. In my experience it is a huge amount, and not only that it is often things that should have been learned in class but are omitted for one reason or another. I thought a thread like this could be not only entertaining (my primary concern of course) but beneficial for those who teach this subject on what is pertinent and therefore should be emphasized in the classroom. For example....My first code (that I was attending) I was not entirely sure where to put the pads. Of course I knew generally where they went but I couldn't remember for the life of me whether it mattered which pad you put where. (Thank god for the pictures :wink: ) After this experience I realized that in all my practice scenarios where I had learned my defib protocols backwards, forwards and inside out, I had never actually applied the pads to anyone’s chest, not even the mannequin :shock:

It just so happens that on another code, where fire was on scene first and had already begun defib protocols, it became very clear to me that we should be cross trained on there machines (I think its the heart start 2000 or something). I didn't have a clue how to switch the cables from their defib to ours.

One more thing about cross training...........I'd bet that the majority of medics (not fire-medics) have never even heard of cribbing. I know I hadn't.

The importance of hands on learning in this field can not be emphasized enough. We learn by doing. Scenarios are all well and good but if you never actually use the suction until you need it on a pt, chances are you will not be comfortable and adept with that piece of equipment when it really counts.

For all you instructors out there, verbalizing procedures is just not enough.

[Ridryder 911]

Good ideas, this does bring up some interesting points as well as for instructors. How much lab time, do you spend with your students, as well when running "arrest scenarios" do they verbalize or actually perform all skills, for example like placing defib pads?.. I know I require electrode placements, and I have a case of expired meds that they are required to administer... verbalization and performing the skill is essential.

I agree most of what our performance is acquired outside the classroom... and again that is why clinical settings are so essential. Tidbits of working knowledge, is honing ones skills and when to apply and not use as well only comes with true time and experience.

It will be interesting to see, what other information people have obtained ...

R/r 911

[chbare]

Hammerpcp, good thread. I remember the first time I had to place pads on an arrest patient. I just froze for a few seconds because I never practiced putting them on in my labs. Thank God for the little pictures. I agree that actually performing skills and procedures as opposed to verbalizing will ensure proper learning and utilization of them in a real situation. I remember a quote that somebody told me that really sums up the learning process. "You do not rise to the occasion in times of distress, you sink to the level of your training." When I helped with training for the National Guard we would set up scenarios similar to what Ridryder 911 suggested. We had a dummy that would accept ECG electrodes and pads, and you could intubate it and perform CPR. We also had a life pack 10, rhythm generator, and a drug box with outdated syringes and vials of meds that we would refill with water after use. In addition, we had an IV arm and IV equipment and an IV that would run into a empty gallon jug for pushing meds and flow rate calculation. We also had airway management equipment and et CO2 detectors. We would set everything up and have the students break into small groups. Out side of the building they would get a scenario and begin from there. They would bring in all of their equipment and start the scenario like any real patient contact. They would have to actually perform assessments and procedures in real time. In addition they had to document the entire code on a SF-600, (Military medical record) and document like the form was going into the patients actual medical record. All of the students liked the added stress and realism.

I also agree that nothing can substitute good clinical experiences.

Take care,

chbare.

[AnatomyChick]

We put our hands on all equipment that they can be tested on... place electrodes to a manikin and the like... we also do "Call Out Scenarios".. that are as true to life as can be attained in a classroom, (office building) setting.....

I believe in Critical Thinking Scenarios, and actually playing them out, not just talking them through. My students are strongly encouraged to actually do the skill and verbalize what they're doing.

[madmedic8522]

i occasionally adjunct for an EMT class, and what i like to do is take my groups outside of the classroom (weather permitting) and go over scenarios in the courtyard. at first the students freak out, but it sure does help them get past that "stage fright" issue. I do this because, getting back to my first arrest, i forgot to let my co-workers in on my little secret, the only help i got was from the experienced Fire capt. on scene. I had to learn real quick to let everybody know what I needed and to quit being so damn shy!