Thinking and Intuition in EMS Education – Part 2

The word for today is asymmetry.

In the last installment of this series I talked about how to add a level of thinking and decision making to your students before they leave your class. I’m not claiming you are going to make them experienced clinicians—but I do believe we can give them more of a “clue” before they hit the street. I also believe this process will prepare them for the NREMT better than our traditional method.

I’m going to tell you about something I tried in my last EMT class as an example of this. It started with a wild hair of an idea at the end of the first class and evolved into a great experience.

I finished my first class session and had about 30 minutes left. After droning on about Intro to EMS I considered letting them out a bit early. Then I had the idea to teach them a little bit of hands-on EMS. I paired them up and they all practiced taking radial pulses on each other. They practiced and counted and multiplied. It was good.

The second session I finished a few minutes early and they learned respirations. Pupils were examined at the end of the next session. I found that I was covering vital signs well—and early. I didn’t need a big lab staff for this. It was just me and it worked well. Eventually I had the lecture on patient history, a review of vital signs and blood pressure. Then the lab to bring everything together.

That was when the idea hit me. I called a local assisted living facility and asked them to use their bus to bring over 5 or 6 residents to practice vital signs on. They said no, but invited us over. So one afternoon my entire class went to the assisted living facility. Five patients were strategically placed in common areas around the facility waiting for my students.

I had a lab assistant with each “patient.” Each group of five students rotated throughout the facility with a first-in bag and the assignment to do vitals and a history. It was beautiful. They actually responded to a new location with no idea who or what they would see.

My students felt pulses from 54 – 102/minute (and some great a-fib), had to deal with 5 layers of clothing and realized that histories obtained from older patients aren’t always an exact science. The students loved it—and more importantly got a view of real world assessment problems and solutions. All of this was because I tried a bit of asymmetry and taught how to take a pulse on the first night of class.

It provided the additional benefit of being able to refer to these “patients” while relating subsequent medical and trauma lectures. Students were more interested in some of the medical conditions and medications they heard about. And perhaps most importantly, their only experience in dealing with the geriatric population wasn’t a 19-year-old male student pretending to be an 84-year-old woman with chest pain.

Little steps out of the norm have big results. Make one today!

Coming in part 3 – An in-class critical thinking exercise.