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dxxdd7 xx9 ddddxx 1 dd 1 dpd.ff$08xr #tdxd9 0 : f? ' f? 8f? 8 "zd|~7 7 d michigan department of consumer and industry services
bureau of health services
611 w. ottawa
p.o. box 30670
lansing, mi 48909
requirements:
ems instructor-coordinator education program
initial course
refresher course
continuing education
instructor coordinator programs must be based on the following criteria and approved by the michigan department of consumer and industry services. individuals completing non-approved programs shall be ineligible for licensure.
revised 7/90, 9/91, 10/96, 9/03 authority: act 368, p.a. 1978 as amended
emergency medical services instructor-coordinator
education program
initial program
i. program purpose:
the emergency medical services instructor-coordinator (ems i-c) program will provide the student with a minimum knowledge base and understanding in order to effectively develop, manage, and instruct the appropriate levels of emergency medical services (ems) education programs.
ii. program sponsor approval:
a. the program sponsor must obtain program approval through mdcis,
as defined in the "i/c program sponsor approval/ "on-site"
evaluation process. for each additional course the sponsor must
submit the "notification of interim course" application.
b. the program will be administered according to the criteria outlined in
the program approval process.
c. the course coordinator of the program will meet all identified
criteria as outlined in the program approval process.
d. the instructor/coordinator(s) of the course will meet all identified
criteria as outlined in the program approval process.
e. instructional staff:
those segments of the course that relate to instructional techniques must
be taught by an individual who possesses, minimally, a baccalaureate
degree in education and demonstrated teaching experience, or any
baccalaureate degree, a teaching certificate at the elementary or secondary
level, and demonstrated teaching experience. two (2) exceptions to this
requirement are the lectures on preparation and use of instructional aids
and practical skills instruction, which may be co-taught by an individual
possessing ems licensure and relevant field experience.
f. the topics of "ems program coordination issues, review of mdcis requirements" and "mdcis exam process overview" must be taught by the regional coordinator. attendance to these sessions is mandatory for student completion.
arrangements for scheduling these classes must be made directly with
the regional coordinator. (simply submitting the course schedule is not
sufficient.)
iii. program length:
the program must include a minimum of 140 hours of classroom instruction,
outlined in the summary of course content minimum requirements.
in addition, a minimum of thirty (30) hours of supervised student teaching are required. student teaching must occur outside of the ems i-c program and under the direction and supervision of a licensed i-c. an evaluation of the activity must be performed by an i-c who is not directly involved with the i-c program. student teaching must be performed, minimally, in the following two categories: an initial training program; and an ongoing or refresher program. see appendix b for specific student teaching requirements.
iv. course materials/text:
the choices of text(s) and handout materials for the program are left to the direction of the program i-c. however, the material content must include the design and use of goals and objectives, test writing and evaluation, current michigan ems legislation and related rules, ems education program application forms, course requirements, and related objectives.
the student will be provided the following information during the first class session:
a. a copy of the mdics program approval.
b. the mdics basic emt course guidelines and objectives.
c. a copy of the current ems law and related rules.
v. required curriculum:
the curricular aspects of the program are to be based on the emergency medical services instructor training program-a national standard curriculum published by national highway traffic safety administration (dot). the lesson plans made available through nhtsa will need to be followed in order to effectively meet the
requirements of the course.
in the nhtsa curriculum, there are areas identified for michigan specific
information to be inserted. the program course coordinator must assure michigan
information is provided to students. (example: module 3: administrative issues).
the michigan supplement to the nhtsa curriculum must be utilized as noted.
vi. examination for licensure:
the program i-c must submit, on mdics approved forms, a list of the names of the
students who successfully met the program requirements. it is the responsibility of
each individual seeking licensure to submit a completed application and proof of
successful course completion to mdics. further exam application process
information can be obtained from the regional coordinator.
summary of course content minimum requirements
recommended hours refresher hours
hyperlink "" \l "module 1: introduction" module 1: introduction 1 .5
hyperlink "" \l "module 2: roles and responsibilities" module 2: roles and responsibilities 6 1
hyperlink "" \l "module 3: administrative issues" module 3: administrative issues 3 1
(see michigan supplement)
hyperlink "" \l "module 4: legal issues in ems education" module 4: legal issues in ems education 5 2
hyperlink "" \l "module 5: ethics" module 5: ethics 4 1
hyperlink "" \l "module 6: the learning environment" module 6: the learning environment 5 2
hyperlink "" \l "module 7: learning styles" module 7: learning styles 5 1
hyperlink "" \l "module 8: domains of learning" module 8: domains of learning 5 2
hyperlink "" \l "module 9: goals and objectives" module 9: goals and objectives 5 1
hyperlink "" \l "module 10: lesson plans" module 10: lesson plans 8 1
module 11: presentation skills 20 2
(includes student presentations)
module 12: evaluation techniques 8 2
module 13: facilitation techniques 5 2
hyperlink "" \l "module 14: communication and feedback" module 14: communication and feedback 5 .5
hyperlink "" \l "module 15: motivation" module 15: motivation 5 .5
hyperlink "" \l "module 16: teaching thinking skills" module 16: teaching thinking skills 5 1
hyperlink "" \l "module 17: teaching psychomotor skills" module 17: teaching psychomotor skills 5 1
hyperlink "" \l "module 18: affective domain" module 18: affective domain 5 1
hyperlink "" \l "module 19: discipline" module 19: discipline 5 .5
hyperlink "" \l "module 20: remediation" module 20: remediation 4 .5
hyperlink "" \l "module 21: cultural awareness" module 21: cultural awareness 4 .5
hyperlink "" \l "module 22: teaching resources" module 22: teaching resources 5 1
module 23: research 4 1
module 24: course coordination in michigan 5 2
mdcis requirements 4 2
nremt exam overview 4 optional
total required course hours 140 30
total required student teaching hours 30
170 total
summary of continuing education topics
hyperlink "" \l "module 1: introduction" module 1: introduction
hyperlink "" \l "module 2: roles and responsibilities" module 2: roles and responsibilities educational administration
hyperlink "" \l "module 3: administrative issues" module 3: administrative issues educational administration
(see michigan supplement)
hyperlink "" \l "module 4: legal issues in ems education" module 4: legal issues in ems education educational administration
hyperlink "" \l "module 5: ethics" module 5: ethics educational administration
hyperlink "" \l "module 6: the learning environment" module 6: the learning environment instructional techniques
hyperlink "" \l "module 7: learning styles" module 7: learning styles instructional techniques
hyperlink "" \l "module 8: domains of learning" module 8: domains of learning instructional techniques
hyperlink "" \l "module 9: goals and objectives" module 9: goals and objectives instructional techniques
hyperlink "" \l "module 10: lesson plans" module 10: lesson plans instructional techniques
module 11: presentation skills instructional techniques
module 12: evaluation techniques measurement and evaluation
module 13: facilitation techniques instructional techniques
hyperlink "" \l "module 14: communication and feedback" module 14: communication and feedback instructional techniques
hyperlink "" \l "module 15: motivation" module 15: motivation instructional techniques
hyperlink "" \l "module 16: teaching thinking skills" module 16: teaching thinking skills instructional techniques
hyperlink "" \l "module 17: teaching psychomotor skills" module 17: teaching psychomotor skills instructional techniques
hyperlink "" \l "module 18: affective domain" module 18: affective domain instructional techniques
hyperlink "" \l "module 19: discipline" module 19: discipline educational administration
hyperlink "" \l "module 20: remediation" module 20: remediation instructional techniques
hyperlink "" \l "module 21: cultural awareness" module 21: cultural awareness instructional techniques
hyperlink "" \l "module 22: teaching resources" module 22: teaching resources educational administration
module 23: research educational administration
module 24: course coordination in michigan educational administration
mdcis requirements educational administration
nremt exam overview measurement and evaluation
appendix a
suggested topics for mini-presentation ii
motivating groups who dont want to be in class e.g. mandatory class
building self-confidence in the insecure student
researching available textbooks for all levels
adas effect on the classroom*
budgeting for a course
recruiting for a course
obtaining and preparing guest instructors*
creating a syllabus
dismissing a student from the class (legally)*
minimizing test and other anxieties
obtaining av resources*
maintaining class records*
arranging student clinical hours*
setting up nremt exams*
.
*it is the responsibility of the i-c of the program to adequately present any of these presentations either not done or done inadequately.
appendix b
student teaching goals and objectives
the student teacher will be expected at a minimum to:
1. develop a lesson plan including audio-visuals and a suitable quiz for each topic they present.
2. present and discuss the lecture outline with the precepting i-c prior to the class.
3. present a class that is primarily didactic in nature.
4. present a class that is primarily psychomotor in nature.
5. provide each student in the class with an evaluation form provided by the i-c of the i-c program.
6. discuss the class with the precepting instructor immediately following the class.
7. ensure that the i-c of the i-c program receives the preceptor and student evaluations as soon as possible following each program they instruct.
all student teaching requirements must be completed within four (4) months of the conclusion of the classroom portion of the course.
module 24
michigan ic course supplement
mdcis education program requirements
instructor: regional coordinator
section i mdcis administration of ems education programs
time: 0.5 hours
objectives: at the conclusion of this session, the student will be able to:
1. explain the role of mdcis bureau of health services, licensing division
2. explain the role of the regional coordinator
3. have an understanding of p.a. 368 of 1978 as amended
4. have an understanding of the administrative rules
section ii initial training
time: 2 hours
objectives: at the conclusion of this session, the student will be able to:
have an understanding of the ems education program sponsor approval process
apply for an initial ems education program sponsor approval
submit notification for interim course
explain the process for program sponsor re-approval
describe the curricula utilized in michigan
explain required documentation for course completion
section iii continuing education
time: 2 hours
objectives: at the conclusion of this session, the student will be able to:
explain the necessary ceu requirements for mfr, emt, intermediate, paramedic, and ic.
complete the notification of intent to conduct continuing education forms
explain the difference between option 1,2, and 3 ceu programs, and required documentation for each.
explain the ceus given for initial education courses.
have an understanding of standardized ceus (blue book)
have an understanding of ceu policies
section iv licensure process
time: 0.5 hours
objectives: at the conclusion of this session, the student will be able to:
1. explain the eligibility requirements for licensure in michigan
2. explain the license application process
3. explain the license renewal process
4. explain the requirements for re-licensure
section v examination process
time: 0.5 hours
objectives: at the conclusion of this session, the student will be able to:
1. discuss nr eligibility requirements for the written examination at each level: mfr, emt, intermediate, and paramedic
2 explain the application process for each level of examination and how to fill out each level of nr application, and required attachments
3. have an understanding of nr felony policy
4. have an understanding of nr accommodations policy
5. explain the differences between exams (times, number of questions, categories, passing scores) for each level of nr examination
6. explain the composition and construction of the written exams
7. explain the re-test process and eligibility
8. have an understanding of the nr practice analysis, and how it relates to both the written and practical exams for each level
section vi practical exam administration (exam evaluator in-service)
time: 3.5 hours
objectives: at the conclusion of this session, the student will be able to:
explain the nr eligibility requirements for the practical examination at each level: mfr, emt, intermediate, and paramedic
explain the application process for each level of examination
understand the roles and responsibilities within the practical examination (host, nr representative, skill examiners)
have an understanding of the orientation to the practical skills evaluator
explain the practical stations and station/equipment requirements for each level of examination
perform as a practical skill examiner
coordination issues for the michigan instructor/coordinator
instructor: regional coordinator
section i & ii introduction and coordination concepts
time: 0.5 hours
objectives: at the conclusion of this session, the student will be able to:
1. identify the general responsibilities for program coordination
section iii program development
time: 3 hours
objectives: at the conclusion of this session, the student will be able to:
1. identify who can sponsor an ems education program
2. explain the role and requirements of the course coordinator
3. identify the role and requirements for the medical director
4. identify the requirements and responsibilities of instructional
faculty
5. define the purpose of financial support for the program
6. identify the requirements for the facility, supplies/equipment and
audio-visual equipment
7. define the required learning resource availability
8. identify and explain the requirements for clinical resources
9. identify and explain the provisions for clinical objectives and
student clinical evaluation
10. identify and explain the required student policies
11. identify and explain the required program operation policies
12. explain the requirements for program evaluation (quality
improvement)
section iv other coordination issues
time 0.5 hours
objectives: at the conclusion of this session, the student will be able to:
1. explain the need for professional role models
2. identify and explain student resources that should be provided
3. discuss instructor performance and instructor development
module 3 michigan insert
state level
michigan department of consumer and industry services
bureau of health services
licensing division
complaint & allegation division
regulatory division
bureau of health systems
emergency medical services section
administrative rules of emergency medical services
bureau of health services
on-line at hyperlink "http://www.michigan.gov/cis/0,1607,7-154-10568_17671_17679---,00.html" www.michigan.gov/cis/0,1607,7-154-10568_17671_17679---,00.html
emergency medical services coordination committee
subcommittees
quality assurance task force
emscc education committee
michigan ems
michigan association of emergency medical technicians
society of michigan emergency medical services instructor coordinators
michigan association of ambulance services
michigan ems for children
swms
f. upems
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/logo.jpg" \* mergeformatinet
2002 national guidelines
for educating ems instructors
national association of ems educators u.s. department of transportation u.s. department of health and human services
table of contents
hyperlink "" \l "module 1: introduction" module 1: introduction
hyperlink "" \l "module 2: roles and responsibilities" module 2: roles and responsibilities
hyperlink "" \l "module 3: administrative issues" module 3: administrative issues
hyperlink "" \l "module 4: legal issues in ems education" module 4: legal issues in ems education
hyperlink "" \l "module 5: ethics" module 5: ethics
hyperlink "" \l "module 6: the learning environment" module 6: the learning environment
hyperlink "" \l "module 7: learning styles" module 7: learning styles
hyperlink "" \l "module 8: domains of learning" module 8: domains of learning
hyperlink "" \l "module 9: goals and objectives" module 9: goals and objectives
hyperlink "" \l "module 10: lesson plans" module 10: lesson plans
hyperlink "" \l "module 11: presentation skills" module 11: presentation skills
hyperlink "" \l "module 12: evaluation techniques" module 12: evaluation techniques hyperlink "" \l "module 13: facilitation techniques" module 13: facilitation techniques
hyperlink "" \l "module 14: communication and feedback" module 14: communication and feedback
hyperlink "" \l "module 15: motivation" module 15: motivation
hyperlink "" \l "module 16: teaching thinking skills" module 16: teaching thinking skills
hyperlink "" \l "module 17: teaching psychomotor skills" module 17: teaching psychomotor skills
hyperlink "" \l "module 18: affective domain" module 18: affective domain
hyperlink "" \l "module 19: discipline" module 19: discipline
hyperlink "" \l "module 20: remediation" module 20: remediation
hyperlink "" \l "module 21: cultural awareness" module 21: cultural awareness
hyperlink "" \l "module 22: teaching resources" module 22: teaching resources
hyperlink "" \l "module 23: research" module 23: researchtable of contents for appendices
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app1" action verbs useful for writing objectives
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app2" academic honesty college procedure
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app3" classroom behavior, "a practical guide for faculty"
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app4" student counseling report (sample)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app5" affective domain evaluation tools (excerpt from 1998 emt-p: nsc)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app6" rubric affective domain tool
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app7" guidelines for activities and classroom exercises on ethical issues
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app8" classroom arrangement strategies
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app9" bloomstaxonomy of the domains of learning
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app10" maslows hierarchy of needs
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app11" lesson plan outline
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app12" unit #1 - pathophysiology and management of anaphylaxis
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app13" daily lesson plan - anaphylaxis unit (sample lesson plan)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app14" confined space rescue awareness (sample lesson plan)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app15" use of safety gear inside a fire scene (sample lesson plan)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app16" ems student handbook sample (emt-basic)
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app17" emergency medical health services program student handbook
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app18" budget considerations
hyperlink "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/" \l "app19" glossary of terms
module 1: introduction
dear colleagues:
in january 2001, the national association of ems educators (naemse) entered into a cooperative agreement with the national highway traffic safety administration (nhtsa) and the health resources and services administration (hrsa). the goal of this partnership was to design an instructor preparation curriculum for guiding ems educators to effectively teach adult learners who populate the ems classroom.
drafted by representatives of the national association of ems educators along with representatives from professional organizations, regulatory groups, accreditation agencies and state education agencies, this curriculum represents a common core of teaching knowledge and skills which will help all ems educators to assist the adult learner acquire 21st century knowledge and skills.
organizations participating with naemse in the task force included:
the national association of emts
the national association of state ems directors
the national council of state ems training coordinators
the international association of fire chiefs
the international association of firefighters
the committee on accreditation of ems programs
the national registry of emts
the national association of ems physicians
emergency medical services for children national resource center
the efforts of the task force constitute the initial step towards a coherent approach to the preparation and certification of the professional educator in the ems setting. the curriculum is based upon the shared view within the ems education community of what constitutes professional teaching.
the task force acknowledges the variety of settings that ems education takes place, ranging from the instruction of citizens (cpr, first aid, etc.) to graduate programs in ems management. the task force also acknowledges the wide variance in the educational preparation of persons who chose to teach in the ems setting. this document addresses the knowledge, standards, and performance expectations deemed essential for all professional educators, regardless of topic area or level of instruction. this document will assist with the implementation of the vision prescribed in the ems education agenda for the future: a systems approach (2000). the education agenda will create an ems education system that "emphasizes high-level cognition, problem solving, and the ability to deal with ambiguity and conflicting priorities"
one intended outcome of this curriculum is to stimulate dialogue among the stakeholders of the ems education profession regarding the best thinking of their colleagues as to what constitutes competent entry-level ems instruction. our work is offered to state and local ems agencies and educational institutions concerned with the professional development of ems educators. the curriculum may serve as a resource to revisit state standards for training and licensing of new ems educators; as a step towards national certification; and, as a part of the process for national accreditation of ems education programs. it is only with consensus among ems educators that a shared vision of future ems education will be forged.
we encourage all ems educators to consider ways that this curriculum might enhance their ems teaching skills and improve the outcomes of the ems student in the education system. our ultimate shared goal is to provide the highest level of quality patient care.
sincerely,
judith a. ruple, phd, rn, nremt-p project director task force co-chair
angel clark burba, ms, nremt-p project director task force co-chair
instructor task force members and representatives
project co-chair
angel clark burba, ms, nremt-p
howard community college
health sciences division
10901 little patuxent parkway
columbia, md 21044
email: aburba@howardcc.edu
phone: (410) 772-4948
fax: (410) 772-4494project co-chair
judith ruple, ph.d., nremt-p
university of toledo, health & human services
2801 west bancroft
toledo, oh 43606
email: jruple@buckeye-express.com
email: jruple@utnet.utoledo.edu
phone: (419) 530-3195
fax: (419) 530-3096
project administrator
joann freel, bs, cmp
executive director
national association of ems educators
700 north bell avenue, suite 260
carnegie, pa 15106
email: joann.freel@naemse.org
phone: (412) 429-9550
fax: (412) 429-9554
iafc
cliff wilson
battalion chief/medical officer
kitsap co. fd7
p.o. box 1517
port orchard, wa 98366
email: hyperlink "mailto:cwilson@kitsapfire7.org" cwilson@kitsapfire7.org
phone: (360) 871-2411
fax: (360) 871-2426expert writer
sandy hunter, m.ed.
program director
eastern kentucky university
225 dizney, 521 lancaster ave.
richmond, ky 40475
email: sandy.hunter@eku.edu
phone: (859) 622-1028
fax: (859) 622-6333
expert writer
heather davis, nremt-p, mph
clinical supervisor
ucla daniel freeman hospital, paramedic school
333 north prairie ave.
inglewood, ca 90301
email: hdavis@mednet.ucla.edu
email: hdavisemtp@aol.com
phone: (310) 674-7050
fax: (310) 680-8640naemse
alice dalton, rn, ms, nremt-p
clinical education coordinator
pridemark paramedic services
689 glenarbor circle
longmont, co 80501
email: twinkers@juno.com
phone:(303) 939-8111
fax: (303) 939-8936expert writer
linda honeycutt, emt-p
ems clinical content editor
healthstream/eminet
209 10th avenue south - suite 450
nashville, tn 37203
email: linda.honeycutt@healthstream.com
phone: (615) 301-3191
fax: (615) 301-3200
coaemsp
chris nollette, emt-p, nremt-p, edd
program director
community college of southern nevada
8340 sky canyon
las vegas, nv 89128
email: chris_nollette@ccsn.nevada.edu
phone: 702-360-8683
fax: 702-651-5028ncsemstc
steve mercer
education coordinator
idph bureau of ems
401 sw 7th st., suite d
des moines, ia 50309
email: smercer@idph.state.ia.us
phone: (515) 725-0322
fax: (515) 725-0318
nasemsd
michael armacost
colorado department of public
health and environment
4300 cherry creek drive south
denver, co 80222
email: mrarmaco@csn.net
phone: (303) 692-2980
fax: (303) 452-9396
naemsp
paula willoughby, do
chicago fire department
4923 s. greenwood ave.
chicago, il 60615
email: paulawilloughby@aol.com
phone: (773) 924-7579
fax: (773) 924-7987nremt
phil dickison, nremt-p
associate director
national registry of emts
6610 busch blvd.
columbus, oh 43229
email: phild@nremt.org
phone: (614) 888-4484
fax: (614) 888-8920
nhtsa
david bryson, ba, cotr
ems specialist
national highway traffic safety administration
400 seventh st. sw (nts14)
washington, dc 20590
email: dbryson@nhtsa.dot.gov
phone: (202) 366-4302
fax: (202) 366-7721naemt
mark terry, ba, nremt-p
emergencies providers inc.
6740 eastwood traffic way
kansas city, mo 64129
email: mterry@micro.com
phone: (816) 924-2500
fax: (816) 923-7314
iaff
lori moore
assistant to the general president
international association of fire fighters
1750 new york ave nw
washington, dc 20006-5395
email: lmoore@iaff.org
phone: (202) 737-8484
fax: (202) 737-8418the ems education agenda for the future clearly articulates a vision for an educational system where national program accreditation and national ems certification are explicitly tied to one another. the current ems education system in the united states has such wide variability in its approach to the education and certification of its ems providers that there is no clear, consistent description of the "typical" ems provider, regardless of level. a result of this situation is the inability of a well-qualified and educated ems provider to readily move from one part of the country to another without exerting significant efforts to re-establish the ability to function as an ems provider. efforts to achieve national consensus on educational issues such as national standard curricula have also been limited by these inconsistencies.
critics of national certification and program accreditation argue that ems practice should be determined at the regional or local level. national certification and program accreditation does not restrict the ability of an ems system or authority to define what may or may not be included in the scope of practice for emergency medical technicians. rather, these concepts support an educational system that better prepares the ems student to function within the local environment. there may be additional benefits that will be realized as cross-region barriers are reduced, such as a larger potential employee pool for ems employers to draw from.
efforts to restructure ems education, as it is envisioned in the ems education agenda for the future, are redefining the mission of ems education programs and the scope of work for ems educators. rather than merely delivering a prescribed curriculum, ems educators will be expected to ensure that all adult learners learn and perform at high levels of competency. ems educators will be expected to find ways to support and connect with the needs of all the adult learners in their classrooms. this new mission requires substantially more knowledge and skill on the part of ems educators and the implementation of a more student-centered approach to providing ems education. these changes occurring in the delivery and content of ems education and in ems program structure require supportive policies for preparing educators and for accrediting ems education programs.
a major initiative to strengthen the ems education profession was the establishment in 1995 of the national association of ems educators (naemse). the mission of naemse is, "to promote ems education, develop and deliver educational resources, and advocate research and life long learning for the professional ems educator". naemse is dedicated to assisting in the development, preparation, and induction into the ems education profession of those persons interested in teaching in the ems setting. the national association of ems educators believes that the complex art of teaching requires the development of performance-based standards and assessment strategies that are capable of capturing ems educators' reasoned judgments and that evaluate what they can actually do in authentic teaching situations.
the national association of ems educators (naemse) entered into a cooperative agreement with nhtsa and hrsa in january 2001, to revise the ems instructor training program (1995). a task force was convened to consider what changes were needed in the document to create standards for entry into the ems educator profession. these are standards that embody the kinds of knowledge, skills, and performances that entry-level ems educators need to practice responsibly when they enter the field of ems teaching. the standards are also designed to be built upon and prepare entry-level ems educators for eventual success as master level ems educators later in their careers.
the goal of the task force was to create a curriculum based on sound educational standards designed to prepare entry-level instructors as well as enhance the teaching skills of experienced instructors. professional organizations, state agencies, and other stakeholders in the project reviewed the standards and the content of the curriculum.
the starting point: a common core of teaching knowledge
the foundation of any educational system is the preparation and experience of its teachers. the ems educational system is no different. however, the current approach still relies heavily upon the concept of a "good clinician" is a "good teacher." this may have served the ems education system satisfactorily when it was in its infancy, however, as the ems profession continues to develop and mature, so must its educators. as the ems profession does not believe that providers of emergency medical care should learn their craft by trial and error; it should not expect that from its teachers. ems educators should be educated in the practice of teaching, and should be able to demonstrate their competency in doing so. the development of national standards for the credentialing of ems educators will be a critical step toward the development of consistent, effective educational practices and successful student outcomes.
the task force began its work by articulating standards for a common body of teaching knowledge and skills that should be acquired by all entry-level instructors. these initial standards will be followed by additional distinct standards for specific areas and levels of ems education. like the first tier of assessment for licensing or certification in virtually all other professions, this body of knowledge is intended to outline the common principles and foundations of practice that cut across specialty areas in ems education. it includes the knowledge of adult learning and motivation theories, curriculum design and teaching methods that all fields of education share.
the initial development of this shared body of knowledge was viewed by the task force as important for two reasons. first, it is the common commitment to ethical practice and foundational knowledge that provides the philosophy that holds members of the profession together. a common language and shared body of knowledge enables educators to better communicate with each other. second, the development of the common body of knowledge becomes the essential foundation for designing assessment methods for the evaluation of instructional skills.
the educational community recognizes that application of this common body of ems education knowledge will occur in specific contexts. the adult learner, level of instruction, and instructional setting will define these contexts. we emphasize the dynamic nature of this set of professional understandings, abilities, and commitment standards.
the curriculum: outcome-based and assessment compatible
an important attribute of this curriculum is that it is outcome-based. the curriculum describes what ems educators should know and should be able to do in an educational setting rather than prescribing what specific course of action should be taken. this shift toward outcome-based standard setting is in line with the ems education agenda for the future. this curriculum will clarify the criteria required for successful completion of the instructor-training course. the flexibility of this document comes into play as the end user (jurisdiction, state, training program, etc.) determines to what level (depth and breadth) assessment will take place. the task force placed emphasis on the abilities ems educators should develop rather than the hours they spend taking classes. ultimately, performance-based certification standards should enable states and other interested parties to permit greater innovation and diversity in how ems educator programs are designed and delivered by assessing their outcomes rather than their inputs or procedures.
the curriculum was developed from six major consensus points reached by the task force during the initial development of the curriculum. the task force agreed that the ems educator (whether entry level or experienced) has the following professional attributes and skills:
ems educators are committed to the needs of the adult learner and their learning preferences.
ems educators know the subjects they teach and how to teach those subjects using different methods to a diversity of adult learners.
ems educators are responsible for managing the learning environment and assessing learning outcomes.
ems educators think systematically about their practice and learn from their classroom experience.
ems educators are members of the larger ems and educational communities and are committed to continual improvement in the ems education system
ems educators are aware of the content and implications of the ems education agenda for the future.
in our work, the task force used historical documents from the federal government, numerous seminal adult education texts, excerpts from previous national standard curricula, and survey information gathered from the states and members of professional organizations as the basis for exploring what entry-level ems educators should know and be able to do. we drew on the work of a number of states who have developed certification standards for ems educators, the valued input of instructional designers, and early versions of professional development courses (bourn, dalton and smith, 1994)
the professional attributes and skills set criteria (module 2) was the reference point in the development process and it permeates throughout the curriculum. the curriculum is not organized within each of the criteria since so many abilities are interdependent. an instructional matrix (figure 1.1) is provided to assist those implementing the curriculum with the selection of topics for inclusion in their individual program. the matrix is based on performance outcomes, matching the education objective level (breadth) to the performance expectations (depth) of what the educator is expected to do in a particular classroom setting.
entry level ems educators vs. master ems educators
the task force spent a great deal of time considering the question, "how do we distinguish between beginning and advanced levels of performance by the ems educator?" the requirements for entry into the ems education profession have become more sophisticated. many states require probationary periods prior to issuing a certification to teach and an increasing number require an internship as part of their preparation. questions arise about what the ems educator should be expected to know and be able to do at various points in their professional development. the task force debated the question of what level of preparation and depth of knowledge would be needed to enable ems educators to succeed at the entry-level. the task force accepted the fact that variation will continue to exist nationally, but successful completion of the instructor course should prepare participants to practice responsibly as an entry-level ems instructor.
the adult learners need for well grounded and adaptive teaching techniques are what must ultimately define the standards for ems educators. the entry-level ems educator must have the ability to engage in learner-centered, outcome-based practices articulated by the curriculum. successful completion of the curriculum should provide the opportunity for building and developing teaching skills on a solid foundation that will lead to higher levels of instructional and administrative expertise.
while revising the course, the task force discussed whether or not the level of knowledge, understanding, commitment, and ability differed between entry-level educators and more expert educators. the group concluded that the appropriate distinctions between beginning and advanced practice are in the degree of sophistication the ems educator exhibits in the application of knowledge rather than in the kind of knowledge needed to perform effectively in the classroom setting.
advanced level ems educators, having greater flexibility and adaptability, are expected to develop their abilities to deal simultaneously with more complex facets of the teaching environment. they should have greater capacity to integrate understanding and performance based upon the adult learners' individual needs. to that end, to eventually become an expert practitioner the entry-level instructor must have, at the very least, an awareness of the kinds of knowledge and understandings needed -- as well as resources available -- to develop their skills. in addition, entry-level instructors must have the capacity to address the facets of the curriculum, classroom presentation, and adult learning styles. the curriculum not only aims to develop entry-level instructors, but it also is designed to improve the performance of expert educators.
peer review
the curriculum was distributed in draft form to members of the task force for review on july 15, 2001. the task force members were asked to review the curriculum based upon the accuracy of theoretical content, presentation quality, and appropriateness of content for entry-level instructors. we asked the task force to identify the curriculums strengths and weaknesses and suggest strategies for revising it.
after incorporating task force comments, we posted the draft curriculum on the naemse web site on july 30, 2001, for further national peer review. in addition, we e-mailed naemse members and published requests to review the draft in the organizations bimonthly newsletter. the ems community and other interested parties were asked to evaluate the quality of the information provided, to examine the curriculum for strengths and weaknesses, and to critique the design and content of the curriculum.
in september 2001, two modules of the draft curriculum were presented to members attending the naemse annual educational symposium. attendees were invited to comment on the modules and encouraged to visit the web site to review and comment on the entire draft curriculum. in november 2001, all additional modifications and revisions were incorporated into the draft prior to the pilot test.
the pilot program
the pilot program was successfully conducted on april 6-9, 2002, in portland, oregon. more than one hundred and thirty persons attended the four-day program. twenty-one task force members and faculty presented a compressed version of the curriculum. the participants evaluated the content, design, and evaluation methods used during the program. the design of the pilot was based on the constructivist model of education as students were active participants in the learning process.
quality assurance activities included focus groups, daily evaluations, and final program evaluations. all quality assurance activities were developed, conducted and supervised by professional ems educators who were not involved in the design and development of the curriculum. the task force reviewed and incorporated many of the suggestions from the pilot participants into the final curriculum.
recommendations for prerequisites
the curriculum emphasizes an academic specialization, specifically, adult learning theory and teaching skills. prerequisites for attending the program will vary according to the particular program, the local and state requirements and the area of specialization the participant is interested in pursuing.
ideally, the entry-level ems educator should have successfully completed a course of academic study and gained clinical experience as an ems provider, registered nurse, physician, or other allied health practitioner prior to entering the educator program. the entry-level instructor should also be educated to a level that is at least one level higher than the level of provider they intend to instruct. for example, an experienced emt-intermediate could become an appropriate entry-level instructor for an emt-basic course. professional knowledge is the foundation of teaching practice.
the intent of the curriculum designers is to assist in the preparation of educators who are proven ems practitioners and enthusiastic role models for lifelong learning and professional standards. participants who attend the entry-level ems educator program should be teacher candidates who have proven their commitment to the profession through self-initiated field experiences and academic performance. previous teaching experience is preferred.
another recommendation is that the entry-level ems educator participates in a supervised teaching internship in an ems program, working and learning under the shared guidance and expertise of experienced educators. during this internship it is recommended that the participant document their learning and professional growth through the development of a portfolio that should be reviewed by the experienced program educators.
it is envisioned that the entry-level ems educator programs, offered at the state and local levels, will evolve in the future and be part of a national instructor credentialing process and the envisioned national accreditation process. a national instructor credentialing process will help pave the way for reciprocal credentialing in other states.
course description
the instructor course curriculum is designed to facilitate the use of professional attributes and skills set criteria as outlined in module 2.
a needs assessment of the intended student population should be conducted prior to the delivery of the course. performance outcomes expected of the participants following completion of the course should be clearly identified and articulated in writing. the question to ask is, "what should the participants be able to do as a result of taking this course?" the answer to this question can come from many sources, including discussions with course participants, faculty, employers, advisory groups, certifying bodies, and ems community representatives.
the first step in presenting this curriculum is to identify the intended learning outcomes for the program. intended learning outcomes answer the following questions:
what will participants know or understand once they have successfully completed this course?
what will they be able to do with their knowledge or understanding when they have successfully completed the course?
once the outcomes are in place, discussions should take place about how the intended learning outcomes will be assessed at the completion of the course or program. in outcome-based educational processes, assessment is not an academic exercise unlike anything the student will encounter elsewhere in life. evaluation methods must parallel what the participant will be expected to as an ems educator. additional questions to be addressed are:
what assessment tasks will the participants have to complete (and to what degree) to assure that the outcomes have been met?
in what ways do these assessment tasks reflect the context in which the participants will be expected to use the knowledge, skills and attitudes learned in this course?
when the assessment process has been delineated, determine the necessary content and appropriate learning processes. questions to address are:
what facts and information do the participants need to have in order to meet the outcomes?
what skills and abilities are essential to the outcomes?
what themes, issues or concepts do participants need to explore and understand?
what experiences will best help the participants to gain the knowledge, skills, abilities and values needed to meet the outcomes?
as an outcome based education program, the course must include instructional methods that emulate the modeling, coaching and facilitating concepts integral to the cognitive knowledge base of the ems instructor. the course should include group activities that encourage participants to link their experiences to conceptual knowledge and learning activities that challenge the participants to use their problem-solving skills and demonstrate their theoretical knowledge. emphasis should be placed on instruction and teaching processes rather than the administrative and managerial functions of ems instruction.
some areas may be best covered in non-traditional methods, such as pre-requisite directed readings. this approach would prove particularly appropriate for those modules that are largely aimed at presenting an introduction to the topic. there is no intent for the modules of this curriculum to be presented in a formalized lecture format.
presenters of this curriculum must be prepared to move back and forth between outcomes, assessment, content and learning processes; to continually learn from the participants; and to constantly question how to better prepare participants for their work in the field of ems education.
acknowledging the diversity of ems educational settings and the individual needs of local, state, and regional governments, the task force developed a matrix (curriculum map) for the implementation of a modular approach to the contents of the curriculum. the matrix outlines the recommendations of the task force for the level of performance the participant should master. this level of mastery is based upon the entry-level instructors responsibility in the program setting. built around the levels of learning that are described in modules 8 and 16, the matrix further defines process, skills, and content topics.
modulesecondary instructorprimary instructordefinition of rolesassists primary instructor to instruct and evaluate any domain of learning in the classroom and laboratory. uses prepared materials without significant modification.instructs and evaluates in any domain of learning in the classroom and laboratory. uses and modifies prepared materials.1. introduction2. roles and responsibilitiesconcept overviewbasic knowledge3. administrative issuesconcept overviewbasic knowledge4. legal issuesconcept overviewbasic knowledge5. ethicsapplicationapplication6. learning environmentapplicationapplication7. learning stylesbasic knowledgeapplication8. domains of learningapplicationapplication9. goals and objectivesbasic knowledgecan modify10. lesson plansbasic knowledgecan modify11. presentations skillsapplicationapplication12. evaluation techniquesbasic knowledgecan modify13. facilitation techniquesapplicationapplication14. communication/feedbackapplicationapplication15. motivationbasic knowledgeapplication16. teaching thinking skillsapplicationapplication17. teaching psychomotor skillsapplicationapplication18. affective domainapplicationapplication19. disciplineapplicationapplication20. remediationapplicationapplication21. cultural awarenessapplicationapplication22. teaching resourcesconcept overviewapplication23. researchconcept overviewbasic knowledgesituational evaluation tools:present lessonmodify lesson plan
concept overviewbrief overview of concepts given, little to no evaluation over these materialsbasic knowledgeintroduction to the topic, cognitive evaluation at low levels (c1)applicationcover the topic in more depth, probably includes practical exercises, cognitive evaluation at mid to high levels (c2-c3)can modifygiven draft materials, the candidate can modify materials to make more useful (e.g. objectives, lesson plans, evaluation tools)figure 1.1conclusion
the task force was charged with articulating standards for entry into the ems educator profession and to develop a curriculum that would assist persons in meeting those standards. the first section of this module presented the philosophical consensus points reached by the task force regarding the professional attributes and skills of the entry-level ems educator. the professional attributes were expanded to describe a common body of teaching knowledge and skills that should be acquired by all entry-level instructors.
the task force realizes the positive impact that the ems education agenda for the future will have on the ems education environment. this environment is characterized by increasing knowledge, complexity, and uncertainty. the task force proposes that the knowledge of adult learning, curriculum design, and teaching methods described in the curriculum are requisite for ems educators, regardless of their level of instruction, their years of experience, or the specific content area they specialize in.
in the second part of this first section, the task force acknowledges the diversity of the environments in which the curriculum will be used and the diversity of the persons who will participate in the course. suggestions are included for designing program offerings at two levels of instructor responsibility: primary and secondary. a description of professional attributes and skills sets, with suggestions for outcomes and assessment, is included.
the effort of the task force constitutes the initial step towards a coherent approach to the preparation and certification of the professional educator in the ems setting. this curriculum is based upon the ems education communitys shared opinion of what constitutes professional teaching. the curriculum serves as the framework for preparing ems entry-level educators to work comfortably in a classroom environment.
the task force believes that to be effective, the entry-level ems educator must be able to integrate content knowledge with pedagogical understanding to assure that all adult learners learn and perform at high levels in their chosen field.
acknowledgements
the task force would like to acknowledge the contributions of the following people to the successful development, refinement and production of the final curriculum.
ms. joann freel, executive director of the national association of ems educators (naemse). ms freel served as the project administrator and oversaw all aspects of the project, specifically in the financial and planning areas. her knowledge of the grant process and dedication to the vision of the task force was key to the success of the project.
the expert writers who captured the essence of the task force discussions and deliberations and distilled the information into draft form for review by the national ems community. after the draft was reviewed, the expert writers incorporated all of the suggestions and modifications into the final product. thank you to ms. heather davis, mr. sandy hunter, and ms. linda honeycutt for your personal commitment and dedication to this important project.
mr. david bryson, nhtsa ems specialist. mr. bryson served as our federal government contact and liaison. his experience and guidance during the development of the project was invaluable.
the national association of state ems directors, the national council of state ems training coordinators and the national association of emts for providing access to survey information and supporting the initial surveys of ems teaching professionals on a national level.
ms. jean miller, director, interstate new teacher assessment and support consortium (intasc) for her input and direction in the process of developing entry-level educator standards. the design models used by the consortium were most helpful.
our colleagues in ems education who participated in the pilot program held in portland, oregon, in april 2002. your thoughtful and thorough evaluation of the curriculum content was essential to the successful completion of this project. thank you for your time and your talent.
thanks to the staff of naemse who provided administrative support throughout this project.
bibliographical resources
boud, d., & feletti, g. (eds.). (1991). the challenge of problem based learning. new york: st. martin's press.
burke, j. (ed.). (1989). competency based education and training. new york: the falmer press.
cross, k. (1981). adults as learners: increasing participation and facilitating learning. san francisco: jossey-bass.
dalton, a. (1996). enhancing critical thinking in paramedic continuing education. prehospital and disaster medicine, 11(4), 246-253.
gagne, r., & briggs, l. (1979). principles of instructional design (second ed.). new york: holt, rfinehart and winston.
hoberman, s., & mailick, s. (eds.). (1994). professional education in the united states (first ed.). westport: praeger.
merriam, s. (1996). updating our knowledge of adult learning. journal of continuing education in the health professions, 16(3), 136-143.
national highway traffic safety administration. (1996). ems agenda for the future. washington, dc: u.s. department of transportation.
national highway traffic safety administration. (2000). ems education agenda for the future. washington, dc: u.s. department of transportation.
national registry of emergency medical technicians. (1993) national emergency medical services education and practice blueprint. columbus, oh:
the pew health professions commission. (1995). critical challenges: revitalizing the health professions for the twenty-first century. san francisco: university of california, san francisco.
the pew health professions commission. (1993). health professions education for the future: schools in service to the nation. san francisco: university of california, san francisco.
the pew health professions commission. (1991). healthy america: practitioners for 2005 an agenda for action for u.s. health professional schools. san francisco: university of california, san francisco.
united states department of health and human services. (1999). building the future of allied health; report of the implementation task force of the national commission on allied health. rockville: u.s. department of health and human services, public health service, health resources and services administration, bureau of health professions, division of associated, dental, and public health professions.
united states department of transportation, national highway traffic safety administration, united states department of health and human services public services, & health resources and services administration, m. c. h. b. (2000). emergency medical services education agenda for the future: a systems approach. washington, dc: united states government printing office.
united states department of transportation, national highway traffic safety administration, united states department of health and human services public services, & health resources and services administration, m. c. h. b. (1996). emergency medical services agenda for the future: a systems approach. washington, dc: united states government printing office.
module 2: roles and responsibilities
cognitive goals
at the completion of this module, the student-instructor should be able to:
use their own words to provide a descriptive definition of the primary and secondary ems instructor
describe the differences between the primary and secondary instructor
describe the duties of a primary instructor providing the majority of instruction during the entirety of an ems course
describe the duties of a secondary instructor assisting a primary instructor
describe the importance of professional development through continuing education, conference offerings and formal academic coursework for the ems instructor
describe sources for locating relevant educational and research materials
describe the relationship between the instructor and the student, assistant instructor, program director and medical director
describe the role of the course syllabus and lesson plan in course management
describe the major components of the syllabus and lesson plan
psychomotor goals
there are no psychomotor objectives for this section
affective goals
at the completion of this module, the student-instructor should be able to:
defend the importance of continuing professional development for the professional educator
value the role of the instructor in the ems classroom
serve as a role model for other educators in the ems setting
assess personal attitudes and demeanor that may distract from professionalism
value the variety of the classroom culture
appreciate the importance of the teacher-student relationship
value the need to provide fair, timely and constructive feedback to students
exhibit professional behaviors in the following areas: integrity, empathy, self-motivation, appearance and personal hygiene, self-confidence, communications, time management, teamwork, diplomacy, and respect
explain the value of serving as a mentor
value the importance of mentoring in the development of a professional ems instructor
declarative
why this module is important
ems instructors do more than teach students in the classroom setting so it is important to have an understanding of the scope of duties and responsibilities
ems instructors should value the team approach to teaching and know those individuals included on the instructional team
ems instructors should know the desirable character traits of an educator and the commonalties that exist between the characteristics of an ems provider and an ems educator
ems instructors should understand the value of mentoring in the professional development of an instructor
module terms
the following terms are used in this module
see the appendix for a complete listing of terminology for this curriculum
primary instructor:
an individual who possesses the appropriate academic and/or allied health credentials, an understanding in education principles and theories, and the required teaching experience to provide quality instruction to a cohort of ems students
secondary instructor:
an individual who possesses the appropriate academic and/or allied health credentials and an understanding in education principles and theories that may have limited teaching experience. this individual is responsible for providing instruction to students and in assisting a primary instructor.
cohort:
a defined group of students who are attending a class together
class:
two definitions are used for class and the context will determine the definition
class: a single block of instruction provided at a single point in time, like when a class meets for 3 hours and the topic is the abcs of cpr
class: refers to a cohort of students who are attending an ongoing program of study (with multiple meeting sessions) that will lead to certification or licensure, like emt-basic training
program:
two definitions are used for program and the context will determine the definition
program: another term for a class of students attending training with multiple blocks of instruction, like first responder training
program: term for an organized body that designs, develops and/or delivers a variety of ems education products including primary instruction, refresher and continuing education. this body may be found within a training academy, hospital, industrial setting, business or academic setting. in this use of the term, programs organize and administrate classes and events.
event: refers to a single educational product like a daylong workshop or a refresher course. event generally does not refer to education products that continue to have classroom sessions for an extended period of time like an emt-intermediate or paramedic course
overview of ems education practice
the primary source for information concerning ems instructor education is derived from the following sources:
national ems education and practice blue print
ems agenda for the future
ems education agenda for the future
revisions of bls and als national standard curricula (nsc)
dot ems instructor nsc (revised 2002)
secondary sources of information on education
education professional groups
academic settings
internet sites on education
collected bodies of knowledge recognized for their expertise in educational theories and best practices
others
professional attributes and skill sets of ems instructors
ten professional attributes and skills sets are identified for ems instructors
professional attributes and skills set criteria #1: the ems educator understands the central concepts, tools of inquiry, and structures of the ems discipline(s) they teach and can create learning experiences that make these aspects of subject matter meaningful for the adult learner
cognitive goals
understands major concepts, assumptions, debates, processes of inquiry, and ways of knowing that are central to the discipline(s) they teach.
understands how the adult learners conceptual frameworks and their misconceptions for an area of knowledge can influence their learning
can relate knowledge of the discipline to other specific subject areas
affective goals
realizes that ems subject matter knowledge is not a fixed body of facts but is complex and ever evolving; they seek to keep abreast of new ideas and understandings in the ems field
appreciates multiple perspectives and conveys to adult learners how knowledge is developed from the vantage point of the learner
has enthusiasm for the discipline(s) they teach and is able to relate the subject matter to clinical practice
is committed to continuous learning and engages in professional discourse about subject matter knowledge
performance outcomes
effectively uses multiple representations and explanations of concepts that capture key ideas and link them to the adult learners prior understandings
can represent and use differing viewpoints, theories, "ways of knowing" and methods of inquiry in the teaching of subject matter concepts
can evaluate teaching resources and curriculum materials for their comprehensiveness, accuracy, and usefulness for representing particular subject matter and concepts
develops and uses curricula that encourage the adult learner to see, question, and interpret ideas and subject matter from diverse perspectives
the ems educator can create interdisciplinary learning experiences that allow the adult learner to integrate knowledge and skills from several subject areas
professional attributes and skills set criteria #2: the ems educator understands how the adult student learns, and can provide learning opportunities that support their intellectual, professional and personal development
cognitive goals
understands how learning occurs--how the adult learner constructs knowledge, acquires skills, and develops values--and knows how to use instructional strategies that promote student learning
understands that the adult learners' physical, social, emotional, moral and cognitive attributes influence learning and knows how to address these factors in the instructional environment
is aware of the domains of learning (cognitive, affective and psychomotor), can identify levels of readiness in learning, and understands how development in any one domain may affect performance in others
affective goals
appreciates individual variations within each domain of learning, shows respect for the diverse talents of all learners, and is committed to helping them develop self-confidence and competence
uses the adult learners strengths as a basis for growth, and their errors as an opportunity for learning
performances outcomes
considers the level of individual and group performance in order to deliver instruction that meets learners' current needs in each domain (cognitive, affective and psychomotor)
stimulates student reflection on prior knowledge and links new ideas to already familiar ideas, making connections to the adult learners experiences, providing opportunities for active engagement, manipulation, and testing of ideas and materials, and encouraging the adult learner to assume responsibility for learning and performance outcomes
considers the adult learners' experiences as a basis for instructional activities by, encouraging discussion, listening and responding to group interaction, and eliciting samples of student thinking orally and in writing
professional attributes and skills set criteria #3: the ems educator understands how the adult learner differs in their approaches to learning and creates instructional opportunities that can be adapted to diverse learning styles and situations.
cognitive goals
understands and can identify differences in approaches to learning and performance, including different learning styles and performance levels, and can provide instruction that helps use the adult learners' strengths as the basis for growth
knows about areas of exceptionality in learning--including learning disabilities, visual and perceptual difficulties, and special physical or mental challenges
understands how individual experiences, talents, and prior learning experience influence adult learning
has a well-grounded framework for understanding cultural diversity and knows how to learn about and draw upon the adult learners experiences and cultures in the instructional setting
affective goals
believes that all adult learners can learn at high levels and persists in helping all students to achieve success
appreciates and values human diversity, shows respect for the adult learners varied talents and perspectives, and is committed to the pursuit of individual excellence for all students
respects adult learners as individuals with differing personal and family backgrounds and various skills, talents, and interests
is sensitive to community and cultural norms
makes the adult learner feel valued for their potential as ems provider
performance outcomes
selects instructional techniques and methods appropriate to the adult learners' learning styles, strengths, and needs
recognizes and seeks assistance in making appropriate provisions (in terms of time and circumstances for work, tasks assigned, communication) for the adult learner who has particular learning differences or needs
can identify when and how to access appropriate services or resources to meet exceptional learning needs
seeks to understand the adult learners' culture, and uses this information as a basis for connecting instruction to the adult learners' experiences (e.g. drawing explicit connections between subject matter and clinical practice, making assignments that can be related to the adult learners experiences)
creates a learning community within the classroom setting in which individual differences are respected
professional attributes and skills set criteria #4: the ems educator understands and uses a variety of instructional strategies to encourage the adult learners development of high level thinking skills, problem solving skills, and psychomotor performance skills
cognitive goals
understands the cognitive processes associated with various kinds of learning (e.g. high level, critical and creative thinking, problem solving, memorization and recall) and how these processes can be stimulated
understands principles and techniques, along with advantages and limitations, associated with various instructional strategies (e.g. lecture format, demonstration, scenario based, participatory learning, etc.)
knows how to enhance learning through the use of a wide variety of materials as well as human and technological resources (e.g. computers, audio-visual technologies, videotapes and discs, local experts, texts, reference books)
affective goals
values the development of the adult learners critical thinking, independent problem solving, and skill performance capabilities
values flexibility and reciprocity in the teaching process as it relates to student responses, ideas, and needs
performance outcomes
uses learning goals to assist in choosing teaching strategies and materials to achieve instructional purposes and to meet student needs
uses teaching and learning strategies to engage the adult learner in active learning opportunities that promote the development of critical thinking, problem solving, and skill performance capabilities and that help the student assume responsibility for identifying and using learning resources
varies their role in the instructional process (e.g. instructor, role modeling, coach,) in relation to the content and purposes of instruction and the needs of the adult learner
utilizes a variety of clear, accurate presentations of ems concepts, using alternative explanations to assist the adult learners understanding
professional attributes and skills set criteria #5: the ems educator uses an understanding of individual and group motivation and behavior to create a learning environment that encourages positive group interaction, active engagement in learning, and self-motivation
cognitive goals
understands how groups function and how to influence people in the educational environment
knows how to assist the adult learner to work productively and cooperatively with others in the educational environment
understands the principles of effective classroom management and uses the knowledge to promote positive relationships, cooperation, and purposeful learning in the classroom
recognizes factors and situations that are likely to promote or diminish intrinsic motivation, and knows how to help the adult learner become self-motivated
affective goals
takes responsibility for establishing a positive climate in the classroom and participates in maintaining such a climate
values the role of the adult learner in promoting each other's learning and recognizes the importance of peer relationships in establishing a climate of learning
recognizes the value of intrinsic motivation to the adult learners life-long growth and learning
performance outcomes
creates a learning setting in which the adult learners assume responsibility for themselves and one another, participate in decision making, work collaboratively and independently, and engage in purposeful learning activities
engages the adult learner in individual and cooperative learning activities that help them develop the motivation to achieve by, for example, relating didactic lessons to clinical experiences, encouraging the adult learner to ask questions and pursue problems that are meaningful to them
maximizes the amount of class time spent in learning by creating expectations and processes for communication and behavior along with a physical setting conducive to education goals
helps the group to develop shared values and expectations for student interactions, academic discussions, and individual and group responsibility that create a positive classroom climate of openness, mutual respect, support, and inquiry
professional attributes and skills set criteria #6: the ems educator uses knowledge of effective verbal, nonverbal, and media communication techniques to foster active inquiry, collaboration, and supportive interaction in the classroom.
cognitive goals
understands how cultural and gender differences can affect communication in the classroom
recognizes the importance of nonverbal as well as verbal communication
knows about and can use effective verbal, nonverbal, and media communication techniques
affective goals
values many ways in which people seek to communicate and encourage many modes of communication in the classroom
is a thoughtful and responsive listener to students concerns and questions
appreciates the cultural dimensions of communication, responds appropriately, and seeks to foster culturally sensitive communication by and among all the adult learners in the class
performance outcomes
models effective communication strategies in conveying ideas and information and in asking questions (e.g. monitoring the effects of messages, restating ideas and drawing connections, being sensitive to nonverbal cues)
knows how to ask questions and stimulate discussion in different ways for particular purposes, for example, probing for learner understanding, helping the adult learner articulate their ideas and thinking processes, promoting risk-taking and problem-solving, facilitating factual recall, stimulating curiosity, helping the adult learner to question
communicates in ways that demonstrate sensitivity to cultural and gender differences (e.g. appropriate use of eye contact, interpretation of body language and verbal statements, acknowledgment of and responsiveness to different modes of communication and participation)
knows how to use a variety of media communication tools, including audio-visual aids and computers, to enrich learning opportunities
professional attributes and skills set criteria #7 the ems educator plans instruction based upon knowledge of subject matter, the attributes of the adult learner, and curriculum goals
cognitive goals
understands the basics of learning theory, and is competent in the subject matter, is aware of the process of curriculum development, and knows how to use this knowledge in the instructional setting to meet instructional goals
knows when and how to adjust instructional delivery methods based on student responses and performances
affective goals
values both long term and short term planning to ensure a productive classroom setting
believes that plans must always be open to adjustment and revision based on student needs and changing performance outcomes
values planning as a collegial activity and includes other instructors and students in the process
performance goals
provides learning experiences that are appropriate for curriculum goals, relevant to learners, and based upon principles of effective instruction (e.g. that activate the adult learners prior knowledge, encourages exploration and problem-solving, and builds new skills on those previously acquired)
plans for learning opportunities that recognize and address variations in learning styles and performance modes
respond to unanticipated sources of input, evaluates plans in relation to short- and long-range goals, and systematically adjusts plans to meet student needs and enhance learning
professional attributes and skills set criteria #8: the ems educator understands and uses formative and summative strategies with both formal and informal techniques to evaluate and ensure the continuous cognitive, affective and psychomotor development of the learner
cognitive goals
is aware of the characteristics, uses, advantages, and limitations of different types of assessments (e.g. criterion-referenced and norm-referenced instruments, traditional standardized and performance-based tests) for evaluating the adult learner
knows how to select and use assessment strategies and instruments appropriate to the learning outcomes being evaluated
affective goals
values ongoing assessment as essential to the instructional process and recognizes that many different assessment strategies, accurately and systematically used, are necessary for monitoring and promoting student learning
is committed to using assessment to identify student strengths and promote student growth rather than to deny the adult learner access to learning opportunities
performance outcomes
appropriately uses a variety of formal and informal assessment techniques (e.g. observation, portfolios of student work, teacher-made tests, performance tasks, projects, student self-assessments, peer assessment, and standardized tests) to evaluate the adult learners progress and performances, and modify teaching and learning strategies
uses assessment strategies to involve learners in self-assessment activities, to help them become aware of their strengths and needs, and to encourage them to set personal goals for learning
evaluates the effect of class activities on both individuals and the class as a whole, collecting information through observation of classroom interactions, questioning, and analysis of student work
monitors his or her own teaching strategies and behavior in relation to student success, modifying plans and instructional approaches accordingly
maintains useful records of student work and performance and can communicate student progress knowledgeably and responsibly to the adult learner
professional attributes and skills set criteria #9: the ems educator is a reflective practitioner who continually evaluates the effects of their choices and actions on others (the adult learner and other professionals in the learning community) and who actively seeks out opportunities to grow professionally
cognitive goals
understands methods of inquiry that provide them with a variety of self- assessment and problem-solving strategies for reflecting on their practice and its influences on the adult learner
is aware of major areas of research on teaching and of resources available for professional learning (e.g. professional literature, colleagues, professional associations, and professional development activities)
affective goals
values high level thinking and self-directed learning
is committed to reflection, assessment, and learning as an ongoing process
is willing to give and receive help
is committed to seeking out, developing, and continually refining practices that address the individual needs of the adult learner
the ems educator recognizes their professional responsibility for engaging in and supporting appropriate professional practices for self and colleagues
performance outcomes
uses classroom observation, information about the adult learner, and research as sources for evaluating the outcomes of teaching and learning and as a basis for experimenting with, reflecting on, and revising practice
seeks out professional literature, colleagues, and other resources to support their own development as a learner and a teacher
the ems educator draws upon professional colleagues as supports for reflection, problem-solving and new ideas, actively sharing experiences and seeking and giving feedback
professional attributes and skills set criteria #10: the ems educator fosters relationships with ems colleagues and ems agencies in the larger community to support the students learning and well-being
cognitive goals
understands the ems educational program is an organization within the larger ems community and understands the operations of the relevant aspects of the ems system within which they work
understands how factors in the adult learners environment outside of school (e.g. family circumstances, community environments, health and economic conditions) may influence the adult learners life and learning
understands and implements laws related to the adult learners rights and teacher responsibilities (e.g. for confidentiality, privacy, and appropriate treatment of the adult learner)
affective goals
values and appreciates the importance of all aspects of the adult learners classroom experience
respects the privacy of the adult learner and confidentiality of information
is willing to work with other professionals to improve the overall learning environment for the adult learner
performance outcomes
participates in collegial activities designed to make the ems program and educational setting a productive learning environment
makes links with the adult learners' other environments on behalf of the adult learner, by consulting with other ems educators and professionals in other ems agencies
can identify and use ems community resources to foster student learning
talks with and listens to the student, are sensitive and responsive to clues of distress, investigates situations, and seeks outside help as needed and appropriate to remedy problems
acts as an advocate for the adult learner
general professional educator characteristics
the following listing of characteristics are considered appropriate for educators in most settings:
possessing integrity and honesty
empathetic and compassionate
highly self-motivated
maintains a professional appearance with good personal hygiene
self-confident
possesses clear verbal and written communication skills
exhibits effective time management
advocates the teamwork approach for teaching and for student interaction
diplomatic and respectful when dealing with others
has a desire to continue improving, growing professionally and intellectually (valuing "life-long learning")
possesses knowledge of the subject and content areas
is a student advocate
ems provider professional behaviors and characteristics
the dot nsc for the emt-paramedic identifies the following eleven professional behaviors for paramedics
these characteristics apply to all levels of ems provider, including instructors
integrity
empathy
self-motivation
appearance / personal hygiene
self-confidence
communications
time management
teamwork and diplomacy
respect
patient advocacy
careful delivery of services
definition of primary instructor
the "primary instructor" is defined by the scope of responsibility more so than by seniority or time spent in direct instruction of students
the primary instructor is often the individual held responsible for a course
the primary instructor has experience in teaching and may be moving into a role with greater program responsibilities in addition to classroom responsibilities
some classification strategies for ems educators call the primary instructor the "lead" or "instructor of record" and instructors who assist this individual in the classroom are sometimes called "support" or "adjunct" instructors
for purposes of consistency in this curricula, the terms primary and secondary instructor will be used
the content of this curriculum applies to both the primary and secondary instructor
the individual user of this curriculum will determine how to best implement this curriculum to meet their unique needs and obligations. see module 1 for a discussion of recommended implementation strategies.
in addition to using "primary" and "secondary" to describe ems instructors, another method classifies instructors into distinct levels based upon education credentials and/or teaching experience
depending upon the classification strategy used the most senior instructor may have a higher or lower number designation
example one: level i: most senior instructor, level ii: assistant instructor, level iii: clinical instructor, level iv: field preceptor, etc.
example two: level 1: classroom presenter and/or probationary new instructor, level 2: experienced educator with x # of hours teaching, level 3: course coordinator, level 4: instructor trainer, etc.
the primary instructor may be called upon to provide leadership or oversight of the course in the following areas:
program responsibilities: the primary instructor may also serve at a program level to assist in coordinating operations of the training program and other courses
course administration: completing documentation and paperwork and providing timely feedback to the stakeholders in the course
stakeholders are those individuals who have a financial stake or interest in the successful completion of the course and its students
examples of some types of stakeholders: employer, employee union, course sponsor etc.
course coordination: including coordinating visiting faculty and guest lecturers, secondary instructors, clinical rotations, fieldtrips, etc.
interface with the medical director and course stakeholders on a regular basis
guidance on policies and procedures for the courses or program
selecting and screening students
evaluating the students and program
student discipline and feedback
assess the student and situation to identify the problem and the cause of the problem
work with medical director, program administration, faculty, and the student to correct problem behaviors
student remediation
assess the student and situation to identify the cause of the problem
develop a workable strategy to assist the student in succeeding on reevaluation
classroom instruction: deliver curriculum, mentor junior and support instructors, and ensure that the class maintains a high standard of quality
perform all of the additional duties listed as secondary instructor duties
definition of a secondary instructor
like the primary instructor, the secondary instructor is often defined by the scope of responsibility
the main responsibilities of the secondary instructor are to provide instruction to the student and to support the primary instructor
because the primary instructor often sets the tone for the class the secondary instructor must be aware of the expectations of the primary instructor regarding:
content to be covered
presentations styles expected for content delivery
rules and regulations pertinent to the class
the secondary instructor generally possesses an entry level competency and is not expected to behave or perform with the same proficiency as an "experienced" teacher
the optimal relationship between the primary instructor and secondary instructor is one where mentoring and professional growth is taking place for both individuals
common ems instructor roles & responsibilities
manage daily class activities
manage the learning environment
monitor student attendance
provide evaluations and feedback to students, course coordinator, medical director, and appropriate stakeholders as appropriate
manage discipline and grievance issues
manage course paperwork
maintain course and student records
teach: deliver didactic content, direct and control classroom discussions, conduct practical skills development sessions, evaluate student performance on cognitive, affective and psychomotor skills
design/develop (as required) and effectively use testing instruments
mentor students and faculty
adhere to the course syllabus
design/develop (if required) and effectively use lesson plans
managing daily class activities
additional information on this topic is interspersed through this curriculum in several modules
maintain schedule as posted in syllabus
set the tone for the classroom environment by modeling desired affective behaviors
managing the learning environment
see module 6: the learning environment for more information
assure classes are held in an adequate learning environment
adequate room size, lighting, ventilation, and temperature are all considerations
start and end class sessions on time
breaks are important
vary the pace of delivery and content of material as appropriate to keep class interesting and the learners engaged
manage student attendance
create and review student attendance rosters
comply with reporting requirements regarding attendance
provide feedback to students and appropriate stakeholders throughout class
provide evaluations and feedback
refer to module 12: evaluation techniques for more information on feedback and evaluations
to be most effective, feedback should be continuous and timely
provide students, course administration, the medical director and appropriate stakeholders with regular progress reports
grade tests and papers quickly
process and report course grades by the specified deadline
manage discipline and grievance issues
refer to module 19: discipline, and module 14: communication and feedback for additional information
each student should be aware of their right to an environment free of violence, threats, harassment, demeaning comments and other negative conduct
students must have access to a process for reporting problems
determine if your agency has a formal policy already in place
provide students with copies of policies and procedures
consider designing a student handbook if one does not exist
involve your medical director, program coordinator and advisory group in the development of any policies or procedures
problems must be investigated and resolved by the instructor
determine if it can be resolved at your level or it needs to be taken further up the chain of command
you may need to consult with your supervisor or employer
remember to maintain confidentiality of all parties involved
students who fail to adhere to appropriate conduct rules may be removed from the classroom and or reported to other authorities
ensure students have knowledge of the appeals process
issues of insensitivity may require outside intervention and or counseling (e.g., racial slurs, inappropriate gender remarks, etc.)
if the incident involves illegal activity, domestic violence or abuse you must report it to the proper authorities
manage course paperwork
understand and comply with all laws and regulations regarding the maintenance and storage of confidential files and information
maintain accuracy and confidentiality of:
attendance roster
course grade report
disciplinary action report
student conference and counseling report
course correspondence
maintain course and student records
verify with the state ems office, accrediting body, and academic host of the course the amount of time required to maintain student and course records
when in doubt dont throw it out!
records may be maintained in writing, on computer file, or via other media (example: microfiche) as approved
records must be kept in a secure area (e.g., locked file cabinet, secured computer with password, etc.)
confidentiality of information is very important
students must not be identified by personal information if grades and or progress reports are distributed publicly
student and course information and records may not be accessible by stakeholders unless:
the student has given written permission to release documents and information
the document or information has been demanded through a legal summons
teach
modules 11 through 18 contain additional information on the following topics; 11: presentation skills, 12: evaluation techniques, 13: facilitation techniques, 14: communication and feedback, 15: motivation, 16: teaching thinking skills, 17: teaching psychomotor skills, and 18: affective domain
deliver didactic content
use a variety of methods including lecture to deliver didactic content
vary the pace and content to keep students engaged
include material for every learning style (auditory, visual and kinesthetic learners)
direct and control classroom discussions
provide equal access to all students and encourage participation, monitoring and controlling students who monopolize conversations
advocate for introverted students by encouraging them to participate
encourage open discussion
do not allow discussions to become lengthy without direction or purpose
conduct instruction in practical skills development
included in the appendix of this document is a practical skill sample lesson plan
meet with all secondary instructors to ensure consistency in procedures and expectations
evaluate practical skills competence
practical skills competence should be measured on multiple occasions at various levels of mastery
mastery of skills must be thoroughly documented and reviewed
observe student classroom and laboratory performance
demonstrate skills objectives during classroom / laboratory setting
allow students to practice the skill under direct observation, for example, by performing the skill in a simulated patient encounter or scenario
direct the practice of the skill with close supervision and feedback
evaluate the skill
remediate as needed to achieve successful performance
reevaluate to document when mastery level performance occurs
review periodically to ensure mastery is maintained
design/develop (as required) and effectively use testing instruments
module 8: domains of learning and module 9: goals and objectives has useful information necessary to understand the evaluation process
module 12: evaluation techniques lists specific types of evaluation instruments
testing may be through written, oral or skills demonstrations and should be conducted in each domain of learning
test design may not be required of entry level instructors
it is important for an entry level instructor to understand the goal of the testing and what level of proficiency is required for the student to be successful
this is critical when psychomotor skills are being evaluated
question items should always be designed based upon the objectives of the presented material
it is always important to review "test banks" or "canned" testing items for accuracy and relevancy
provide students with timely feedback following an evaluation (report grades and give suggestions for improvement when appropriate)
many written test formats are available
multiple choice
short answer / essay
true false
fill in the blank
matching
test item formats are explored in detail in module 12: evaluation techniques
multiple choice questions are extremely common in ems tests
national and state licensing examinations usually contain only multiple choice items
multiple choice questions may be purchased through vendors in test banks (textbook publishers, websites, colleagues) or written by the instructor
regardless of the format used, all test items should be evaluated for validity and reliability
validity - does the test item test the knowledge intended
reliability - does the test item reproduce similar results when administered over a period of time
mentoring
ems instructors should develop professional relationships with students
foster growth and development of students through excellent teaching, feedback and support
encourage students who show an aptitude for teaching to get more involved
help facilitate their progress through the instructor credentialing process
serve as an on-going and renewable resource for students by assisting the process of networking
assist other instructors in their development by sharing ideas and experiences
seek their input and advice on issues of importance as well as day to day issues in classroom administration
encourage experimentation in the classroom by new instructors
model the behaviors you expect instructors to emulate
understand that failure is a natural and expected part of the growth and development of competence in teaching
introduce new instructors to your network of peers
maintaining the course syllabus
the course syllabus is a dynamic document that provides accurate information on the policies and procedures for the course
it is often considered a legal document so it is important to review and revise the syllabus prior to beginning each new cohort group
it may be the basis for determining the course rules, regulations, policies and procedures when a grievance is brought forward by a student
many programs require students sign documentation verifying receipt of the syllabus or to verify they have read and/or understand the document
check with your agency for guidelines and a sample document
determine if there is a specific format that is required
the entry level instructor may not be called upon to actually write a syllabus, but every instructor should ensure that the following elements are included:
instructor's contact information
objectives for the course
outline of topics of instruction
details of grading scale and policy
rules, regulations, policies and procedures
additional information
instructors contact information
do not disclose home address or phone number
arrange a means of contact through the course administrator/coordinator that allows for reasonable access during normal business hours
arrange for a means of communication when access is needed outside of normal business hours, like during weekend clinical rotations, that maintains your personal privacy
objectives for the course
sometimes a reference to a block of dot/nsc objectives along with information on where to obtain the dot/nsc curricula are given instead of listing every objective
when this occurs it is recommended that copies of the dot/nsc curricula objectives be easily available to students upon request
outline of topics of instruction
include date, time and location of each class session (especially if this varies)
reading assignment
include additional information pertinent for that session like any uniform or special dress requirement, equipment or supplies the student should bring with them, etc.
details on grading scale
include an evaluation strategy or process for each domain of learning: cognitive, affective and psychomotor
more information on this topic is available in module 8: domains of learning
rules, regulations, policies and procedures
address the following:
absences
tardiness
grievance procedures
rules and regulations come from many sources: state and national standards and guidelines, local jurisdiction, hosting academic setting, and your personal rules and regulations
it is important to review these to determine if there is any conflict between the rules and regulations from a variety of sources
seek to resolve these conflict before a problem occurs in the classroom setting
example: the state ems agency allows students to miss a total of 9 hours during an emt-b course but the college that hosts this course does not have any attendance policy and their student guidebook states that there is no official attendance policy. this issue needs to be resolved before the class begins.
provide students with information on their rights as well as their responsibilities and how to begin a grievance
additional information
inclement weather statements, ada accommodation requirements and physical examination requirements are examples of additional information that may be included
design/develop (if required) and effectively use lesson plans
this section provides an overview of why lesson plans are important and lists several sources for lesson plans
module 10: lesson plans has additional information on lesson plans, including a description of all of the elements that make up a lesson plan
an entry-level ems instructor may not be required to write a lesson plan
each time an instructor teaches, even if they are using a prepared lesson plan, they need to modify it to their specific needs
ems instructors have varied perspectives for the amount of detail in lesson plans
included in the appendix of this curricula are several sample lesson plans that illustrate different levels of detail
even experienced educators need to use lesson plans to keep their teaching focused and organized
a lesson plan should be used to assure that required material is covered during the allotted time and that it is covered in the correct sequence
lesson plans should be available for all instructors and guest lecturers
update lesson plans to reflect changes in curricula and or current educational models
sources for prepared lesson plans
federal agencies
dot/nhtsa
national standard curricula for ems topics and for specialty items like transportation issues
according to the ems agenda for the future, the future of the nsc is to move away from providing lesson plans in the curricula so it is imperative that ems educators know how to design, develop and utilize a lesson plan
maternal child health bureau (mchb)
department of labor (dol)
occupational safety and health administration (osha)
centers for disease control (cdc)
department of the environment (doe)
federal emergency management agency (fema)
lesson plans for proprietary continuing ems education courses (sometimes referred to as "canned products")
there are too many courses to list each individually and more are being developed all the time
using these materials may or may not require additional instructor credentials, special permission or financial arrangements
resource materials from these courses may be available even if you are not seeking course completion or certification
publishers have companion material for textbooks
instructor guides and lesson plans
website support
other sources of material
medical equipment and supply manufacturers and vendors
canned specialty topic areas for their equipment or supplies
be cautious of bias in their presentations
ems instructor groups sharing resources
state ems agency training division or bureau
bibliographical references
altman and cashin. (1992). writing a syllabus, idea paper no. 27. manhattan: kansas state university.
dot/nhtsa emt-paramedic nsc.
grunert, r. m. (n.d.) the course syllabus: a learning-centered approach. bolton: anker publishing company.
nilson, l. b. (n.d.) teaching at its best a research-based resource for college instructors. bolton: anker publishing company.
module 3: administrative issues
cognitive goals
at the completion of this module, the student-instructor should be able to:
identify resources at the federal level for obtaining information on policies and procedures for ems education programs and courses
identify resources at the state level for obtaining information on policies and procedures for ems education programs and courses
identify resources at the local level for obtaining information on policies and procedures for ems education programs and courses
psychomotor goals
there are no psychomotor objectives for this module
affective goals
at the completion of this module, the student-instructor should be able to:
3.1 describe the importance of understanding the policies and procedures put in place for ems instructors for conducting ems education programs and courses
declarative
why is this module important?
instructors must adhere to the local, state and federal rules and regulations which pertain to the ems education program
in some circumstances, violations of these rules or regulations may result in criminal and/or civil liability to the instructor or training agency
example: violation of a students confidentiality or privacy rights by disclosing information to unauthorized sources
example: failure to meet established deadlines for submission of student applications to national registry resulting in the inability of the student to take the licensing examination when he or she planned to
sources of information on policies and procedures
federal level
united states department of transportation
national highway traffic safety administration
health resources and services administration
maternal child health bureau
ems for children
national association of state ems directors
national association of state ems training coordinators
american college of emergency physicians
national association of ems physicians
national registry of emergency medical technicians
committee on accreditation for ems professionals
continuing education certification board for ems
american society for testing and materials
federal emergency management agency
national association of emts
international association of fire fighters
international association of fire chiefs
national association of ems educators
occupational safety and health agency
state resources
insert information from your own state here
state ems office
location of agency varies by state and may be found within the health department or some other department or bureau
often the agency is subdivided into smaller units
education and training section
certification and licensure section
administrative section
public information and media relations
etc.
state code or laws for rules and regulations regarding all aspects of ems
how can you access this information?
is it available online?
state chapters of federal organizations listed above
state higher education commission
accreditation bodies
state ems accreditation standards
national ems program accreditation bodies
academic schools and higher education (colleges and university) settings accreditation bodies
local or program specific sources
insert information from your own state here
jurisdictional training agency rules and regulations
college or university based rules and regulations
company policies and procedures
types of information available to you
curriculum standards and resources (model curricula, lesson plans and even entire programs)
legal statutes
safety rules and regulations
information on contacts within the organization
best practices standards
equipment and vehicle standards and guidelines
educational research and other grant opportunities
department policies and procedures
for legal protection, awareness in the following areas as appropriate to the level of instruction is required
rules and regulations from your organization (instructor or faculty manual)
job description and listing of duties and responsibilities of the ems instructor
student handbook
see appendix for sample student handbook
student grievance procedures
disciplinary guidelines
see appendix for sample document on classroom behavior
inclement weather policy
program administrative procedures
mission statement for the agency you are teaching for
contact information for course coordinator, medical director, program administrator and training site support personnel
other documents as described by your sponsoring organization
bibliographical references
bartram, s., and gibson, b. (1995). the training needs analysis toolkit. amherst: hrd press.
chism, n.v.n. (n.d.). peer review of teaching: a sourcebook. bolton: anker publishing company.
merriam, s. (1996). updating our knowledge of adult learning. journal of continuing education in the health professions. 16(3), 136-43.
module 4: legal issues in ems education
cognitive goals
at the completion of this module the student-instructor should be able to:
define liability, negligence and the standard of instruction
identify areas of legal liability for the instructor and the educational institution
identify risk management considerations for the student, instructor, and educational institution
explain the importance of confidentiality
identify applicable federal, state and local laws which affect the ems teaching profession and the educational institution
explain legal considerations regarding copyright and intellectual property issues
psychomotor goals
there are no psychomotor objectives for this module
affective goals
at the completion of this module the student-instructor should be able to:
value the importance of adhering to local, state, and federal laws governing the teaching profession and the conduction of ems education programs
declarative
why this module is important?
we live in a litigious society and ems instructors and training institutions are not immune from suits or liability
ignorance of the law is not an excuse
all ems providers should have a clear understanding of the common elements of ems law
it is the ems instructors responsibility to inform the student of ems laws
instructors should provide students with current legal resource sites
instructors should be aware of laws that pertain to the practice of teaching
liability
something for which one is legally obligated
negligence
is considered synonymous with malpractice
4 elements are included and must be proven
duty to act
the individual believed to be responsible had a legal obligation to act
breach of duty
the duty to act was breached by doing (committing) or not doing (omitting) a reasonable and prudent action
injury
an injury was sustained to the person who is suing
cause (or causation)
a linkage exists between the injury that occurred and the breach of the duty to act
standard for instruction
the standard of instruction is similar in concept to the standard of care
it represents the actions of a "reasonable and prudent" individual who possesses similar training and experience
it may be defined within state law
national standards for ems instructors
currently there is no standardized set of guidelines agreed upon by all stakeholders of ems regarding instructor standard of practice
this document (and previous versions of this document) is an attempt to provide a standard
some states and jurisdictions have formalized programs of instruction and processes for certification and review for instructors to ensure consistency and quality of instruction
various organizations have standards for instructors that may or may not carry the force of law
nhtsa/dot standards and guidelines
programs with formal instructor training competencies bcls, acls, pals, btls, phtls, etc.
national organizations for ems instructors within fire-based systems
others
areas of potential liability for instructors
discrimination
use consistent, fair practices for all your students
listen first and then decide guilt or innocence using due process
written documentation of every incident for your protection
harassment
use consistent, fair practices for all your students
bring in other instructors to assist you- but do not influence their objectivity with your personal opinions
sexual harassment
always be aware of how your actions may look to observers
avoid intimate situations or contact with students
counsel students in private but leave the door open
avoid suggestive statements, even in jest they may be misinterpreted and offensive
student injury
clinical experience accidents
instructor error
improper or inadequate supervision
inadequate, malfunctioning or faulty equipment
patient injury
due to improper actions by the student (not due to instruction)
due to improper instruction
due to inattention of the preceptor
americans with disability act
scope of this law as it applies to making accommodations for students with learning or physical disabilities
there will be more information on this topic later in this module
grievance procedures for students
provide written information on grievance procedures and due process in the student handbook
allow students to go through the process without intimidation
document all incidents at the time of occurrence so you can protect yourself later if a grievance arises
academic honesty issues
written policies given to students should include:
academic standards
grading policies
penalties for infractions
policy on internet usage
web sites to use to check to see if the paper a student submits is plagiarized
clearly written statement regarding what constitutes academic dishonesty including:
cheating on examinations
falsification of clinical work and experiences, logs or other program documents
attempts to reconstruct or obtain information regarding examination
affirmative action / equal opportunity
prerequisites and entrance requirements must be fair and impartial
provision for remedial or developmental education
drug and alcohol free environments
drug testing of students
may be easier to administrate in settings where the individual is also an employee, (training academy setting) than in a purely academic environment (college)
random and suspicion-based drug testing may be legal
drug testing of instructors
random and suspicion-based drug testing may be legal
possession issues
unauthorized (not prescribed) possession of controlled substances is never allowed
code of conduct
professional standards like the emt code of conduct exist for practitioners of the ems profession
these documents define the ethic and moral standards of the profession and are applicable to the instructors of these practitioners as well
student rights and responsibilities
written code of conduct for the academic setting
places the emphasis on students having responsibilities in addition to rights
student judicial powers
may be seen in academic settings like colleges and universities
honor code for cadets of academies may have statement on judicial powers
risk management considerations
student health insurance
health insurance supplied by educational or the student is responsible to obtain it independent of the training institution
requirements imposed by the clinical affiliations regarding immunizations, physical examinations, safety training, etc
student malpractice insurance
required by the clinical setting
individual policies may be obtained by students from insurance brokers
instructor malpractice insurance, including errors and omissions
coverage by the employer
scope of coverage
individual policies are available from many of the insurance brokers who provide malpractice insurance to ems providers
instructor health insurance
liability for your instructors (classroom and clinical) in the event of accidental exposures to biohazard materials
institutional considerations
clinical sites liability
policies and procedures for reporting incidents and exposures
written and notification process
indemnification issues from clinical sites or other agencies
indemnification: to protect and insure against loss, damage, theft, etc. that also provides for reimbursement
this is difficult for some clinical sites, including the government, making clinical contracts sometimes difficult to negotiate
confidentiality
buckley amendment (the family education rights act of 1974):
this law specifies:
the conditions for availability of funds to educational agencies or institutions
the process for inspection and review of education records
limits on the specific information to be made available
the procedure for access to education records, including the reasonableness of time for such access
the process for hearings
the procedure and limits on providing written explanations to parents
the law provides students the right to:
access their education records upon request
challenge their educational records
disclosure of "personally identifiable" information from these records, without permission, is illegal
the educational institution has an obligation to notify students in writing of their rights
identification numbers and privacy
it is a violation of privacy to post student's names with grades or other sensitive information in public view
training programs may instead use a number to identify students
this creates a secondary issue of security because of the possibility of obtaining a lot of information from an individual through the use of an id number like the social security number
some states have enacted legislation prohibiting the use of the ssn (social security number) for identification purposes (other than social security) and include the use of the "last 4" digits within that legislation
if a number system is chosen, it should not be the ssn or an easily decoded number
u.s. department of labor, internal revenue service
employers must follow laws regarding
wages and hours to work.
taxes and fica
worker's compensation
americans with disabilities act (ada)
certain reasonable accommodations must be made to students with documented disabilities
these accommodations must be reasonable: in other words, if the accommodations represent something that would not be an expected element of job performance, than it is generally safe to provide it
example 1: your student cannot read and he has asked for an accommodation to have the test read to him. you will of course take this matter to your administration (and perhaps their lawyers and the state ems or attorney generals office) to solve but most likely you will not have to accommodate this because reading ability is a requirement for the profession
example 2: your student has documentation diagnosing dyslexia from a physician. she is able to process information if given a little longer to take written tests. again you consult with your administration and they rule that it is acceptable to add some additional time to the written test because there does not seem to be a standard in ems requiring how fast a person must be able to read.
occupational safety and health administration:
education programs must follow all applicable national and state osha rules and regulations
copyright and intellectual property issues
a document does not have to carry the copyright symbol to be copyrighted
any document that you did not author completely by yourself is owned by somebody else
the owner/developer deserves credit, and maybe even compensation, for work used in other sources
the "public domain" is anything that is exempt from copyright laws because of the age of the document or if the information is considered to be known by most individuals
for example: the phrase and descriptions for "the abcs of cpr" is not owned by any particular organization because all of the medical field, and the majority of the lay public, has knowledge of this information and it would be difficult to find the original author of the concept
you should always make a good faith effort to obtain permission to use any document that is not your own
copyright clearance center
is the clearinghouse for permission to use copyrighted materials
a fee is charged for this service
contact them at: copyright clearance center, inc. 222 rosewood drive, danvers, ma 01923 phone 978-750-8400 fax 978-750-4470 www.copyright.com
copyright act of 1907
the original copyright law
difficult to determine how it applies to internet and digital distributed materials
application of federal law varies by the state and district
academic usage standards are more general than for the public, but they still exist
"fair use" test is generally applied for use of materials in an academic setting
many factors in the fair use test
consult with the agency attorneys for advice regarding use in academic setting
"fair use" involves determining how much material is being distributed (whole document vs. parts of a document), how many times it is being used (generally the first time is the only time that is acceptable without paying a fee for use), if the authors are properly cited for their work, and how much the use of the document impacts the owners ability to realize a profit from your use of it
digital millennium copyright act (1998)
this law was enacted to cover copyright issues regarding digital transmission of information
law is still being defined and tested in court
for example: be careful that you do not link too far into a website as this may open you up to liability companies do not want you to bypass their opportunity to present their "for sale" items and may bring suit if you link directly to a document on their website
intellectual property rights
actual ownership of educational materials you design and produce while employed for an educational setting
determine if there are any rules and regulations prior to usage
employer generally if the product is produced during employment then the employer may claim that it is within the scope of your duties and may retain ownership of the product
if created on your own time, with your own materials you own it
work for hire arrangements are in effect when you are contracted to produce a product (usually for a publisher)
you seldom retain ownership in this circumstance
royalty arrangements
individual is paid a fee per every item sold
individual may also receive a flat fee for work
other laws and regulations
insert here any additional laws that are important to the teaching of ems in your jurisdiction
sources for information on ems laws:
state ems office
federal government agencies dealing with regulation and oversight
national organizations
national association of state ems directors
national association of state ems training coordinators
national association of emts
national association of ems educators: legal committee
trade journals for ems
books on ems law
internet
lexus-nexus is a database of legal manuscripts
ems organization websites
bibliographical references
aiken, t. d. (2002). legal and ethical issues in health occupations. philadelphia: w. b. saunders company.
module 5: ethics
cognitive goals
at the completion of this module, the student-instructor should be able to:
use their own words to define ethics and morals
use their own words to identify and describe the basis of the six moral theories described in this module
describe one strength and one weakness for each of the six moral theories described in this module
identify sources of ethical mission statements for educational and emergency medical organizations
describe attributes of an ethical instructor
list venues in education that should have ethical role models
describe ways in which ethics can be incorporated into the ems curricula
psychomotor goals:
given a lesson plan or session topic, describe an activity that incorporates an ethical lesson into that session
affective goals
at the completion of this module, the student-instructor should be able to:
defend the need to model ethical behavior as instructors
declarative
why this module is important?
ethics is an important part of medicine
students will frequently be exposed to situations requiring ethical decisions
medical advances are occurring faster than policies regarding medical ethics
bringing ethics into the classroom
jump right in ethics is a hot topic and students are interesting in talking about it
by introducing it into the course it suggests to students that it is an integral part of ems
you are qualified to teach it more than you think you know ems and can easily think of times when an ethical question may arise
we all are ethical people (who follow various theories) and know the difference between right and wrong
you are teaching not preaching
your role is to facilitate discussion
introduce ethical issues, concepts and theories
challenge students to find ethical problems in an ethical issue or case study
guide students towards finding responsible answers or solutions to the problems posed
module terminology
ethics, morals and values are difficult to define and many definitions are acceptable
1. ethics is generally thought of as the study of right action and morals is the system through which that action is applied
ethics
the critical examination and evaluation of what is good, evil, right and wrong in human conduct (guy, 2001)
a specific set of principles, values and guidelines for a particular group or organization (guy, 2001)
ethics is the study of goodness, right action and moral responsibility, it asks what choices and ends we ought to pursue and what moral principles should govern our pursuits and choices (madden, 2000)
morals
those principles and values that actually guide, for better or worse, an individuals personal conduct (guy, 2001)
morality is the informal system of rational beings by which they govern their behavior in order to lesson harm or evil and do good, this system, although informal, enjoys amazing agreement across time and cultures concerning moral rules, moral ideas and moral virtues (madden, 2000)
values
where emphasis is placed and what is rewarded in an organization and society
guiding principles of behavior and conduct.
the core motivator for behaviors
ethical theories
in-depth knowledge is not required but it is important to have an understanding of some of the major theories to help shape classroom discussions
divine law
based in many religions, primarily judeo-christian and islamic
what is considered good? gods will and word
what is right behavior? obeying gods will
what are the strengths of this theory? moral certainty and guidance
what are some of the weaknesses of this theory? moral certainty, self-righteousness and intolerance
virtue ethics
based in ancient greek philosophy: plato and aristotle
what is considered good? seeking happiness and living the good life
what is right behavior? acting virtuously which is necessary for happiness
what are the strengths of this theory? virtue is its own reward and leads to self-actualization
what are some of the weaknesses of this theory? consequences, the common good and principle are ignored
egoism
based in classical and contemporary philosophy
what is considered good? what i think is best for me is good
what is right behavior? promoting what is good for me only
what are the strengths of this theory? leads to moral certainty and moral autonomy
what are some of the weaknesses of this theory? self-centeredness, moral certainty, selfishness and unrealistic thinking
ethical relativism
based in classical and contemporary philosophy
what is considered good? only whatever the individual/group/culture decides is right is right
what is right behavior? acting in accord with the groups values and principles
what are the strengths of this theory? tolerance of others, flexible thinking and practicality
what are some of the weaknesses of this theory? it rules out criticism of obvious evil and all is considered relative
utilitarianism
based in british/american philosophy: bentham and kant
what is considered good? happiness/pleasure, diminishing misery and pain
what is right behavior? promoting the greatest good for the greatest number
what are the strengths of this theory? practical, considers consequences of actions
what are some of the weaknesses of this theory? a good end may justify a bad means, it is often a vague theory, and justifies mistreatment of a minority group of people as the means to an end if they do not agree with the majority, it can be dehumanizing
duty ethics
based on theories by kant
what is considered good? good will that is good-hearted and extended to others
what is right behavior? doing your moral duty and acting as a model for others to follow
what are the strengths of this theory? highly principled behavior, consistent and certain, showing respect for self and others
what are some of the weaknesses of this theory? it ignores circumstances and principles and offers no way to choose among competing principles
guidelines for leading a discussion on ethics
the appendix has information on some suggested classroom activities on ethical topics
the key in answering ethical questions is knowing when and where to ask the right questions.
what are the facts of this particular case?
do i have everything i need to know or am i acting on rumor?
am i letting bias or emotions distort the facts?
is this primarily a legal or policy issue instead of an ethical one?
who is involved?
who is responsible for causing this issue or problem?
who is responsible for deciding what to do?
who will be harmed or helped by the actions taken?
why have i chosen the ethical action i have?
what values and principles am i basing my decision upon?
set the tone for the discussion
everyone who wants to speak may do so
students will respect each others diversity of opinion
students will be polite to each other
students must back up their opinions with the facts as they see them, not just spout opinions
ethical issues in teaching
plagiarism
falsifying documentation
cheating or academic dishonesty
dangerous acts when treating actual patients
unethical or inappropriate language or behavior with patients, families, and staff
unacceptable classroom behavior such as violence, threats, harassment, etc
dealing with ethical issues in teaching
foster a positive learning environment to minimize behavior problems
model ethical behavior
appropriate dress
appropriate language
demonstrating concern and respect for others
commitment to academic excellence and lifelong learning
publish classroom rules, policies, and expectations
apply discipline or consequences consistently and fairly
provide plenty of supervision, mentors, and role models
bibliographical references
aiken, t. d. (2002). legal and ethical issues in health occupations. philadelphia: w. b. saunders company.
coughlin, s., soskolne, c., and goodmath, k. (1997). case studies in public health ethics. washington, dc: american public health association.
edge, r., & groves, j. (1999). ethics of health care (2nd ed.). new york: delmar publishers.
flight, m. (1998). law, liability, and ethics (3rd ed.). new york: delmar publishers.
goleman, daniel. (1998). working with emotional intelligence. new york: bantam books.
guy, jr., alfred h. (n.d.). successful ways to teach ethics in any discipline.
madden, theresa. (2000) a compendium of ideas and resources for using ethics across the curriculum. howard community college.
s. coughlin, c. soskolne, & k. goodmath. (1997). case studies in public health ethics. washington, d.c.: american public health association.
module 6: the learning environment
cognitive goals
at the completion of this module the student-instructor should be able to:
state the importance of a positive learning environment
list desirable behaviors for students in your classroom setting
identify unacceptable student behaviors
describe methods to engage students in the learning process through a positive learning environment.
psychomotor goals
at the completion of this module the student-instructor should be able to:
create a positive learning environment given a group of students in a classroom setting
role-play effective methods of engaging students in the learning process as described in this module
affective goals
at the completion of this module the student-instructor should be able to:
appreciate the importance of a positive learning environment and the overall impact that has on the success of a class
act as a role model for the positive behaviors expected in the classroom setting
discourage rude, offensive or distracting behavior and language in students
declarative
why is this module important?
a safe or positive learning environment is one in which students and faculty are free from harm, discrimination and teasing; where tolerance and acceptance are present; where new ideas and creative problem solving are encouraged; and where students can ask questions and learn without fear of mental or physical discomfort
promote learning with a positive environment
where practical, involve students in deciding what they will learn as this can help motivate them to want to learn
example: if you are covering several unrelated topics in class allow them to decide which order the presentation of topics will follow
give students choices about how material will be covered
evaluate students learning preferences and styles and integrate activities and learning experiences into their class that target their preferences
communicate expectations (in writing and verbally) to the students regarding:
course participation
grading policy
attendance
reading assignments
grievance procedures
emphasize the most important material in the curriculum
use the nhtsa/dot course objectives, job description, and task analysis to determine what is the most relevant information to cover
identify from the language of the objectives the level (depth and breadth) the material should be covered
module 8: domains of learning provides more information on the concept of depth and breadth of objectives
make lectures and activities relevant to the content area
make additional resources available
design classroom rules to foster learning and discourage negative behavior
the value of a positive learning environment
students learn better and faster when basic needs are met
require repetition of skills performance, even when the student performs the skill well
repeat practice on more than one occasion
reinforces student attainment of the level of mastery required
demonstrates student is able to maintain proficiency
allows students to grow by taking risks in the classroom
encourage safe experimentation for alternative methods to learn the content of the course
provide a safe place to make mistakes
builds confidence
nurtures students who are experiencing difficulty
builds leaders by encouraging students to extend their abilities
desirable student behaviors
nhtsa/dot nsc for emt-p has an evaluation instrument which is used to evaluate the affective domain
a copy of this document is included in the appendix
desirable student behaviors or characteristics to reinforce include:
moral integrity
strong work ethic
honesty
courtesy
respect
engaged and active learner (an active participant taking responsibility for their actions)
knowledgeable
competent
values life-long learning
are there other characteristics?
undesirable student behaviors to discourage (or not reinforce):
the opposite behavior of each characteristic listed above is undesirable and should be discouraged
lying
cheating
stealing
violence
intolerance
prejudice
carelessness
unprofessional behavior
unprofessional appearance
the instructors impact on the learning environment:
model desirable behaviors
if you want students to value personal protective equipment use it when demonstrating skills
if students are expected to be on time to class do not be late
if you expect a high level of skills proficiency monitor their practice closely and provide timely and constructive feedback
make time for conferences and meetings outside of class time
arrive at the classroom early
set up equipment and arrange room
be over-prepared for the presentation
review the objectives for the course (or lesson) and compare to bloom's taxonomy to determine the depth and breadth required to meet the objective
refer to module 8 for more information on the domains of learning
know the information two levels deeper than students need to know it
because of memory degradation present more information than the objective indicates
have a back-up method of delivering content in case av resources or equipment fail
have slides or overheads of the material on video or an alternative topic to cover
make a commitment that canceling class because of an av or equipment problem is not an option
ask for help when needed
as an entry level instructor you should expect that your employer and supervisor will assist in your growth and development as an instructor
seek out a mentor to guide you
senior instructor who models quality
does not have to be an ems instructor
if an ems instructor, select someone with high levels of student success
high pass rates and/or low attrition rates
remain current on skills and knowledge
attend workshops
learn about education theory and practices
do not limit your opportunities to the ems environment
consider taking courses at a college or university
join the national association of ems educators and other professional educator groups and organizations
observe other instructors as they present and watch what works and what doesn't
watch your language content and tone of delivery
be honest and frank with students
accept the uniqueness of others and show your students that you appreciate their individuality
maintaining a positive classroom environment
model behaviors expected of students
have rules and enforce them consistently
provide written copies of the rules (via a student handbook) and review in the first class session
require written verification of receipt and review of rules
review rules periodically as this is less threatening than confronting a student directly and it may correct minor behavior discrepancies
be consistent in enforcing rules and regulations
follow them exactly, then dispense flexibility where appropriate
easier to "lighten up" than "tighten up"
challenging to start with inconsistency then try to regain control
reinforce positive behavior
sincerely praise students who exceed expectations
provide explanation so praise is tied to specific behavior, not to "pleasing" the instructor
use progressive discipline principles in managing conflicts or problems in the classroom
encourage self-policing
can only be accomplished when student knows rules and regulations
identify student leaders to help with problems in the classroom
leaders can help police problem students
monitor closely to ensure that it is a fair application of the rules
document disciplinary actions and provide copies to the student, course director, medical director and other members of the teaching team as appropriate
it is necessary to obtain permission from the student to release information
obtain written permission in first class session
give the student a copy of the signed document and place the original in the student's file
seek guidance on disciplinary matters from members of the teaching team: faculty, administrator and medical director
positive design elements for the physical classroom space
a clean, safe, and well-maintained classroom space promotes learning
handicap accessible and in compliance with all federal, state and local access laws
adequate size room for student needs
appropriate workspace with tables, chairs and desks
comfortable furniture
room for practical skills development and practice
desks arranged so students have an unobstructed view of the instructor and any av materials that may be used
secured storage area for personal effects
located close to amenities: food service area, break room, restrooms, kitchen area, etc.
good environmental controls of classroom
room should have comfortable temperature with good air flow
adequate lighting
independent controls for various lighting levels are ideal
ability to block out natural light
area should be capable of minimizing distractions by closing doors or walling off the space
adequate equipment
adequate amount in good working order
appropriate storage
arranged logically so equipment is easy to find
safely stored so injuries cannot occur from falling objects or trip hazards
secure area
appropriate management and storage for soiled equipment, supplies and biohazard material
strategies of arranging the classroom
classroom arrangement strategies - illustrates classroom arrangement styles for various settings and needs (see appendix for classroom arrangements)
lecture style
teacher centered approach
instructor is positioned in front of students with desks lined up in rows
fyi: student centered approach enables student to be "center" of learning environment
optimal set-up for situations when students are together to give out information prior to dividing into groups
not recommended for small group work or psychomotor skills development
may allow students to "hide" behind those in front of them
theater style
teacher centered approach
instructor is centered in front of the students but the students desks are arced in a half-circle around the instructor and may be arranged on terraces or levels (amphitheater)
the instructor can see every student
circle, square or rectangle with open center
combined teacher and student centered approach, depending upon how it is used
chairs or desks arranged in a circle, square or rectangle with an open space in the middle
this allows for the formation of a very large circle
instructor may sit with the group or may enter the center area
ideal set-up when all students are expected to participate as it allows each student to see the other
good set-up for a discussion
circle, square or rectangle with closed center
student centered approach
chairs or desks arranged in a circle, square or rectangle with no open space in the middle
this allows for the formation of a smaller group setting
instructor should sit with group to participate or stand off to the side after providing any instructions
ideal set-up when all students are expected to participate as it allows each student to see the other
good for a discussion group
partial circle, square or rectangle with an open area
combined teacher and student centered approach, depending upon how it is used
focus is on person centered at the front of group but configuration allows for discussion and interactivity as well
chevron or "u" shape also possible
individual workstations
student centered
some multimedia environments are designed as individual workstations
these areas are difficult to use when a "teacher centered" approach is required as many participants may be unable to see the instructor
you can improve this environment if you provide additional faculty facilitators to circulate around the room assisting students
this is an ideal environment for individual instruction or for groups of 2-3 students to work relatively uninterrupted
group workstations
student centered
instructor should circulate around the room or have additional instructor facilitators assist in monitoring the work of the individual stations
focus of instruction is within the space of the individual table or station
tables or workstations oriented within a large open space
visualization of each station may not be an issue but it can be controlled with partitions or room dividers
chairs can be placed around the tables or workstations
adequate room should be maintained between stations to allow for movement and to reduce the noise level at the station
groups can be working on the same activity simultaneously (but independently) or different activities
allows for multiple activity stations
instructor balances between monitoring activity and allowing student to direct their own learning
student can rotate between stations independent of instructor or as directed
student can progress around the room in a group or individually, depending upon how the instructor sets up the activity
bibliographical references
adult continuing education homepage. retrieved from hyperlink "http://adulted.about.com/" http://adulted.about.com
davis, barbara gross, wood, lynn and wilson, robert; a berkeley compendium of suggestions for teaching with excellence; hyperlink "http://teaching.berkeley.edu/compendium" davis, barbara gross, wood, lynn, & wilson, robert. (1985) a berkeley compendium of suggestions for teaching with excellence. retrieved from http://teaching.berkeley.edu/compendium
davis, barbara gross. (1993). tools for teaching. san francisco: jossey-bass.
difficult behaviors in the classroom. (n.d.). retrieved from hyperlink "http://www.hcc.hawaii.edu/intranet/committees/facdevcom/guidebk/teachtip/behavior.htm" http://www.hcc.hawaii.edu/intranet/committees/facdevcom/guidebk/teachtip/behavior.htm
enerson diane, ed. (n.d.). teaching at chicago: a collection of readings and practical advice for beginning teachers. retrieved from hyperlink "http://teaching.uchicago.edu/handbook" http://teaching.uchicago.edu/handbook
harrison cheryl. (1988). learning management. retrieved from eric digests 73 hyperlink "http://www.ed.gov/databases/eric_digests/ed296121.html" http://www.ed.gov/databases/eric_digests/ed296121.html
imel susan. (1994). guidelines for working with adult learners. retrieved from eric digests 154 hyperlink "http://www.ed.gov/databases/eric_digests/ed377313.html" http://www.ed.gov/databases/eric_digests/ed377313.html
imel susan. (1994). guidelines for working with adult learners. retrieved from eric digests 77 hyperlink "http://www.ed.gov/databases/eric_digests/ed299456.html" http://www.ed.gov/databases/eric_digests/ed299456.html
imel susan. (1995). inclusive adult learning environments. retrieved from eric digests 162 hyperlink "http://www.ed.gov/databases/eric_digests/ed385779.html" http://www.ed.gov/databases/eric_digests/ed385779.html
imel susan. (1995). teaching adults: is it different? retrieved from eric digests 82 hyperlink "http://www.ed.gov/databases/eric_digests/ed305495.html" http://www.ed.gov/databases/eric_digests/ed305495.html
johnson, david and others. (1992). cooperative learning: increasing college faculty instructional productivity. retrieved from eric digests hyperlink "http://www.ed.gov/databases/eric_digests/ed347871.html" http://www.ed.gov/databases/eric_digests/ed347871.html
kleberg, j. r. (1992). quality learning environments.
land, s. m., and hannafin, m. j. (1996). student-centered learning environments: foundations, assumptions, and implications.
obanion, t. & associates. (1994). teaching and learning in the community college. washington, dc: american association of community colleges.
scholtes, peter (1988). the team handbook. madison: joiner associates.
module 7: learning styles
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to define and describe "learning style" and "learning preference"
list common learning styles found in adult learners
identify the following characteristics for each learning style:
student needs, desires and preferences in instruction
strengths and weaknesses inherent in that style
explain how learning styles impact classroom dynamics
given a lesson plan, describe activities that may be used to target a specific learning style
identify surveys and other tools used to classify learning styles
describe how his or her own learning style will affect instruction
psychomotor goals
at the completion of this module the student-instructor should be able to:
create a lesson plan which utilizes a stimulating variety of teaching techniques, activities and breaks for the purpose of maximizing the various learning styles present in students (this goal should only be attempted if module 10: lesson plans has been completed)
affective goals
at the completion of this module the student-instructor should be able to:
value the diversity found in the various learning styles
support the use of learning styles assessment in ems education
support the use of a variety of teaching styles to reach all learning styles
declarative
why this module is important
classroom teaching is an ongoing experiment into the modes, models and preferences of thinking and processing information by learners
maximize success within the classroom by understanding that various learning styles and preferences exist and vary among students
incorporate activities that will maximize students preference
this will make learning more enjoyable for you and the student, but will also make it faster and easier for them to learn the material
what is a learning style?
throughout this module, the terms "learning style" and "learning preference" will be synonymous
each person perceives, processes, stores and retrieves material in a unique way that is individual to their preference and style
educational researchers, psychologists, and sociologists have observed adults in education settings to identify patterns of learner preferences and determine if there are any commonalties
learning style theories are the result of research
a learning style theory will look at only one aspect of the spectrum of learning
for example, a given theory may describe the manner in which an individual processes material
learners have preferences for different types of input and experiences such as:
1. some prefer structure and others like flexibility
2. some prefer independence while others like a social or group learning environment
3. some prefer auditory (hearing) input, others visual (seeing) and still others like kinesthetic (movements) inputs
an important point to remember as you progress through this module: adult learners are flexible and adapt to a variety of presentation styles
although we have inherent preferences we will learn in most every environment
teaching and learning is more pleasant when our individual preferences are targeted in the methods chosen to present material
assessing students learning styles
instructors can assess learning preferences via entrance exams and learning style profiles
health occupation basic entrance test (hobet)
myers-briggs personality type indicator (mb-pti)
learning styles inventory (dunn and dunn)
many more instruments exist
assessing your personal learning style
instructors should know their own learning preferences
we tend to teach the way we like to learn which may be a disservice to our students
when a misunderstanding arises in the classroom use your knowledge of learning styles to reflect upon how you are presenting material
this may provide clues to the reason there is a misunderstanding
using information on learning styles in your teaching presentations
provide variety in the classroom
avoid labeling students by their preferences
you may alter your expectations of students when you label them
some choices for variety in class sessions and assignments include:
provide visual stimulation through the use of powerpoint, video, or overheads or writing on a chalk or white board or flip chart
provide kinesthetic activities such a model building, use of equipment, and skill labs
provide group or social activities such as discussion, work groups, and response teams
knowledge of learning styles and creation of diverse lesson plans helps each student to be comfortable in an optimal learning environment for their learning preference during part of each class session
diverse lesson plans with lots of variety help students to grow and develop beyond their learning preferences
as learners, we all can adapt to the different learning environments
as an example, reflect on an undesirable classroom experience to see if part of the problem may have been due to the differences in learning styles between the instructor and you
examples of learning preferences, characteristics and successful teaching techniques to incorporate in to your teaching strategy
these are only three examples of many types of learning styles or preferences
auditory-visual-kinesthetic preferences
social and independent learning styles
analytic and global learning preferences
auditory-visual-kinesthetic learners
expresses a preference in the manner in which information is received
auditory learner
learns best through hearing information
benefits from oral presentation of information: discussion, listening, and verbalizing
encourage students to audiotape lesson
use lectures, oral presentations and class discussions to stimulate learning
visual learner
learns best by taking information in visually
benefits from visual presentation of information, looking things up, writing things down, and "seeing" the words (forming word pictures in the brain)
provide handouts of content
use videotapes, slide presentations, overheads, illustrations, posters, x-rays, moulage and other visual props
kinesthetic learner
learns best by manipulating information through physical means through handling and touch
benefits from taking things apart, making things work, using their hands and tactile stimulation
use 3 dimensional models and replicas, laboratory sessions, scenarios and role-play
social and independent learning styles
describes preferences in receiving information
social learners
process information best when multi-tasking in busy environments with other people
tend to enjoy study sessions, group projects and cooperative learning
use group work in class, classroom discussions, study groups, skills groups
allow music or other background noise
independent learners
process information best when working independently or isolated
tend to work best in quiet, undisturbed, regular study environments
use reading assignments, written exams, papers and reports
analytic and global learning theory
this theory describes the order in which a learner prefers to process information received by looking at the whole then breaking it down into individual parts or by looking at each individual part and then combining it into a whole
sometimes called right-brain and left-brain
global learner (right-brain)
needs to process the big picture (overall) view first then can concentrate on the individual parts that make up the big picture
they are uncomfortable learning when they do not have a sense of the big picture
these students appreciate an overview of the material before you start teaching
process information globally and simultaneously, deals in images
tend to be creative, artistic, imaginative, emotional, and intuitive and generally like working on teams
try mental imagery, drawing, maps, metaphors, music and dance, experiential learning
analytic learner (left-brain)
process information logically, sequentially, in small parts
they are uncomfortable with learning that is occurring out of sequence
tend to enjoy spelling, numbers, thinking, reading, analysis and speaking
try lectures with outlines, reading assignments, and multiple-choice exams
the differences between analytic and global learners: the forest or the trees?
analytic learners separate the forest from the trees: analytic learners look at every tree in the forest before being comfortable enough to declare that they are in the forest
global learners will walk up to several trees, quickly declare it is a forest, and then will begin to look at the individual trees
theory of multiple intelligence's
howard gardner described "multiple intelligence's"
gardners idea was that measuring "iq" through a series of cognitive exercises does not fully measure the range of intelligences expressed by each individual
hypothesized that each person has aptitude in the following areas, with each individual having some areas with greater aptitude than others
linguistic: enjoys working with the spoken word and languages
spatial: enjoys visual, artistic imagery, has the ability to construct visual pictures in their mind
logical-mathematical: enjoys puzzles and problem-solving requiring thought
musical: enjoys music and understands the language of music
body kinesthetic: has aptitude for sports and recreational activities involving bodily movements
interpersonal: works well with others and is tuned into those around them
intra-personal: enjoys self-reflection and introspection, is aware of their body
further work by gardner and his team has added categories in the area of religious/theological and botanical science
bibliographical resources
ast, h. j. (1988). learning styles: implications for curriculum and instruction.
dunn, joe. (1994). reflections of a recovering lectureholic. the national teaching and learning forum, 3:6.
dunn, r., ed., and griggs, s. a., ed. (2000). practical approaches to using learning styles i higher education. westport: greenwood publishing group.
entwistle, n. j. (1983). understanding student learning. new york: nichols publishing.
kariuki, p. n. (1995). the relationship between student and faculty learning style congruency and perceptions of the classroom environment in colleges of teacher education.
newble, d. i. & entwistle, n. j. (1986). learning styles and approaches: implications formedical education. medical education 20, 162-175.
module 8: domains of learning
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to state a definition of cognitive, psychomotor and affective domains of learning
identify the domain of learning and level of depth for a correctly written objective
give examples of behaviors that exemplify the three domains of learning
within the context of an ems call, identify knowledge and behavioral examples for cognitive, psychomotor and affective domains
list classroom activities for each domain of learning
state at least one appropriate evaluation method for each domain of learning
psychomotor goals
there are no psychomotor objectives for this module.
affective goals
at the completion of this module the student-instructor should be able to:
acknowledge the need to teach within the three domains of learning as identified within the national standard curriculum for any level of ems course
support activities that teach and evaluate the three domains of learning
value all three domains of performance by the ems professional
declarative
why this module is important
"pedagogy" is defined as the art and science of teaching
teaching is both art and science
the art of teaching involves creative aspects like instructional design, developing classroom presentation skills, etc.
the science of teaching is based in educational psychology and research and deals with learning theories and preferences, how people think, the domains of learning, and other aspects of learning
the domains of learning are a tool for understanding how people think, feel and act
by understanding the domains of learning we can better plan what needs to be taught and how far we need to go through the material
also called "depth and breadth"
domains of learning
developed by benjamin bloom, et al, in 1956
his research described the major areas of learning and thinking and classified them into three large groups called the domains of learning:
cognitive (thinking)
affective (feeling)
psychomotor (doing)
figure 8-iii shows the classification strategy for the three domains of learning by the degree of sophistication
the degree of sophistication increases as you extend deeper into the list requiring greater depth and breadth for mastery of that level
the domains of learning are used in instructional design to write goals and objectives for a curriculum
commonly used in ems educational products
serve as a means for instructors to decide about depth and breadth issues when developing lesson plans
serve as a means for instructors to develop test questions
levels within the domains of learning
see appendix for blooms taxonomy
as the student progresses from one level to the next within a given domain of learning a deeper and fuller understanding of the material is required
two strategies to classify these levels
lower and higher levels
this strategy places the levels into two categories
the first level (or first two levels) of each domain is considered the lowest level
levels beyond this level are considered higher levels
sometimes this strategy is confusing as there are no clear division points between high level and low level resulting in greater of subjectivity
3 level system
groups the levels of each domain into one of three categories: knowledge, application or problem-solving
knowledge: first (lowest) level
helps students comprehend facts, procedures and feelings
includes simple skills or thought processes like imitation, recall, definitions of terms, receiving and responding to new information
application: second (some low some high) level
builds upon the foundation established in the knowledge level
involves the integration and execution of principles, procedures and values within specific situations
includes precision in the skills execution, the application of principles and valuing feelings and beliefs
problem solving: third (highest) level
builds upon the application level and indicates that mastery has been achieved
involves the analysis of information, procedures, and feelings in order to modify and adapt specific tasks depending upon situations
when an individual is at the farthest part of this level they are capable of metacognition (thinking about thinking)
as stated previously, the language of the objective should clue you in to the level of depth and breadth you should cover for the material
the appendix has information on verbs commonly used to describe objectives for each domain of learning
common cognitive verbs: define, know, describe, design, analyze, discuss, and identify
common psychomotor verbs: demonstrate, show, perform, and conduct
common affective verbs: defend, appreciate, value, and model
you cannot push students through the levels
they must be allowed to move from level to level on their own or with your guidance
if you push them from one level to the next too quickly they will not learn the material and will make mistakes
the cognitive domain
deals with didactic information; knowledge and facts
consists of six (6) levels of sophistication from simplest to most complex
knowledge (level 1) memorization and recall
comprehension (level 1) interpretation and understanding of the meaning behind the information
application (level 2) application of classroom information to real-life situations and experiences
analysis (level 3) separation of the whole into parts in order to analyze their meaning and understand their importance
synthesis (level 3) combining of pieces of information into a new or different whole
evaluation (level 3) making judgments and decisions about and with the information presented
the psychomotor domain
deals with skills, actions and manual manipulation
consists of five (5) levels from basic to complex
imitation (level 1) repeated the example given by instructor or role model
manipulation (level 1) practicing and creating his or her own style
precision (level 2) performs skill without mistakes
articulation (level 3) proficient and competent performance of skill with style or flair.
naturalization (level 3) mastery level skill performance without cognition
sometimes referred to as "muscle memory" or automatic
the affective domain
deals with attitudes, beliefs, behaviors, emotions and how much value an individual places on something
considered the most difficult domain to evaluate
consists of five levels from simple to complex
receiving (level 1) awareness of the value or importance of learning the information and a willingness to learn
responding (level 1) willingness to actively participate in the learning process and deriving satisfaction from doing so
valuing (level 2) perception that behavior has worth
organization (level 3) integration of different beliefs, reconciling differences.
characterization (level 3) development of ones own value system that governs ones behavior
some classroom activities to target each domain
cognitive-lecture, discussion, reading, diagramming, case studies and drills
psychomotor-skills practice, scenarios, simulations, and role playing
affective-modeling behaviors you expect the students to emulate (tolerance, punctuality, respect, kindness, honesty and integrity), role playing situations involving affective domain content, sensitivity training and awareness courses
evaluation of the domains of learning
learning within one domain of learning is often interdependent with another domain
psychomotor skills development requires cognitive knowledge of the parts, concepts and processes for practice to be most effective
for example: a student will achieve mastery of endotracheal intubation faster if he can identify the needed equipment, understand the indications for the skill, and recite the sequence of events for completion of the skill before he ever attempts the skill
some educational learning models encourage an environment where students do a high amount of experimenting as a means to learn, but even in these situations the student should be guided and mentored by the instructor
these learning situations are most successful with students who possess a high level of self-directedness (ability to easily motive themselves who have a passion for learning)
review the course and lesson objectives to determine depth and breadth
try to teach one level deeper than the objective requires because over time, memory degradation will result in the loss of retention of some of the information
research shows that the more senses that are engaged in the learning process the more material is retained for a longer period of time
we remember about 10% of what we read
about 20% of what we hear
about 30% of what we see
about 40% of what we see and hear
about 70% of what we can describe and talk about (say)
about 90% of what we can say and do
research also shows that the more times material is reviewed and reinforced the more it is retained in long term memory
depth and breadth samples
example 1: objective a states the student should take a supplied list of names of 10 organs and label those organs on a mannequin and objective b states the student should draw a human skeleton and label all of the major bones from memory
objective a deals with a much lower level of cognition (knowledge) than objective b (synthesis) so you should be very thorough on teaching objective b compared to objective a
example 2: objective c states the student should be able to take an empty oxygen cylinder and switch the regulator to a full tank
if all you have ever discussed or demonstrated is how to open the tank and check it for leaks it is unlikely that your students will be successful in an evaluation of this skill
example 3: objective d states the student should be able to list the "5 patient medication rights" and you only stressed 3 or 4 of them
it is unlikely that the students will be able to successfully test on this objective unless they are highly self-motivated and learned it on their own through reading, a study group or a tutoring session
cognitive knowledge of a skill does not imply competency in performance of the skills
cognitive knowledge must be integrated with psychomotor skill practice and performance
for example: a student who can answer multiple-choice exam questions about the procedure for spinal immobilization is not necessarily able to fully immobilize a patient without compromising the spine
evaluating the affective domain of learning
the appendix has a tool that will be useful in evaluating the affective domain
this tool comes from the dot/nhtsa/hrsa emt-p curricula
evaluation methods for each domain
module 12 has general information on the concepts of evaluation
modules 16, 17 and 18 contain additional information on the evaluation of each of the domains of learning
cognitive-written examinations, static presentations, and oral examinations
psychomotor-skill competency exam, scenario-based exam, evaluation in clinical or field setting, on-the-job performance
affective-class participation, leadership, peer supervision, role modeling, adherence to policies
most students have a preference or aptitude for one learning domain over another
some students are excellent in the classroom, but struggle with the psychomotor skills of ems, and vice versa
the ems profession requires use of all three domains
minimum competency in all domains must be achieved for practice as a professional in ems
for example, an emt must know (cognitive) the indications for oxygen therapy, recognize (cognitive) the signs and symptoms of respiratory distress, be able to assemble (psychomotor) an oxygen tank and flow the oxygen, and appreciate (affective) the level of distress and anxiety felt by the patient in order to effectively treat the patient
bibliographical resources
anderson, c. w., & krathwohl, d. r. eds. (2001). a taxonomy for learning, teaching and assessing a review of bloom's taxonomy of educational objectives. boston: addison wesley longman, inc.
bloom, benjamin s. et al. (1956). taxonomy of educational objectives, book i: cognitive domain. new york: longman.
coles, c. r. (1990). evaluating the effects curricula have on student learning: toward a more competent theory for medical education.
gagne, r. m., briggs, l.j. (1979). principles of instructional design. new york: holt, rinehart and wilson.
hodell, chuck. (1997) basics of instructional systems development. astd info-line, issue 9706.
mcclincy, william d. (1995). instructional methods in emergency services. new jersey: brady publishers.
whittle, j. (2001). 911 responding for life. new york: delmar publishers.
williams, l. (1983). teaching for the two-sided mind. simon & schuster.
module 9: goals and objectives
cognitive goals
at the completion of this module, the student-instructor should be able to:
use his or her own words to define and describe goal, objective and performance agreement
use his or her own words to identify and describe the abcd parts of an objective
use his or her own words to describe each of the three domains of learning: cognitive, affective and psychomotor
use his or her own words to describe how to evaluate a planned learning activity (lecture, demonstration, etc.) to determine if there is performance agreement between the planned learning event and the course goals and objectives
if module 8: domains of learning has been covered, the student should be able to determine the level (1-3) from the language of the objective based on abcd elements
psychomotor goals
at the completion of this module, the student-instructor should be able to:
take objectives supplied by the instructor and identify the a, b, c, and d components
take incomplete objectives (lacking 1 or 2 of the abcd components) and rewrite the objective to contain all of the necessary elements
take a goal provided by the instructor and write at least one abcd objective for each domain of learning
compare goals and objectives provided by the instructor to determine if performance agreement exists
affective goals
at the completion of this module, the student-instructor should be able to:
explain why goals and objectives are important to well designed learning
explain how the evaluation of goals and objective for performance agreement enhances quality
if module 8: domains of learning has been completed, the student should be able to explain why understanding the three levels within each domain are important in planning and executing instruction
declarative
why this module is important
in order for instruction to have meaning, all educational materials should have goals and objectives
without goals and objectives the instructor would not know what to teach and the student would not know what they are expected to learn
entry level instructors may not be asked to write objectives, but they must be able to work with educational curricula that contain objectives
understanding the basic components of an objective will enable the instructor to determine if they are meeting their teaching goals
if the instructor writes test questions the objectives will assist in the development of the test
objectives can help the instructor determine how much information should be covered on a given topic
you can separate what is "needed to know" from what is "nice to know" and determine the depth and breadth of the material you are presenting
the wording of a well-written objective will show you what level of understanding the student is expected to achieve
does the student need to master the material or only be familiar with it?
instructors must evaluate their classroom performance and objectives serve as the means to measure the effectiveness of teaching activities
module terminology
goal
overarching, global statement of expected learning outcome
it is usually without any discussion of methods required to accomplish it
an example of goal statements can be found at the beginning of each module separate by domain of learning
objective
statement of expected learning in terms of behaviors students will exhibit
an objective should clearly articulate the audience, expected behavior, condition under which that behavior will be performed and the measurement tool or strategy used to determine successful completion of the objective
a well written objective should lead to the completion of the goal
performance agreement
a process used by both instructional designers and classroom instructors
an instructional designer compares objectives and goals to determine if the content to be delivered (as described and defined by the objectives) will meet the goal(s) established for the course
the classroom instructor uses performance agreement to ensure that the content found within the lesson plan and the content presented in the classroom match the goals stated for the lesson
basic principles of goals, objectives and performance agreement
mager is credited with the modern concept of educational goals and objectives (1962)
the need for goals and objectives to be concrete (solid) measurable statements (with clearly identifiable outcomes) not "fuzzy" or nebulous statements
the need for instructional designers to clearly communicate to teachers and students what behavior is expected in order to accomplish a goal
each objective should relate to at least one goal and each goal should be represented by at least one objective
course instructors use performance agreement principles to determine if they are teaching appropriate levels of content (depth and breadth) to their students
pre-presentation evaluation
compare lesson plan to what is written in the course goals and objectives
post presentation evaluation
review what was taught to determine if there were omissions
cover in next class session or provide alternative learning opportunity
revise and enhance the lesson plan for the future
evaluate your performance through self-reflection, observations by other teaching professionals and through feedback from students
you can also review students performance on tests- but there are a lot of variables affecting testing performance so dont rely on it as the only measure of your success or failure
common characteristics of goals
goals are global statements of intended learning
they may be philosophical in nature (similar to a vision or mission statement)
does not communicate specific information on how to accomplish the goal or how to measure the expected behavior or performance
a goal may or may not contain all of the abcd elements (which are explained later in this module) commonly seen in an objective
example of a goal: the goal of this program is to provide the tools necessary to become an entry-level ems instructor
also called primary objectives, first level objectives or expected learning outcomes
common characteristics of objectives
objectives are observable and measurable
every objective should articulate an expected behavior that can be observed
it should describe how this behavior will be measured (for example when the objective states that a psychomotor skill must be performed to a specific level of competency)
objectives are unambiguous
the objective should be written in clear terminology (avoid jargon and define all terms the first time they are used)
it should be apparent to both the student and instructor what behavior is expected to successfully complete the objective
objectives are results oriented
objectives are different from goals because objectives describe specific expectations of performance, knowledge acquisition, feelings or attitudes
objectives should be measurable by both quantitative and qualitative criteria
quantitative (quantity) criteria
successfully meeting the objective requires that the expected behavior be exhibited under the conditions specified
both student and teacher should know how that behavior will be measured
examples of quantitative criteria
the lowest acceptable passing score
the number of attempts allowed during a skill test
a time limit imposed on a skill test
qualitative (quality) criteria
describes non-numerical observations with the purpose of expressing underlying dimensions or patterns of relationships
examples of qualitative criteria
value a concept or idea
defend the need to perform a skill
adopt a new behavior
a performance level of 100% accuracy on quantitative or qualitative measures is not required for every objective
may have an acceptable level of performance already established that allows the student to "miss" some elements but still pass the evaluation process
example: an acceptable minimum score for first responder in a state is 70% so an instructor requires all student to achieve a score of at least 75% on all his quantifiable objectives
may not have a required overall score for an objective
there may be items or steps identified as "critical criteria" that would result in failure if performed
example: failure to use recommended bsi precautions before performing a skill
the order the steps of the procedure are performed is as important as the steps
example: not applying oxygen to your critical patient in a timely manner
objectives should be written in terms of performance
if an objective does not describe or define the expected behavior you cannot evaluate if learning has taken place
objectives should communicate successful learning in behavioral terms
to have meaning, an objective should define the expected behavior change you are looking for to determine that learning has taken place
examples of expected behavior:
select from an assortment of ems equipment and supplies those items required to perform spinal immobilization
demonstrate how to perform a database search on the internet with a topic provided by the instructor
state three reasons why it is important to take bsi precautions when providing patient care
the domains of learning
module 8 provides in depth information on the domains of learning
even if you have already covered the information in module 8, this section will provide a comprehensive review and is recommended material
learning takes many forms and can be categorized or grouped into domains (domains are logical chunks of related elements)
examples of types of learning:
how we feel emotionally about an issue
recalling definitions of medical terms
how we relate to each other
personal values and morals
how we perform skills and procedures
the grouping of these learning elements varies with different educational psychology models
cognitive, affective and psychomotor domains are used most frequently in the design of ems instructional materials
domains of learning are based upon work done by benjamin bloom in the 1950s (bloom called it the taxonomy of learning)
domains are divided into sub-sections that reflect the need for the students to have a deeper level of understanding (and sophistication) as they progress in the domain
see appendix for blooms taxonomy
the degrees of sophistication that require less depth of knowledge (for example when a student defines words or matches terms with meaning) are referred to as the "lower level or level 1" objectives
level 2 objectives are an intermediate level between 1 and 3
"higher level" learning requires students to think critically about a topic, debate it, and understand it in depth
level 3 objectives are considered the highest level
some strategies of classification also include level 2 objects in the "higher" level category
what is most critical for the instructor is to recognize that an objective relates to a higher or lower order or process
see appendix for "verbs to use when writing objectives"
based upon blooms taxonomy and separates information into three discrete levels within each domain
cognitive domain
emphasizes remembering or reproducing something which has presumably been learned
deals with what a learner should know about a subject
the three levels within the cognitive level
level 1: knowledge (or recall), comprehension and application
level 2: analysis
level 3: synthesis, and evaluation
psychomotor domain
emphasizes muscular motor skill, manipulation of material and objects, or some act that requires neuromuscular coordination
concerned with how a learner moves or controls his or her body
the lower levels in this domain will deal with skill performance with assistance or following a demonstration and progresses to "muscle memory," when the performance of the skill is done almost without conscious thought by the student
the three levels within the psychomotor level
level 1: imitation and manipulation
level 2: precision
level 3: articulation and naturalization
affective domain
composed of two different types of behaviors: reflexive (attitudes) and voluntary reactions and actions (values)
this domain is often difficult to write objectives for and to evaluate if learning (expressed as a measurable change in behavior, value or attitude) has taken place
perhaps the best "teaching" you can provide to your students in the affective domain is to model the behaviors you want them to adopt
the three levels within the affective domain
level 1: receiving and responding
level 2: valuing
level 3: organizing and characterizing
consider domains of learning when planning lessons and evaluating instructional techniques
before you teach, review the lesson plan and objectives to determine the depth and breath you must cover the material for that session
after you teach, evaluate if the level taught was adequate for learning to take place
did it target the level specified in the objectives?
example 1: your objectives state that the student should apply the information presented on therapeutic communications by describing how they would react in a scenario
class time was used to define terms but no time was spent role playing therapeutic communications
the material was not taught to the level the student will be tested
example 2: your objective states that the student should match a set of given directional terms to their correct definitions
the instructor taught all the medical terms in the textbook by the latin word root, suffix, and prefix
students had an extensive list of medical terminology and the class was several hours behind schedule
in this example the instructor went way beyond what was required by the objectives and threw off the schedule
goals and objectives in lesson plans
goals and objectives are often presented in two distinct levels with objectives being subordinate to goals
goal
the first level identifies the overall goal of the instruction for the program or instructional event
in addition to simply being called a goal, it may also be called a "terminal objective" or "primary goal of instruction"
goals do not contain specific information on how learning is to be accomplished or measured
goals are philosophical statements of what learning is intended to produce
the statements found at the beginning of each module in this curricula are goals
objectives
the objective is subordinate to the goal and should relate to the goal
in completing the objective the student is moving toward meeting the goal
sometimes these objectives are called "enabling objectives"
because these are true objectives, they should follow the abcd format described in this module
performance agreement
performance agreement is a process of critically evaluating the goals, objectives and course content to force logical relationships to each other
every goal should have at least one objective related to it
every objective should relate to at least one goal
the content of the lesson should relate to the goals and objectives
there should not be any content that does not relate to goals and objectives
when the goals, objectives and content all relate to each other there is performance agreement
methods to evaluate performance agreement are described later in this module
examples of objectives
given a standard sentence, the english 101 student should be able to identify the noun and verb without error.
given an assortment of ems equipment, the paramedic should be able to identify all of the equipment necessary to perform rapid sequence intubation without error.
the emt-b participant in this pediatric workshop should be able to identify at least 4 warning signs of possible child abuse from a mock family members interview that contains 8 warning signs.
from a listing of roles and responsibilities, the first responder student should be able to identify all those pertinent to a first responder level provider with at least 70% accuracy.
parts of an objective
many methods, models, and templates are available on writing objectives
an easy to remember generic model utilizes the letters a-b-c-d to indicate the important information to include in an objective
a= audience, b= behavior, c= condition and d= degree
note that an objective does not have to be written in this order (abcd) but it should contain all of these elements
two simple models to follow in writing an objective:
the (audience) will _(behavior) in (condition) circumstance to _(degree) level
given _(condition) the (audience) will _(behavior) to _(degree)
audience
describe the receiver of the instructional activity
often the audience is identified only in the 1st level of objective (which is usually the goal) or the first objective in the series of objectives for that section
examples of audience statements
the emt-b student
the emt-i refresher course participant
the prehospital care provider attending this seminar
behavior
describes learner capability
what the receiver will be expected to do following the instructional event
must be observable and measurable
if it is a skill, it should be a real world skill
it should relate to current clinical practice
the "behavior" can include demonstration of knowledge or skills in any of the domains of learning: cognitive, psychomotor or affective
examples of behavior statements:
should be able to write a report
should assemble the equipment necessary to perform needle thoracotomy
defend the need to use reasonable force for self-protection
terminology may be important here
wording like "should be able to" or "will be able to" carry different legal expectations and may be an issue to your organization
this may only be an issue for someone who is writing objectives if you are concerned about this, consult with your supervisor or a senior instructor
condition
the condition describes any circumstances that will impact upon the behavior the student will exhibit
equipment or tools that may (or may not) be utilized in completion of the behavior
environmental conditions or situations (temperature requirements, seasonal conditions, weather impact, swift water, time of day, etc.) may be included as conditions
time limits may be imposed as a condition for performance
examples of condition statements
given an oxygen wrench, regulator and d tank with oxygen
given the complete works of william shakespeare
following the last ventilation given by bmw and within 30 seconds
degree
states the standard for acceptable performance (time, accuracy, proportion, quality, etc)
in the event that the degree statement is not included in the objective you may infer that the acceptable standard for performance is 100%
examples of degree statements
without error
9 out of 10 times
without committing any critical errors
review of abcd objectives
well written objectives will tell you the following:
who is to exhibit the behavior (target audience)?
what observable performance is the learner to exhibit?
what conditions are provided for the learner at the time of evaluation?
what constitutes a minimum acceptable response?
evaluating goals, objectives and content for performance agreement
compare the content you intend to deliver to the course goals and objectives to determine if the content being delivered actually enables the student to meet the objectives
if you cannot clearly see that the content being delivered meets the objectives then you must modify, enhance or remove content to meet the objectives as stated
you need to determine if you are teaching too much or too little (depth and breadth) or if you are off the topic
review the verbs in the goals and objectives looking for clues of the level the statement is written to
you should do this before and at the end of each presentation to determine if you are on target
it is much easier to make minor adjustments as you go along than to wait until testing time to evaluate if you taught the material to the right level
bibliographic references
bloom, benjamin s. et al. (1956). taxonomy of educational objectives, book i: cognitive domain. new york: longman.
hardt, u. h. (1977). determining goals, objectives and strategies for the domains of learning and instructional intents. a guide to lesson and unit planning.
hodell, chuck. (1997) basics of instructional systems development. astd info-line, issue 9706.
nooman, z. m. schmidt, h. g., & ezzat e. s., eds. (n.d.). innovation in medical education. new york: springer publishing company.
novak, j. d. (1977). a theory of education. ithaca cornell university press.
smilkstein, r. (1993). acquiring knowledge and using it. gamut, 16-17, 41-43.
module 10: lesson plans
cognitive goals
at the conclusion of this module the student-instructor should be able to:
define a lesson plan
define and describe the following components of a lesson plan:
needs assessment
overall goal of instruction
cognitive objectives
psychomotor objectives
affective objectives
lesson motivation
recommended list of equipment and supplies
recommended schedule
list and describe the components of a needs assessment used for preparing a lesson plan
list and describe the items to consider when evaluating the intended audience during needs assessment
discuss the methods for determining the depth to which the content will be covered in a prepared lesson plan
discuss the process of aligning objectives of the curriculum with the specific objectives of the lesson plan
discuss how to use a lesson plan to present course content
discuss methods to evaluate the effectiveness of lesson plans:
formative evaluation strategies
summative evaluation strategies
written testing instruments
practical skills demonstrations
psychomotor goals
at the conclusion of this module the student-instructor should be able to:
use the information described in this module as a template and evaluate a supplied lesson plan for completeness and accuracy
conduct a needs assessment with a group of ems students using the parameters discussed in this module
take a goal of instruction and supporting objectives supplied by the instructor and write a brief lesson plan that includes all of the elements presented in this module
affective goals
at the conclusion of this module the student-instructor should be able to:
support the use of lesson plans in guiding the planning and presentation of instruction
defend the need to perform a complete and thorough needs assessment prior to the development of a lesson plan
declarative
why this section is important
using a lesson plan is an effective method to organize your teaching presentation
provides a guide to follow when presenting
assists in the evaluation process
objectives determine the content of tests
lesson plans and objectives indicate the depth and breadth to cover the material
an entry level instructor may not be called upon to prepare a lesson plan
should know the required components of a lesson plan
should be able to evaluate a lesson plan to determine if it is complete
purpose of a lesson plan
to serve as a framework or guide to the instructor while the lesson is being presented
it should assist the instructor in the selection of content to be presented
it should not be used as a substitute for preparation
sources of prepared lesson plans
state ems office
senior or mentor instructors
publishers
be careful of bias toward their products or services
organizations with certification and continuing education courses
national association of ems educators
the dot/nhtsa/hrsa national standard curriculum (nsc) for all levels of ems are not written as a lesson plans and cannot be used as such
they are used as a source of the goals and objectives that should be taught
sample outline in appendix
needs assessment
a needs assessment is performed before a lesson plan is written
the first part of the instructional design process
a critical component to the development of a successful education presentation and should not be omitted
a good analysis is essential
the anticipated training is evaluated to determine who, what, where and when
who will attend your course? (identify your audience)
determine the demographics of typical and atypical students
content may affect various communities differently
age of student
professional adult
youth
race
diverse cultural background can increase the richness of discussions
be alert for biases in content
gender
be alert for biases in content
where are they traveling from to the course site?
is travel distance an issue?
will weather or traffic patterns impact travel time?
volunteer vs. career (paid)
although each group is comprised of professional students, motivations (intrinsic and extrinsic) may be different between a volunteer and a career student
are they required to be there or do they want to be there?
learning preferences and styles
diagnostic instruments are available to determine students preferences
implement teaching strategies that will make learning more meaningful and enjoyable for the students
educational background
do students need additional preparation prior to entering the course?
who is responsible for providing the remedial or developmental education?
prerequisites
entrance tests
education prerequisites: anatomy and physiology, english, and/or math course work
certification level or experience requirements
do they need to show competency or performance verification prior to enrolling?
technology requirements
if technology is a component of the course consider the impact of access to technology and user competence that is required
ems experience
what is their experience level?
are they doing this to change careers?
other commitments that may detract from student's learning capabilities
family and social
work schedules and responsibilities
shift work
inflexible schedules
on call status
time of day the class is offered conflicting with other commitments
what do students need to learn?
this is important in discovering motivational strategies
are there job-related requirements?
are there are certification related requirements?
separate the "need to know" from the "nice to know" material
is there a standardized curriculum you can use as a guide?
where and when will the course be given?
is the environment friendly and inviting to students?
well lit room
designed for the use intended
desirable for studying and learning
comfortable temperature
free of distractions
time frames for each element of the course should be pre-planned but must be flexible
other considerations in a needs analysis
is certification or licensure a required outcome of your course
ascertain student needs in regard to professional certification
decide if class meets professional certification requirements
if the sponsor of the course is different from the student, what are their expectations for the outcome of the course?
compile all of the information above and use it to direct instructional design strategies
you may not use all of the information
it is helpful to know these issues were considered
information learned in this process may result in alternations to your original plan or concept
example: students in your course will not be available at a certain hour of the day due to other commitments so you must change your proposed schedule to accommodate this and increase attendance
example: students do not have the background or experience necessary to make them ready for your course but it appears that they can be ready with a few hours of targeted instruction of prerequisite material and you have the budget and means to support this additional training
overall goal of instruction
also called "primary goal of instruction" or "terminal objective"
once you have a clearer understanding of the audience look at what you want/need to teach
this will become part of your objective for the course
information on writing objectives is contained in module 8: domains of learning and module 9: goals and objectives
the overall goal of instruction should be clearly articulated to the student at the beginning of the educational experience
it should also be supplied to them in written form
your overall goal of instruction is further broken down into measurable pieces of behavior called objectives (or sometimes: enabling objectives)
entry level instructors may not be called upon to write objectives, however, it is important to understand the concept of objectives and to appreciate what a good objective should contain
objectives should clearly state what is to be learned and/or accomplished by the student
objectives are measurable statements of behavior required to demonstrate that learning has occurred
for example, the objectives for a trauma course should be designed to validate that students have learned how to perform a trauma assessment. it would not be appropriate for the objectives of a trauma class to include how to clear a meconium filled airway in a neonate
we have discussed three primary types of objectives: cognitive, behavioral and psychomotor
although there are other types, these are standardized in ems and allied health education
refer to the appendix for a recommended list of verbs to use in writing objectives
cognitive domain objectives
describe the level of understanding a student should have about the material
blooms taxonomy is a helpful list of verbs used to describe expectations
the verbs are grouped according to the depth of understanding required at each level
example: knowing or comprehending information is a lower cognitive skill than evaluating it
every lesson has cognitive objectives
psychomotor domain objectives
domain for skills performance
includes gross body movements, fine body movements, speech behaviors and non-verbal communication
not every module has a psychomotor component because not every module requires you to perform a skill
typical verbs used to describe psychomotor objectives are demonstrate, apply and perform
affective domain objectives
this is one of the most difficult areas to work within because it deals with how students feel about issues
some educational researchers even believe it is impossible to change emotions, values or feelings or to do it in a measurable way
some of the verbs used in affective domain objectives include accept, defend, challenge, judge, participate, and support
lesson motivation
the lesson plan can provide information to the instructor for motivating students
intrinsic motivation comes from inside the student
often comes from the affective domain (feelings and emotions)
may be intensely personal, for example: a student wants to learn this material because he had a loved one who died from a disease you are going to discuss
you can help intrinsically motivate the student by asking him or her to look inside for a reason to learn this
students with a high "need to achieve" may not require a motivation from you
education may help them maximize their personal needs (maslows hierarchy of needs: see appendix for more information)
extrinsic motivation comes from outside the student
goal of external motivation strategies is to get students to buy in to the importance of the material so they are willing to learn it
engage students in discussions about the importance of the topic
describe how this material fits into the overall scope of the program or course
coaching students may help motivate them
ask them to provide reasons why this material is important to learn
recommended list of equipment and supplies
include all equipment or supplies needed to present the material
av projection equipment
instructional equipment and supplies (flip charts, chalk, etc.)
medical equipment and supplies
manikins and models
use as a resource when preparing to teach
arrive early to test the equipment and set up the room
bring spare bulb for av projection equipment
have a back up plan in case of equipment failure
decide what adjuncts will be needed in the classroom e.g., manikins, blankets, vehicles, iv arms, etc.
have a complete set of working equipment and supplies for each group of students that will reflect what they will have to work with in the field
the behaviors you model may have as great an impact upon the students as what you tell them
recommended schedule
guides the pace of the course
class size and instructor to student ratios will affect schedule
physical location of the class will also effect the schedule
poorly designed rooms, many distractions and poor temperature controls will affect students concentration
plan for frequent breaks
always plan a break within an hour following mealtime
break for at least 5 minutes each hour
optimal method is to vary the instruction at least every 20 minutes
example: a 20 minute video clip followed by a 15 minute in-class exercise (then a 5 minute break) followed by a 20 minute lecture, a 20 minute skills demonstration and another break
plan breaks at appropriate times so that you dont interrupt momentum
determine from the lesson plan how much detail regarding the information needs to be presented
you must decide if the student needs to have an awareness about the material or if they must master it
if you are unsure and have the final exam, reviewing it may help you determine how much material to present
by reviewing blooms taxonomy you can determine how detailed the presentation needs to be
the verbs used in the objectives will provide clues
cognitive domain verbs are placed into 6 groups, starting with the lowest level required and increases to the highest level of understanding of the material
the 6 groups, in order, are knowledge, comprehension, application, analysis, synthesis, and evaluation
basic level understanding (level one)
students acquire new information or develop a new skill
this level requires feedback by the instructor
includes objectives that demonstrate knowledge and comprehension
intermediate level understanding (level two)
students connect the knowledge learned in the basic level with knowledge gained through experience
includes objectives that demonstrate application
advanced level understanding (level three)
students function with little or no supervision
instructor serves more as a facilitator than a teacher
instructor focuses student towards learning why events occur as opposed to how to perform a skill
instructor may assume a coaching or mentoring role
includes objectives that require analysis, synthesis and evaluation
using a lesson plan to present course content
explain the importance of the curriculum
begin with a statement listing and explaining the primary instructional goal and objectives
allow students to give feedback about the objectives
this is especially important when the audience is made up of professionals who have specific and intrinsic needs
deliver the content
select methods suitable to student learning styles and consider constraints in the ability to deliver the material
allow students to practice skills
document competence
allow feedback.
encourage students to interact and contribute
allow time for remedial education
evaluate performance of students and lesson plan
student tools
encourage students to take notes
it may be useful to provide students with an outline of the lecturers notes
several computerized programs allow instructors to print a succinct outline of text and or graphics for a given presentation
interactivity
allow students to submit questions during and after class time
encourage appropriate discussions
encourage students to take responsibility for their learning
evaluation of the lesson plan and the content delivered
the process of aligning objectives of the curriculum with specific objectives of the lesson plan is called performance agreement
cumulative lesson objectives should address the courses goals
lesson plans should build upon previous course goals and objectives
didactic and practical objectives should be aligned in support of each other
formative evaluation
you will perform formative evaluation as you write the lesson plan
compare the overall goal of instruction, lesson objectives and the content
determine if you have performance agreement between these three elements and make any adjustments necessary
if you are not writing a lesson plan, but are using one that is already written, evaluate the instructional goal, objectives and content to determine if they are complete
make any necessary adjustments to make sure that there is performance agreement
review testing instruments to see if they match objectives and content
summative evaluation
summative evaluation is performed at the completion of the lesson
use it to determine the effectiveness of your teaching strategy and to improve future performance of the same material
methods of performing summative evaluation
survey tools
test item validation
comparison of course and program outcomes
evaluation tools
see module 12: evaluation techniques for more information
document student performance using a written evaluation tool
share results of evaluation in a timely manner
work out a plan for improvement that the student has participated in designing so they can take ownership and responsibility for their improvement
written evaluation tools
tests and quizzes
the objectives should serve as the foundation for any written test
multiple choice items
national certification and license tests are generally multiple choice
it is difficult to test higher levels of cognition with multiple choice testing
it is very difficult to successfully write test items at these levels
be aware of the cognitive levels your test questions target you may need to do other types of testing (for example short answer, fill in the blank or essay questions) to validate the higher cognitive levels
matching and true false
similar to multiple choice but removes some of the ability to take a guess as necessary information is omitted from the testing item
still somewhat difficult to test higher cognitive levels
fill-in-the-blank, short answer, and essay questions
typically more difficult and time consuming to grade but will provide a more comprehensive evaluation of the students mastery of the higher levels
practical skills evaluation tool
skills check-off sheet
incorporate skills in to an overall scenario - allows students to demonstrate their ability to synthesize material into an overall ability to use critical thinking
can be used to evaluate higher levels of cognition as well as acquisition of psychomotor skills
bibliographic references
benefit, arian b. (1995). instructional design process: a case example. performance & instruction, september, 40-42.
butruille, susan. (1998). lesson design and development. no. 8906 astd.
carolan, mary d. (1993). seven steps for back-to basics training, nineties-style. training & development, august, 15-17.
chapman, bryan l. (1995). accelerating the design process: a tool for instructional designers. journal of interactive instruction development, fall v8 n2, 8-15.
evers, linda m. (1992). designing an informational/instructional strategy. technical & skills training, november/december, 25-31.
filipczak, bob. (1996). to isd or not to isd? training. march, 73-74.
flannery, timothy, j. (1995). developing lesson plans, part 1: what do we need to teach? fire engineering, vol. 148 issue 7.
flannery, timothy j. (1995). developing lesson plans, part 2: what is the objective? fire engineering, vol. 148 issue 8.
flannery, timothy j. (1995) developing lesson plans, part 3: creating the lesson. fire engineering, vol. 148 issue 12.
ford, donald j., ed. (1997). astd's in action series: designing training programs. virginia: astd.
gramiak, lori h. (1995). maintenance: the sixth step. training & development, march, 13-14.
holton, elwood f., & bailey, curt. (1995). top-to-bottom curriculum redesign. training & development, march v49, n3, 40-45.
huang, zhuoran. (1996) making training friendly to other cultures. training & development, september 1996, 13-14.
katz, michael, & rosenberg, jacob. (1996). from complex expert thinking to lucid learning methods. performance & instruction, july, 12-13.
kirkpatrick, donald l. (1996). evaluating training programs the four levels. california: berrett-koehler publishers, inc.
moller, leslie. (1995) working with subject matter expert. techtrends, november/december v40,n6, 26-27.
shultz, fred, & sullivan, rick. (1995). a model for designing training. technical & skills training, january, 22-26.
(1995). three factors to consider when developing courses. training, december, s3.
(1997). the astd training and performance yearbook. alexandria and new york: asti and mcgraw-hill.
tracey, william r. (1992). designing training and development systems. (3rd ed.). new york: american management association.
module 11: presentation skills
cognitive goal
at the completion of this module, the student-instructor should be able to:
describe four different instructional styles
describe the proper use of instructor presence in the classroom setting
list types of media available for classroom use
list criteria for successful classroom presentations
list strategies that can be used to augment classroom presentations
psychomotor goal
at the completion of this module, the student-instructor should be able to:
demonstrate a brief presentation in each of the following methods:
lecture
student centered activity like a role playing scenario, simulation or game
demonstrate how to gauge students response to your presentation
affective goal
at the completion of this module, the student-instructor should be able to:
explain how different classroom presentation strategies enhance learning
describe the importance of including varying learning styles in each lesson plan
value the importance of diversity in the types of media used to deliver subject matter
declarative
why this module is important
the art of teaching often lies in how effectively the teacher is able to present material
the method of presentation will greatly impact upon how successfully the material is learned
common instructional styles
traditional lecture
also called face-to-face (f2f)
classroom setting
instructor-centered technique
standardized approach that works well with expert guest lecturers
tends to be boring and students are easily disengaged
best for visual and auditory learners
poor approach for kinesthetic learners
behaviorist approach
referred to as the "sage on the stage" because the instructor is the expert who is the center of the learning experience
roots in socrates and ancient philosophical methods
role playing
student centered learning
scenarios, case studies, rehearsals and practice drills
good for all types of students, especially kinesthetic ones
good for developing psychomotor skills
good for developing higher order critical thinking skills
may require additional preparation time if the role-play is elaborate
they do not need to be elaborate to be effective
uses constructivist learning principles
constructivism: student makes meaning by experiencing things for themselves
students are actively involved in the learning process
collaborative / informal
student centered learning
team activities and open dialogue
good for engaging students but must be monitored closely
more passive learners may let more active learners do all the work.
uses constructivist learning principles where the instructor guides coaches and mentors the student
progressive
distance education
learning is taking place where student and instructor are separated either by time or place
this is not a new method of learning
1760s first documented case in united states was a correspondence course for learning shorthand
many forms of distance learning are possible and include a variety of media: print, audiotape, videotape, satellite, technology and multimedia based programs, computer software based programs and internet based programs
make the presentation
introduce the subject matter early in the presentation
introduction should include:
validity of the instructors credentials / experience / knowledge
description of the content
the importance of the material
you may need to provide motivation to the students
relevance of the material to their work or personal lives
course outline
briefly describe the content for the presentation
requirements for successful completion of the course or lesson
expected course outcomes
additional rules and regulations
if you are a guest lecturer inform student of any special information that may be different from their normal routine
when breaks will be scheduled
how students should handle questions: wait until the end or interrupt the presentation
instructor presence in the classroom
you will develop your presentation style as you become more relaxed in the classroom
anonymous instructor saying: "students will not care how much you know until they know how much you care"
if you behave like you do not have any respect or tolerance for the students they will quickly become disrespectful of you
plan to arrive early
you will appear more organized
check the room and arrange it so it is inviting
check the av equipment
cue up videotapes, audio tapes and other presentations
make sure av wires and cords are not a safety hazard
set up other equipment you will need
check batteries in equipment
greet students as they arrive
make yourself available for questions or make appointments
take some personal time with each student if possible
appropriate use of barriers when teaching
many instructors feel more comfortable sitting at a desk or standing behind a podium
think about where you are in relation to the students
are you hiding behind objects?
can the students in the back row see you?
how formal or informal do you appear as you sit or stand?
do you want to look casual or formal?
how approachable or friendly do you appear by where you are standing?
generally you want to stand about 8 feet away from your first row of seats
try to move around the room if you can
disruptive students are less of a problem if you can move closer to where they are sitting
speaking in public
always use appropriate language
avoid overly familiar terms like "sweetie" or "honey" when addressing students
do not use obscenities in the classroom, even when amongst your peers
it is unprofessional, offensive and may alienate a student
speak clearly and distinctly
use amplification devices where available
humor may fall flat if used inappropriately
avoid denigrating other professionals
never use to denigrate a student or to point out their mistakes
use sparingly
related to the subject material
should not conflict with standard practice or courses core material
do not reinforce short cuts or other bad practices
the profession of ems is prone to dark humor as a means of dealing with overwhelming tragedy and as a means of stress relief
be alert to the mood of your students by observing their humor
always keep in mind that they will model after your behaviors including your humor
avoiding jargon
ems terminology is a fact of our profession, but make sure everyone knows what you are saying by defining all terms at least once during your presentation
never assume your audience knows the terminology define the terms the first time you use them, if it seems like they understand then you can continue
catchy and colorful phrases should be used with caution, and should never be used to put down another group or person
eye contact while speaking
maintain eye contact with class by moving your eyes around the group
make sure you do not hold anyones gaze for too long, as this can be uncomfortable for them
watch for personal blind spots (places you tend to look all the time) because you can ignore students who are not in your normal vision area
appearance
dress appropriately for the environment you are working in
a uniform may be required for both you and the student make sure yours is well cared for
ask your primary instructor what dress is appropriate
sportswear is generally appropriate for classroom presentations
think about what you will be doing that day in class
be adequately rested
lack of sleep affects humor, attitude, demeanor, and judgment
respect personal space
avoid unnecessary physical contact
treat all students the same
engage students equally and avoid bias
avoid gender bias in dialogue and practical exercises
watch your class closely and make sure you advocate for students who are "outsiders" from the group
avoid picking favorites
do not pass judgement on students
you can easily decide a student who is sitting with their eyes closed is sleeping, but they may be concentrating on what you are saying
just because a student appears to be taking notes does not mean they are paying attention- they may be writing a letter or doing something unrelated
use of audio-visual equipment
preview all av equipment and resources before use
have a back-up
classroom may not accommodate use of planned materials
equipment may fail
writing surfaces
black board / white board
commonly available
usually non-portable
time consuming to use
flip charts / poster board
portable
may be difficult to adhere to wall surface
you must turn away from the student to write on the board
avoid talking to the writing surface while you are writing on it
overhead projector
portable
inexpensive
may require minor repair (bulb)
allows for colorful display
may be time consuming to use and poor handwriting makes it difficult to read
you may be blocking students view when you are standing next to the machine to write on it
slide projector
portable
inexpensive
may require minor repair (bulb)
wide range of presentations available
costly to produce personal slides
digital and computer technology devices
digital projector
initial purchase may be expensive.
resolution needs must be considered with purchasing
different resolutions offer different quality of images projected
requires additional computer equipment to interface with it
compatibility issues when you are a guest lecturer so always take presentation on a disk in addition to on your hard drive
cd (in class and out-of-class)
easily created with a variety of software packages (auto-run and non-auto-run)
may be a learning curve to using the software
publishers offer a wide variety of standard presentations
dvd (in class and out-of-class)
expensive to create
some publishers offer standard presentations
internet (in class and out-of-class)
requires an internet connection
relies on the speed of the internet connection
modem
lan (local area network)
allows display of large multimedia files
provides students with increased freedom to schedule course work.
audio
microphone (wireless and wired)
audiotape and videotape
cue up to the place you need
make sure they are appropriate to the setting you will use them in
gauging students response to your presentation
observe students to see if any are having trouble following the presentation
may be embarrassed to speak-up about a disability or problem
if you detect a problem you may be able to move students around (by doing an activity) so that the student with the problem can move closer
this technique also works when you want to separate students who are acting out or not paying attention
other barriers to learning to be aware of
non-english speakers (as primary language)
hearing impaired
sight impaired
other disabilities
designing lesson plans to meet the needs of varying learning styles
lessons should be designed to incorporate a variety of methods for delivery of subject matter
students have a variety of learning styles and preferences
educational psychologies are categorized by describing modes of thinking, processing thoughts and the students individual preferences in how they learn
reevaluate lessons periodically to review the effectiveness of teaching styles
lessons should include a variety of methods for augmenting lecture material
methods include:
case studies
scenarios
simulations
personal experiences
games / entertainment
case studies
written situation is simplest type
elaborate multimedia presentation with photos of the patient and participation by the members of the health care team who provided patient care
these may be presented to an individual or group of students
scenarios
hands on practice where the students simulate being the practitioner
scenarios work best with preplanning on the part of the instructor
discuss with the students the ground rules and your expectations
scenarios can also be written down (allowing for short answer responses) or can be done in small groups as discussions
simulations
use of moulage, victims, and equipment to role-play scenario
simulations can be observed by the student (like a demonstration) or the student can participate
personal stories of clinical situations
also called "war stories"
can help students develop concrete cognitive images of subject matter
must not allow students to digress into non-purposeful discussion (one-ups-manship)
war stories can sew the seeds for some great discussion opportunities and can be a means to work on critical thinking skills
they should enhance the educational experience, not detract from it
games / entertainment
most adult students enjoy playing games, but they should have relevance to the course
they can provide break from the routine and may serve to reenergize the students
will not be advantageous to some learners
bibliographical references
dowling, ellen. (1995). the standup trainer. american society for training and development.
johnson, d., johnson, r. & smith, k. (n.d.). active learning: cooperation in the college classroom. (2nd ed.). edina: interactive book company.
macgregor, j., cooper, j., smith, k., & robinson, p. (2000). from small groups to learning communities: energize large classes. new directions for teaching and learning. indianapolis: jossey-bass.
pike, robert w. (1994). creative training techniques handbook. minneapolis: lakewood books.
module 12: evaluation techniques
cognitive goals
at the completion of this module the student-instructor should be able to:
define evaluation, formative evaluation and summative evaluation
distinguish between formal and informal evaluation
identify various types of evaluation, and the advantages and disadvantages of each
understand specific types of test items and the advantages and disadvantages of each
understand general guidelines for test construction
define reliability
define content validity
list several examination resources
psychomotor goals
at the completion of this module, the student-instructor should be able to:
develop two examples of correctly constructed test items for cognitive evaluation in each of the following categories:
multiple choice
true/false
matching
completion
essay
develop a skills checklist to evaluate a psychomotor skills performance
affective goals
at the completion of this module, the student-instructor should be able to:
explain why evaluation is important to the total quality control of an ems program
explain why formative and summative evaluations are both important in the evaluation process
declarative
why this module is important
without a mechanism to evaluate the student you will never know if you have achieved the objectives and goals of instruction
the evaluation process helps determine strengths and weaknesses of students and your program
program evaluations help improve the quality of the instruction
student evaluations help determine whether students are progressing satisfactorily
evaluations can also be used to determine if an individual is compatible with the ems field (by targeting the affective domain)
see the appendix for a sample affective domain evaluation tool
entry level ems instructors may not design and develop test items (questions), but should have familiarity with the concepts of evaluation and how to construct solid test items
even if using a prepared test bank, you should understand how to determine if these questions are well written and match the objectives of your lesson plan
evaluation
process of making a value judgment based on information from one or more sources
a mechanism of determining student progress toward, or the attainment of, stated cognitive, psychomotor, and affective objectives
the evaluation process should look at two components
instruction as provided by the instructor
the performance of the student on course and lesson objectives
purpose of evaluation
provide feedback to student on progress or performance
provide student gratification and motivation to succeed
measure effectiveness of teaching style and content of lesson
measure effectiveness of the educational program in meeting written goals and objectives
formative evaluation
ongoing evaluation of the students and instruction conducted throughout the course
compare the overall goal of instruction, lesson objectives and the content to the performance by the students
compare the objectives of the course to the testing strategy
cognitive component: testing knowledge
psychomotor component: testing skill performance
affective component: testing attitudes, beliefs, ethics and morals
formative evaluation is important in gaining insight early in the program
use this information to make changes in the program, to provide remediation, or to redirect presentations
methods of performing formative evaluation during a course or class
module or section testing within a larger topic area is a form of formative evaluation
"taking their temperature" is an informal method of obtaining a quick response of student's questions or to clarify content just delivered
two of the many methods to take their temperature
one minute paper: ask student to write their response to a question then compare their answer to another student's
the muddiest point: ask students to write any questions they have on note cards and collect prior to a break
after the break begin with a review of the most common questions
give frequent, short-duration written or practical drills or quizzes
the intent is to provide feedback to both the student and instructor on the progress of the student
summative evaluation
summative evaluation is performed at the completion of the delivery of a larger section of material, a module or program
provide feedback to the students of their successful mastery of the content
determine the effectiveness of teaching strategy and to improve future teaching performance
methods of performing summative evaluation during a course or class
survey tools
gather opinions about various aspects of the course and instruction
comparison of course and program outcomes
determine if all goals and objectives were met
final examinations: practical and written
test item validation
determine if questions were valid
psychometric assessments can be performed to validate tests and questions
this level of evaluation is beyond an entry level ems instructor
a formative evaluation can also be summative
depending upon the context in which it is used, a test may represent formative or summative evaluation
for example: a multiple-choice final exam given at the end of a topic will be both formative and summative
it is summative because it represents the end of that topic area
it is formative because it represents only a part of a course
formal and informal evaluation
both formal and informal strategies are critical to the success of courses and programs
some of the evaluation strategies listed can be conducted formally or informally
formal evaluation
a structured instrument to assess students attainment of interim and/or terminal course objectives
a formal written examination can determine a grade for a course or serve as a means to continue in the program
if you review the test and allow students to challenge questions (prove it wrong through the use of textbooks and class notes, etc.) it can serve as a powerful learning tool
problems with formal evaluation techniques
place stress on the student (especially the ill-prepared ones)
may not provide a mechanism for remediation or retention when they represent a final summation of learning
informal evaluation
less structured method of assessing student achievement used primarily to provide corrective feedback to both the student and instructor
informal evaluation tools may not be graded or the instructor may not record the grades
student benefit: identify weakness (and strengths) and offer suggestions for improvement; may serve as a "wake-up" call
instructor benefit: compare results from the class to identify trends and problems and to develop corrective instruction or remediation
if the instructor makes an evaluation informal it may cause conflict when students have the expectation of a formal evaluation
problems with formal evaluation techniques
may not allow for remediation or retraining
problems with informal evaluation techniques
students may not perceive the value in these instruments because grades are not recorded
instructors may not wish to spend class time doing informal evaluations
instructors may not grade or provide the student feedback on informal evaluations further diminishing their importance in the students eyes
written examinations
types
multiple choice
true/false
matching
completion
essay
terminal/certifying
terminology
item: common instructional design term for all of the components of a written examination question including the question, correct (or best) answer and incorrect answers
stem: part of the item that is first offered, it may be written as a question or an incomplete statement, the stem is often called the "question"
distracter: an answer to a test question that is a false or incorrect answer designed to be a plausible alternative to the correct answer
key: the correct (or best) answer to the item
source of test items: the course and lesson objectives
test items should come from the course objectives and lesson plan
if you are testing information you have not directly covered in the class you should ensure students have been directed to this information via reading assignments, projects, or some other form of independent study
advantages of written examinations
can be used with a large number of students
measures cognitive objectives
provides for consistent scoring
grading and compiling result is quicker than for other types of examinations
disadvantages of written examinations
time consuming to develop
difficult to develop adequate measurements for the higher order levels of the domains of learning
complex validation procedures
could discriminate against students with reading difficulties
poorly written items may evaluate a students reading ability more than they evaluate knowledge of the material
cannot measure skills performance
questions can be asked about the procedure to perform, but the actual skill demonstration cannot be evaluated via this type of test
general guidelines for written test item construction
test must be related to objectives and developed from a blueprint
a blueprint is an outline for the test
include test items on each objective
decide the depth and breadth (level) to cover for each item
exam must be an appropriate type
considering your domain of learning and how far into the domain (high or low level or lever 1, 2 or 3) you want to go
this can help determine the appropriate instrument to use
the following are a partial list of suggestions to follow
low level cognitive: multiple choice, matching, true/false, simple completion (fill-in-the-blank) or short answer essay, and oral exam
high level cognitive: long and short answer essay, fill-in-the-blank, some true/false and completion, oral exams, projects (case studies for example), and observational reports
low level psychomotor: rote skills, oral, and observational reports
high level psychomotor: situational scenarios, projects (designing scenarios for example), and observational reports
low level affective: oral, short-answer essay, projects (opinion papers for example), and observational reports
high level affective: oral and situational scenarios, projects (group designed presentations for example), and observational reports
organize exam in a logical manner
group like items (similar content area) together on a written exam
have questions follow a linear or logical sequence in an oral or situational (scenario based) examination
if timed, allow an appropriate amount of time to answer questions or perform a skill
determine if timing the test is appropriate
when preparing for a timed licensure or certification exam
mirror timing strategy of terminal exam in your preparatory exam
if the goal is for students to think or act quickly
some suggested timing strategies
one minute per item for a standard multiple-choice test
allow 2-3 minutes to read a scenario then one minute for each multiple choice question
allow longer time to read a scenario and compose an essay answer
allow longer time to respond to a situational skill than a rote one
allow longer response time for a higher level question (in any domain) than a lower level one
provide clear complete directions about the test
can or cannot write on the test
use a pencil to fill in the answer sheet
time limit
whether or not breaks will be allowed during the test
have another instructor review the examination for clarity and completeness
be sure exam is legible, free of typographical, grammatical, spelling and content errors
be consistent in the design strategies you are using for the graphics (fonts) on a written examination
use all capitals or all lower case letters consistently throughout the test for both the key and distractors, both in the numbering strategy (a, b, c, d or a, b, c, d) and for the first word of the key and distracter
be consistent in the use of punctuation
use a consistent strategy to draw attention to material in the test
be consistent with the use of underline, bold or italics
position key and distractors appropriately
observe for answers that build logically
if your answer choices are the letters "a," "b," "c" and "d," place them in that order
place number answers in ascending or descending order
specific types of written test items: multiple choice
common method of conducting formal and informal evaluation
written national and state certification and licensing examinations are multiple choice
limitations of multiple choice questions
bias cueing occurs from leading students to the correct answer by the way the stem is worded or from the grammar choices
inadequate stems require students read all of the answer choices before selecting an answer
negatively worded stems should be avoided
students are used to looking for positively worded stems and can be tricked by (or misread) negative ones
questions should not build on previous questions information
exception is in testing the sequencing of steps
avoid questions written with a fill-in-the-blank segment in the middle of the stem
difficult to read and the meaning may be skewed
avoid "all of the above" or "none of the above" as a distracter
recognition of one other incorrect distractor immediately eliminates "all of the above" as a possibility
recognition of a couple distractors as correct (or possibly correct) leads the student to guess that "all of the above" is the correct answer
"none of the above" can be an alternative if the question is a mathematical (computational) one
when you need to combine answers to obtain a correct answer all of the possible combinations should be used to make up the distracters
questions with only four options result in over fifteen answer combinations making this impractical
overlapping responses are a problem
if the question asks for a range and one answer offers a single number it can be immediately eliminated
if distracters overlap into the range you are looking for it can be confusing to the student
example: the correct range is 6-8 and the choices are 2-6, 4-7, 6-7 and 5-9
specific types of written test items: true/false
includes a complete statement and a two choice alternative of true or false
limitations
item must be limited to the two choices of true or false
does not allow for any gray area
difficult to construct good items in a positive voice
avoid negatively worded statements using "is not", etc.
avoid extreme answers that include the absolute statements "always" or "never"
specific types of written test items: matching
typically two columns of information are offered with the intent of selecting items from one column and matching them to items in the other column to form correct or complete statements
limitations
works best with definitions and terms or with simple concepts with obvious relationships
difficult to properly design
multiple matches may be possible within the columns
items used must bear some similarity
unless you were matching terms with definitions it is useless to match terms like humerus, beta blocker, and inferior because the answers would be obvious
unclear directions how matching will occur
explain if students will use each term 1 time or multiple times
explain if single or multiple answers are needed to complete a match
specific types of written test items: completion
fill-in-the-blank
statements with part of their information omitted so student must complete the statement
limitations
enough information must be included for the student to glean the intent of the statement without leading the student to the answer
meaning may be unclear and several answers may emerge as correct
the answer space may provide a problem
gives a hint to the student if a blank line is used for each word of the answer
a single line may mislead student to think the answer is a single word when it is actually two or three words
specific types of written test items: essay
short answer
requires a bulleted list of responses or several questions to complete
long answer
requires students to provide a lengthy prose style answer
limitations of both types
may not be effective for measuring the lower levels of the domains of learning
time consuming and sometimes difficult to grade
grading can be very subjective
group grading is an alternative
scoring can be difficult as you try and assign a point value to the various components of the expected response
rubrics are helpful tools for grading essay questions because a rubric will describe the criteria for each grade level
example: for an "a" the student must provide all the correct information and write in complete sentences without committing any spelling errors and for a "b" the student must provide 80% of the required answer and commit one to three spelling errors
students often write illegibly because of time pressure or may try to add information at the end making the response difficult to follow
some students thought processes do not flow easily a linear progression causing an unfair disadvantage in a timed test
students may include much more information than desired in an attempt to be thorough
if students do not understand the question, they may provide a very well thought out, but incorrect, answer
should you award partial credit for a well-constructed incorrect answer?
specific types of written test items: terminal/certifying
final summative examination with the intent of granting permission to attempt a licensing or certifying examination
most often a multiple-choice examination
examination given with the intent of granting a certification or license by a regulating body such as a state or the national registry of emts
requires successful completion of one or a combination of two or three of these examinations to obtain certification or licensure
written examination (generally multiple choice)
oral examination
practical skills examination
post written examination quality review by students
will students be allowed to retain the test?
advantages
provides a learning aid for later testing
provides examples of your style of question writing
disadvantages
generally eliminates the test (and maybe all of the questions) from reuse
allow students the opportunity to review the test
highlights areas of weakness for further study and remediation
highlights areas of weakness in the presentation of the material
can help control bias or discrimination concerns when students see what other students missed
promotes a climate of fairness when students can challenge questions, answers, or the wording of a question
can be used as a learning aid for both the student and instructor
post written examination quality review by faculty
compile the results, including an accounting of incorrect answers
if the upper one-third of the group missed a specific item determine the following:
is the test item keyed correctly?
is the test item constructed properly?
is it free from bias, confusion and errors in grammar and spelling etc.?
was the content covered in class?
if not, were the students directed to it through self-study?
if the lower one-third of group missed a specific item:
which distracters were most attractive? (in other words, were most often selected)
improve distracters that were not attractive
consider a distracter well written if it is not selected by the upper- third of the class but it is selected by the lower third
oral examinations
exams in which both questions/instructions and answers are given out loud by a student to an instructor, or group of instructors
advantages
evaluates "quick thinking" or reactions
evaluates the students thought processes
can be evaluated by multiple listeners simultaneously
disadvantages
limited number of students may be examined at any one time
difficult to standardize
examiner may unintentionally give clues to the examinee
time-consuming and labor-intensive
subjective
to be fairly administered, a great deal of attention and concentration is required on the part of both the evaluator and the student
unexpected distractions can impact upon the test
instructors may be required to evaluate a large number of candidates with little opportunity for breaks
leading to uneven evaluations over time
may also lead to identification of themes or trends with unfair emphasis or focus on those repeated mistakes, i.e., holding successive students accountable for preceding students performances
project assignments
advantages
allows independent completion
may be done during class or outside of class
evaluates ability to synthesize data
individual projects for specific learning styles or preferences
students may select from a group of recommended projects or encouraged to develop their own
can promote autonomy and independent learning
allows students to work in groups
they can develop people skills and conflict resolution skills
students can learn from each other and stronger students may tutor weaker students
disadvantages
difficult to standardize
possible plagiarism
if not carefully designed, they may measure only the product excluding the process
sometimes the process used to produce the product is just as important as the final project
for example, learning how to find resources to use in solving a problem or developing critical thinking skills
if a presentation is required, the grade should not weigh solely on the presentation but should also include the content of the presentation
when group members are not working together it places unfair workloads on the members who are contributing
observational reports
advantages
can be used for psychomotor or affective evaluation
reliability is inherent due to repeated observation
reliability can be increased by increasing the number of observations
disadvantages
presence of evaluator may influence student performance
student performs better when being directly observed
instructor/evaluator may misdirect student resulting in the need for retraining
time-consuming and labor-intensive
frequently a one-on-one experience
developing criteria can be a complex task
experiences may not be available at the time they are required
student attends a clinical setting and there are no patients
practical examinations
two basic types: situational and rote
situational: demonstration of a skill in the context of a scenario allowing for manipulation of the outcome or procedure by the student
good for evaluating critical thinking skills as well as skills performance
rote: demonstration of the steps of performing a skill independent of manipulation of outcomes
generally follows very specific order of steps
advantages
most closely approximates actual job performance
allows observation and evaluation of related behaviors and attitudes
allows evaluation of psychomotor skills, decision-making abilities and leadership skills
disadvantages
difficult to standardize
time-consuming and labor-intensive to prepare and deliver
limited number of students may be examined at one time
instructor providing feedback needs to be clear about expected outcome, whether a situational or rote response is required, and should evaluate accordingly
practical skills evaluation
rote mechanical skill
requires simple task analysis
is the easiest skill examination to administer
may or may not reflect the actual field performance capabilities of the student
isolated skill performed without "real world" stresses may not adequately evaluate affective and psychomotor domains
situational skills
evaluates judgment and/or decision-making
required more elaborate simulations
more difficult to develop and deliver
is a more accurate predictor of field performance because it asks to student to critically think through a scenario that does not always have an obvious answer
simple skill evaluation
define the skill
determine the degree of expected proficiency
select a representative sampling if all skills in a given area are not evaluated
create a written task analysis of the skill if one does not already exist
develop checklist commensurate with the task analysis
each step should contain some measurable criteria so all evaluators can agree on criteria of successful completion of each step
look for established standards (i.e. national registry practical skills examination sheets) for guidance
keep the number of steps to a minimum to reduce errors in evaluation
allows the evaluator to observe the task as it is performed and complete the evaluation form afterward
performance evaluations
determine and define expected outcome
are skills performance or decisions-making process more important in the situation?
how stressful or complicated a situation is the student prepared to handle?
determine what standards will be used to evaluate the performance
design the situation to be representative of the desired outcome: realistic environment, realistic patient complaints and injuries, manikins vs. real people
evaluate the resources needed for testing
the higher the domain level the more realistic the scenario should be
simulate situation and responses as accurately as possible
list all activities which should be completed in the situation
prioritize activities and list them in their linear (start-to-finish) sequence
weigh most important aspects and critical criteria appropriately
checklist should contain
the minimum number of properly ordered steps necessary to complete the task
steps which are independently observable and measurable
an outcome consensus understood by each evaluator
avoid qualification of student performance by the evaluator
during the examination the evaluator should be free to observe the activity and quantify the behavior (check if it was performed or not) and should not be focused on measuring how "much" they performed each step
assure adequate organization to ensure outcome of a situational-oriented performance evaluation
provide a skeletal framework for the evaluator to follow
if scenario involves patient care include information so instructor can provide consistent feedback to each student
example: vital signs for appropriate and inappropriate treatment
characteristics of skill/performance evaluations
objectively measures the performance
by the instrument
by the observer
replicability
does the instrument measure similar performances consistently
from one student to another?
from one class to another?
from one location (situation) to another?
fair standards
standards are known by student and faculty
practice with similar instrument during the training session
realism
situations, scenarios, and patient information are plausible
reactions or changes in the patients are realistic given the intervention and treatment
external distractions are realistic
stress is similar to work environment
reliability
the extent to which an exam is consistent in measuring student performance
does it measure a behavior or body of knowledge consistently on different occasions?
does the environment influence consistency?
do different administrators influence results?
does it discriminate against groups or individuals?
content validity
the extent to which an examination is representative of a defined body of knowledge; the ability of an examination process to measure the knowledge and skills it was intended to measure, in accordance with curriculum objectives
are the sub-tests weighted and distributed properly?
do they place an over importance on a single test?
is that your intent?
does it cover a reasonable sample of the knowledge and skill objectives?
is it an accurate predictor of field performance?
resources for examinations
peer instructors within your organization may be a good source for examinations of all types
formalized instruments from certification and licensing bodies (which may also be validated instruments)
jurisdiction or state ems office
national registry of emts for sample multiple choice items, practical skills, and oral examinations
written examination resources
nremt
publishers test banks
ems textbooks
ems textbook instructor guides
textbooks of practice certification examinations
on-line and computer based practice certification tests
ems internet sites
practical examination resources
nremt
naemse
ems internet sites
ems textbooks
ems continuing education programs
oral examination resources
nremt
naemse
ems internet sites
project assignments
naemse
ems textbook instructor guides
college or university resources
learning styles / preferences information with practical application suggestions
bibliographical references
american psychological association. (n.d.). standards for education and psychological tests. (revised ed.). washington d.c.: american psychological association.
burba, a.c. (1998). multiple choice item writing. domain3, winter 1998.
johnson, d. w., & johnson, r. t. (1996). meaningful and manageable assessment through cooperative learning. edina: interactive book company.
judd, r. l. (1998) the pedagogues column the matter of advising on test construction. domain3, winter 1998.
merwin, s. (1992). evaluation: 10 significant ways for measuring and improving training impact. resources for organizations, inc.
waagen, a. (1997). essentials for evaluation. astd, issue 9705.
module 13: facilitation techniques
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to provide a description of facilitated learning
describe why motivating students is an important factor in an environment that promotes facilitated learning
identify classroom arrangements and formats that promote and enhance facilitation techniques
explain why the standard lecturing method does not provide a facilitated learning environment
list methods to enhance the lecture method to make it a more facilitated learning experience
explain the role of group work in a facilitated learning environment
list tips or methods to facilitate a discussion in the classroom
list tips for facilitating a practical (psychomotor) classroom session
describe methods to maintain classroom control when using a facilitated learning environment
psychomotor goals
at the completion of this module the student-instructor should be able to:
apply the learning principles described in this module to facilitate a discussion of a small group (three-five participants) of student-instructors
apply the learning principles described in this module to facilitate a psychomotor classroom session
affective goals
at the completion of this module the student-instructor should be able to:
value the need for providing a facilitated learning environment for adult students
share techniques described within this module with other instructors to promote facilitated learning principles
declarative
why this module is important
teaching is both an art and science
teaching science includes learning styles, learning theories and pedagogy
development of your presentation style, presence in the classroom and rapport with the students is less easily found in science
facilitation is one method of reaching students in an effective manner that makes the learning experience more productive and enjoyable
what is facilitation?
the word facilitate means to "make easier"
it is a method of interacting with students that enhances their learning
a variety of techniques involving coaching, mentoring and positive reinforcement
many terms describe the facilitated learning environment including; experiential learning, constructivist learning, and invitational learning
to be effective at facilitation you need to know and understand your audience
adults as learners
adult learning styles are different from children
most of us have not experienced excellence in education as adults
when we have no reference point for excellence we rely upon traditional lecture and practical sessions
adult learners need to see that professional development and their day-to-day activities are related and relevant
adults need to "buy-in" to the process
making the learning meaningful is one method to promote this
adult learners need direct, concrete experiences in which they apply learning in the real world
activities need to be thought out carefully so they integrate into the total learning experience
adult learning has ego involvement
professional development must be structured to provide support from peers and to reduce the fear of judgment by others
adult learners need constant feedback
feedback should include performance evaluation and methods to improve performance
adults should be allowed input into the feedback process
discuss the correct answer instead of telling them the correct answer
adult learners need to participate in small group activities during the learning experience to move them through the various levels of the domains of learning
transfer of learning for adults is not automatic and must be facilitated by the instructor
transfer of learning refers to the process where adults move what they are learning from the lower domain levels into the higher domain levels
coaching and other support methods are needed to enhance transference
characteristics of adult learners
adults are generally autonomous and self-directed
the function best in a student centered environment instead of an instructor centered environment
lectures are instructor centered
small group activities are student centered
they need to be free to direct themselves
when teachers act as facilitators this allows the student to retain control, or at least to have a stake in directing their learning
get students perspectives about what to cover (cover a topic more or less fully based upon their feedback)
students who have say in some aspects of the program are more likely to support the process
adults have a foundation of life experiences
work, family, and previous education all have shaped who they are today
this may enhance or detract from learning
instructor needs to connect learning to this knowledge/experience base
engage students by drawing on their experience in class
relate theories and concepts to the "real world"
adults are goal-oriented
adults know why they are in the class
determine if this conflicts with your expectations
they appreciate organization and clearly defined goals and objectives
the instructor should know what each of the students goals are
adults are relevancy-oriented
adults want to see the reason they are doing something
place the learning in context to help motivate them
learning has to be applicable in order for it to have value
adults are practical
instructor needs to show students how the content will be useful
students may only be interested in material they feel is crucial to learn and may not be interested in learning anything else
this may conflict with developing a desire in students for life-long learning
adults need to be shown respect
recognize the wealth of experience students bring to the classroom
students should be treated as peers
encourage students to share their opinions and experiences
motivating the adult learner
module 15: motivation has additional information
one of the keys to being able to facilitate is to be able to motivate students
the following are areas to consider for motivation
social relationships: to make new friends or meet a need for association or friendship
external expectations: to fulfill the expectations of someone of authority
social welfare: community service and to serve mankind
personal enhancement: achieve higher status at work, provide professional advancement, or stay abreast of competitors
escape/stimulation: to relieve boredom, provide a break from the routine at home or work, or provide contrast to the exacting details of life
cognitive interest: to learn for the sake of learning, seek knowledge for its own sake, or satisfy a curious mind
barriers to motivation
many barriers to motivation are present:
lack of time
lack of money
lack of confidence
scheduling problems
"red tape," bureaucracy, or politics
problems with child care
problems with transportation
be aware barriers exist, but also understand those you can do something about in your role as a mentor, guide, and advocate and those you are not responsible for
can you mitigate any barriers?
should you mitigate any barriers?
the best way to motivate adult learners is to enhance their reasons for enrolling in the course and decrease barriers
critical elements of adult learning
motivation
set an appropriate stress level: not too high and not too low
sometimes ems classes promote higher stress because the student will eventually be responsible for human life
reinforcement
reinforcement should be part of the normal routine of your class to maintain consistent positive behavior
positive reinforcement
set an appropriate level of difficulty that is not too high or too low
challenge students
it might be a slightly different level of difficulty for each student
provide feedback from instructor, peers, and when appropriate, other students
when student is interested in the subject it increases their responsibility for learning
negative reinforcement
it is best to avoid negative reinforcement
the result of negative reinforcement is extinction of the undesirable behavior
it may also result in alienation of the student
retention
students must retain the information from the class in order to benefit from the learning
information must be retained before it can be transferred
the instructors job is not to lecture it is to help students retain information relevant to the course
retention is directly related to initial learning
if the student did not learn the information very well she will not retain it
retention is effected by the amount of practice that occurs during learning
transference
ability to use the information learned in a new setting
positive transference student uses the behavior learned in the course
negative transference student does not use the behavior learned or uses it incorrectly
positive transference is the goal
reach the student in all three domains of learning; cognitive, affective and psychomotor to have the greatest transference occur
keys to facilitation
create action in the classroom
avoid lecturing
engage students in learning through activities
the classroom layout sets the tone
see classroom layout from module 6: the learning environment
what layout is best for the desired setting?
group work: tables and semi-private or secluded workspaces
interaction between students and instructor: arranged so the focus is taken off of the instructor and placed on the group but still allowing interaction with the instructor
create expectation in students that they will participate in learning
this is difficult if students have been conditioned to be passive learners
be patient and provide guidance and positive reinforcement
as students succeed they will change their expectations
some will continue to want to be passive learners despite your best efforts do not be discouraged, eventually they may participate or other students may influence them to participate
lecturing does not facilitate facilitation
lecturing is a time honored technique that places the focus on the instructor
a method of disseminating a lot of information quickly with a lot of instructor control so it remains a common practice in the classroom
lecturing will never lead to active learning
move beyond simple lectures:
build interest
maximize understanding and retention
involve participants
reinforce what has been presented
how to add more interest to the lecture environment
beginning of lecture: lead off with a story of a patient encounter, use an interesting visual aid, present a case study, or ask a test question
maximize understanding and retention by saying less and allowing students to do more
give students the headlines reduce lecture to major points
alter your presentation so you present the highlights in lecture form to the whole class, but place students in small groups for reinforcement activities with several instructors
add visual appeal to your presentations
provide a handout with the pertinent points then focus on the practical aspects
involve participants in the presentation
spot challenges and ask about concepts
provide activities spaced throughout the lecture
assign portions of the material to be presented by the students
allow students adequate time to prepare
be prepared to intervene if they present incorrect information
reinforce the lecture
review the material covered through the use of an activity
provide an application problem and let the students solve the problem
participants conduct a review
with each other or in groups you can provide a template to follow
play games
group work
one of the best methods of ensuring active learning is through group work
form groups quickly time is precious
in some settings, using the same group over and over again is best
in others the groups are better when changed
vary skill levels to even the level of each group
creative ways to choose groups:
randomly: by counting off, using letters, colored stickers, etc.
allows students some control in the sorting process but also lets it occur randomly
teacher controlled: instructor uses a strategy ahead of time to sort students
can be effective when you wish to separate students, match students, or set up a group for specific characteristics
student controlled: students select how the groups form, individually or collectively
this option offers less instructor control, but may be effective when you want to solicit more active levels of student participation or to offer them some control
assigning jobs in the class setting
one method of increasing participation is to have students assist in some of the day to day activities of the course
setting up the room or bringing in the equipment
functioning as a "master at arms" and serving a minor disciplinary role, or by controlling when breaks begin and end
serve as recorders and note takers when not actively involved in a scenario or role-playing exercise with the purpose of providing constructive feedback
serve as mentors and coaches when they study together and help each other learn skills
instructor may assign the task (leader, recorder, spokesperson, etc.)
use a creative selection strategy:
alphabetical
birth date
date hired to work for the ems service (oldest or youngest)
color lottery (who is wearing the most blue?)
close your eyes and point to someone
random # (last 4 digits of phone number)
sticker (on name tag, chair or handout)
rotate duties equally among the student body to avoid favoritism
managing groups effectively
this strategy works best with teams of four members
peer facilitators may be added to group as a fifth member to help guide and mentor group and to problem solve conflicts
groups work best when they agree upon the ground rules up front
provide the following ground rules as a foundation for the group:
come to class on time every session
cone to class having done the assignment and prepared to discuss it
must notify members of the group ahead of time if class will be missed
we willing to share information
respect the views, values and ideas of other members of the group
other rules as agreed upon by the members
groups should rotate roles so everyone stays active
discussion leader: keeps group on track and maintains participation
recorder: records assignments, strategies, unresolved issues, data and convenes group outside of class
reporter: reports to whole class during discussions and writes up final draft of assignments
accuracy coach and timekeeper: checks understanding of the group, finds resources and manages time
using groups in large classes or with inexperienced students
use well defined activities with clearly stated objectives
bring the class together for discussion and/or clarification at frequent intervals
plan both group and individual assignments
look for signs of behavior that undermine group function
use peer facilitator to assist group
resolving conflict within groups
level 1: preventing escalation
monitor group for early signs of conflict
intervene immediately
use group evaluations to help control individual student behavior
encourage spontaneous verbal feedback
level 2: empowering students
listen to student concerns
encourage students to resolve conflict
coach students on possible resolution strategies
level 3: resolving conflict
establish ground rules for the discussion
ask each student to present point of view while others listen
ask each student to define ideal outcome
review group ground rules
facilitate discussion of possible outcomes
level 4: instructor intervention
refer to course syllabus
refer to student manual
depending upon the severity of the situation, involve other members of the teaching team
facilitating discussions
discussion is one of the best forms of participatory lecturing
effective for:
recertification or refresher classes during a review of concepts
topics involving opinions
getting started or wrapping up a classroom session
tips for facilitating discussion:
get all of the students involved
use small groups discussing the same idea to include all students
inattentive students should be redirected back to the group
move the discussion around the class (use a prop or some other strategy to facilitate this)
you dont have to comment on each persons contribution
paraphrase: check your understanding and the students
compliment a good comment and redirect an inaccurate or incorrect statement to the class for correction
elaborate suggest a new way, even when the student seems to have answered the question correctly
energize quicken your responses, use appropriate humor, prod students for an answer
disagree (gently)
mediate differences in opinion
mediation is a balancing act; you are trying to keep the discussion going without interjecting yourself as the authority, which could damage momentum
encourage students to back up their statements with facts
remind everyone to respect differing opinions
pull together ideas
summarize what occurred in the discussion group
provide follow-up information for additional study or reading
practical (psychomotor) sessions
experiential (or practical) sessions help to make training active
remember: transference occurs with repeated practice
examples: role-playing, games, simulations, and problem-solving tasks
tips for practical sessions:
explain the objectives
explain the benefits
divide students into groups
small enough size so all participate
students not active in the practice activity are recorders or peer evaluators
speak slowly when giving directions
begin with a brief overview of the activity then provide specific information
this meets the learning style preferences of global and analytic learners
if the activity involves new equipment give directions before handing out the equipment or supplies so students concentrate on your directions
an alternative is to let them look over the equipment or setting for a minute before you begin giving your instructions
demonstrate complicated activities
best accomplished if done one time for the entire group, including any adjunct faculty, to provide consistency
may require a repetition of the skill or steps once the students begin rotations through stations as a quick review
set a time limit and inform students of the time limit
keep the activity moving
challenge the students
begin with simple or rote exercises and build towards critical thinking situations
recap and critique at the end of each session
allow team leader or person performing the skill to give you their impression of what they did "good" and "bad" first
allow other student participants to give feedback (partner, peer evaluators, "patients," recorders, etc.)
you provide positive-negative-positive feedback
positive-negative-positive format: begin with specific positive statements followed by constrictive criticism and end with positive statements
facilitating activities take time
the objectives can often be met in a lecture format faster than in a facilitated learning format
remember: students retain more when they practice over and over again
they do not argue with their own results of learning, if they discovered it for themselves - they own it
the goal is to assist students to become professionals who think critically about what they do and move beyond the lower levels of thinking into the higher levels
this cannot be done with passive learning techniques
tips to save time during practical sessions:
start on time
give clear instructions one time
prepare visual information ahead of time
distribute handouts quickly
expedite group reporting
record on flip charts - no repeating of information from group to group
shorten discussion points emphasize short answers
get volunteers rapidly
quicken the pace to create energy
come back from group work or breaks promptly
classroom control issues with facilitation
instructors can easily lose control in an environment with a high amount of facilitation
students may perceive that you are "not doing your job" because they are participating more actively in their learning
students are also more responsible for their learning
co-workers may also believe this if they do not understand facilitated learning
ensure students stay on task
conversations should be monitored to ensure they are on topic
students having difficulty may give up and quit working before asking for assistance
offer assistance in finding resources but do not get tricked into doing their work.
the "3 before me" technique works well in helping students become more independent
when they ask for assistance they should be able to inform you of at least three places they looked to find the information first
if they do not have three (or an appropriate) number of resources direct them to the appropriate resources instead of simply telling them the correct answer
tips for calling participants to order
regardless of what technique you use, start on time whether students are back or not otherwise you reinforce that it is acceptable to be late
kitchen timer, watch alarm or laptop timer
flick light switch on and off
"now hear this" into the microphone
create a verbal wave clap hands or everyone repeats "times up"
play music
unique sounds a gavel, a bell, a dinner gong
designate a time keeper for the breaks who calls students back to the room
tips for maintaining order in the group:
group work is not purely freedom
signal nonverbally
use body language and eye contact to show students you are attentive
bring discussion back to the center when someone strays, argues, or monopolizes the discussion
encourage all students to participate
ask how many people have a response, and then call on someone who has not participated and whose hand is raised
occasionally restrict participation to people who have not spoken
each new comment must build on the previous idea
connect on a personal level
when you know students, they tend to control their behavior better in your presence
change the method you are using
switch from full class to smaller groups or pairs
ignore small nuisances
discuss negative behaviors in private
do not take personally the difficulties you encounter in the classroom setting
seek support from other faculty members
bibliographic references
johnson, johnson & smith. (1998). maximizing instruction through cooperative learning. aahe prism, february.
norman, g. r. & schmidt, h. g. (1992). the psychological basis of problem-based learning: a review of the evidence. academic medicine 67 (9), 557-565.
rideout, e. (2001). transforming nursing education though problem-based learning. sudbury: jones and bartlett publishers.
springer, stanne & donovan. (1999). review of educational research.
module 14: communication and feedback
cognitive goals
at the completion of this module the student-instructor should be able to:
describe the process of active listening
state the importance of timely feedback
compare and contrast counseling and evaluation
describe several unique types of questioning that could be used to solicit student responses
explain how body language affects ones verbal communication reception
recognize the need to check for understanding when giving students information
state the benefits of honest communication in the education environment
psychomotor goals
at the completion of this module the student-instructor should be able to:
demonstrate active listening during a role-play exercise in the classroom
employ the use of the pause when questioning students in a role-play exercise in the classroom
demonstrate the proper use of positive and negative feedback in a counseling scenario
demonstrate the use of questioning techniques to solicit student responses in a mock classroom environment
model body language that is recognized as open, interested and positive
affective goals
at the completion of this module the student-instructor should be able to:
support the need for positive communication in the learning environment
encourage open communication in ones classroom
value the need for honesty in academic communications
declarative
why this module is important
the ability to communicate well is a key skill for the ems instructor to possess
it is also a key skill for an ems provider
good communication ability is an aspect of professionalism
many problems within the classroom will be caused by, or contain an element of, miscommunication
communication in the classroom
the instructor should create a positive environment for communication
we communicate with people when the subject is both positive and negative, during brainstorming and problem solving
praise in public and punish in private
catch people doing things right, and praise them for good behavior
feedback
provide feedback as immediately as possible after the action
provide feedback about both positive and negative behaviors and performance
try to begin with positive statements, cover the negative information (via constructive criticism) and then end on a positive note
employ active listening
listen to what another is saying
listening is a difficult skill to develop, especially when you are engaged in the conversation and are thinking of a response
paraphrase and repeat back what was said to verify your own understanding of the message that you received
check for understanding in the message you send
ask the receiver to rephrase what you said
provide more information as needed for clarification
use open body language
hands and arms relaxed
comfortable personal space
give your full attention to speaker
neutral or positive facial expression
questioning techniques to use in the classroom
the "pause"
ask a question and then wait several seconds for a reply
used to add emphasis, allow time to process information, or to formulate a response
helpful when students are not focused on you as they will notice the silence and redirect attention
allow students an equal amount of time to think (think time) before you begin to answer the question or ask another student to answer
studies have shown that instructors will allow longer think times for students they believe can actually answer the question
calling on students in class
checks an individuals level of recall or understanding
do not always call on the first one with a response
do not let the fastest replying student dominate the class
do not single out an individual student
go around the room in a pattern
use a prop to pass around with each answer
work alphabetically through your roster
draw names or numbers from a hat
watch the students to determine how comfortable they are with this technique as this may intimidate shy students
if you establish up front when they can expect to be called upon by using one of the techniques listed above they may be less anxious
open ended questions
invites dialogue and discussion
may be used to evaluate critical thinking
move students into small groups for an initial discussion then ask them to report consensus points to entire group
make sure you circulate around the room and ensure students stay on task
facilitation and coaching
this can be accomplished through individual or small group work
this is a very intensive method of evaluating students
counseling students
involve appropriate members of the education team while also assuring confidentiality for the student
medical director
your supervisor or employer
your mentor or an experienced instructor
the students supervisor or employer
begin with a friendly greeting
state the facts of the behavior or performance issue, as they are known to you
allow the student an opportunity explain the situation from their perspective, what he or she was thinking, and reasons for their action
confirm they understand the problem, check that you have all the facts, ask for clarification if needed
state and explain rules, regulations, laws, and standards which govern the behavior and any consequences
work together to create a plan of action or intervention
may result in a learning or behavior contract
review what has been covered, discussed and decided
close with a positive and supportive message
document the session in writing
provide copies to the student and all appropriate stakeholders
inform the student of the individuals who received this information
put a copy of the document in the appropriate student or course files per your organization mandates
always document, even if you consider it a minor infraction, so you have these documents as support if problem continues
use professional ethics in academic communication
always be honest
protect confidentiality
address people directly
treat people how you want to be treated
bibliographic references
adler, rosenfeld and towne. (1983). interplay, the process of interpersonal communication. new york: reinhart and winston.
resurreccion, r. (1995). coaching and counseling skills. education and training for work.
stritter, f. & flair, m. (1980). effective clinical teaching. bethesda: us department of health, education and welfare.
weider-hatfield. (1981). a unit in conflict management skills. communication education, 30, 265-273.
module 15: motivation
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her words to define intrinsic and extrinsic motivation
list intrinsic motivators of behavior
list extrinsic motivators of behavior
given a description of behavior, identify the motivator for that student's behavior
describe techniques to increase motivation in different types of students
identify techniques to increase self-motivation for instructors
psychomotor goals
at the completion of this module the student-instructor should be able to:
create and conduct an activity to identify motivational factors for students in a given class
demonstrate behaviors that motivate students
demonstrate how to create a classroom environment that is motivating to students
affective goals
at the completion of this module the student-instructor should be able to:
appreciate students have different motivations for participating in an ems course
respect an individuals motivator for success
value the need to rejuvenate motivation as an instructor
declarative
why this module is important
motivation is the key to getting students involved and becoming active participants in the education process
students who value education are easier to teach
instructors must motivate themselves to be the best teacher they can be
method to discover motivation within your students
begin each course with an activity to identify the students primary motivation
understanding their motivation can help identify the cause of positive and negative classroom behavior
helps you provide appropriate examples for why a student should do something you ask of him or her
helps you plan activities that build intrinsic motivation
intrinsic motivation
comes from within the individual
includes:
desire to help others
wish to perform community service
personal growth and development
drive to succeed
some students have a high level of intrinsic motivation
these students may help motivate other students
extrinsic motivation
comes from outside of the individual
includes:
money
time off of work
job requirement
activities that help to motivate students
set high standards for your class and students will rise to meet them
establish clear and reasonable expectations for student behavior and learning outcomes
whenever possible, allow students to participate in deciding what they will learn and how it is to be accomplished
create challenges for students which require use of problem solving skills and create a sense of satisfaction
utilize past experiences of students and call on their individual expertise
create a desire to learn by helping students understand how they will use this information or skill
respect the individuals commitments, preferences, and needs as adult learners
be positive, encouraging and give praise when it is earned
avoid embarrassing or humiliating students, especially in front of others
circumstances which can drain an instructor of motivation
abusive or rude students
model exemplary behavior
establish behavioral expectations verbally and in writing
have rules and policies clearly defined and written in the student handbook
gain administrations support for policies before discipline is needed
boredom
participate in career development activities such as seminars and committees
continue life-long learning
set new personal goals
change your routine in the classroom if you are bored chances are the students are too
lack of support from administration
participate in campus or department meetings
seek agreement on issues before they arise
educate administration on your needs and education philosophies
budget constraints
apply for grant funding
seek sponsorship or donations for goods and services
barter for in-kind services (teach first aid or cpr in exchange for other services or goods)
conduct fundraisers
be creative
flea markets and discount stores
recycled equipment and supplies from other programs
make it yourself
poor compensation
negotiate a raise based on industry standards for your position
seek benefits of value to you in lieu of more money
conference or workshop attendance
time-off
network for other positions
excessive hours
value the need for rest and recreation
get organized
tasks take less time when you are organized
use work-study helpers, student aids and volunteers
take vacation when it is earned
bibliographic references
cherry, richard. (1990) keeping the spark alive. jems, march 62-65.
cornwell, j.b. (1996) stimulating and managing participation in class. training.
lin, y. & mckeachie, w. j. (1999). college student intrinsic and/or extrinsic motivation and learning. washington, dc: american psychological association.
mcclelland, d. c., (1987). human motivation. new york: cambridge university press.
pike, robert. (1994). motivating your trainees. minneapolis: lakewood publications.
module 16: teaching thinking skills
cognitive goals
at the completion of this module the student-instructor should be able to:
differentiate between learning and knowing
list activities that foster thinking skills
define high level thinking
describe how "critical thinking" effects the practice of prehospital medicine
describe the benefits of an active classroom or experiential learning
psychomotor goals
there are no psychomotor objectives for this module
affective goals
at the completion of this module the student-instructor will be able to:
acknowledge the importance in developing good judgement and thinking skills in students
support activities that encourage high level thinking skills
value the use of scenarios and simulations in the classroom
declarative
why this module is important
definition of terms
learning indicates that a person has been exposed to material, understands the material, and can or could recall the information
knowledge goes beyond recall and includes information processing, application to other situations, consideration of the meaning, and contrasting with other concepts
knowledge is clearly superior to learning in ems because it creates images, ideas and solutions to problems even before the student has encountered the situation in reality
using the term "critical thinking"
this term is somewhat outdated and some educators consider it inaccurate in reflecting the behavior of problem solving
better terminology is to use wording that reflects higher levels of thinking skills
targeting levels of blooms taxonomy that deal with mastery of material
refer to blooms taxonomy handout in appendix and module 8: domains of learning and module 9: goals and objectives for more information
simulation and scenarios
simulations include role-playing of a realistic patient situation in the classroom or other educational environment
simulations usually require a patient actor, responding crew, bystanders, and a facilitator (instructor) to give patient information that is not readily apparent
realistic simulations are best but are time consuming
ways to make simulations more realistic include
moving outdoors, to the hall, parking lot, bathroom, or other location
using moulage and makeup
using background noise
using props such as pill bottles, medical alert tags, dishes, food wrappers, medical supplies, newspapers, and other domestic products.
have simulated patients follow a script or role-play in character
benefits of simulations include using all three domains of learning (cognitive, psychomotor, affective)
one of the most effective ways to measure affective domain
allow students to make mistakes in a "safe" environment
add to the students exposure to different types of patients and situations
help students reason through a problem in real time
improves communication skills
suggested use of simulations in the classroom
to open the class session, capturing their attention and providing a realistic example to refer to throughout the lecture
at the conclusion of a class session to practice or evaluate their grasp of the material covered
for remediation in clinical or field when a similar call has gone poorly
during full day laboratory sessions which can either be random or by topic such as trauma, pediatrics, medical emergencies or cardiac emergencies, etc.
higher level thinking
higher level thinking is using experience, reflection, reasoning, and communication as a guide to belief or action
begins to move the student into the "metacognitive" level of thinking when considering thought process equally important with thinking
higher level thinking is desirable in ems because it facilitates good judgment by relying on previously established criteria, is sensitive to the current context, and is self-correcting
effective thinking does the following
welcomes problematic situations
uses active inquiry
tolerates ambiguity
searches for alternative solutions
requires reflection
higher level thinking is driven by questions
allow students to ask questions of you, their classmates, themselves
facilitating higher level thinking in class
support reading for information recall giving students questions to answer from their reading
begin lessons with case studies or scenarios
have students conduct self-assessments of their performance and decision making skills
call on students who do and do not raise their hands
ask students to summarize passages, your lecture, or comments of other students
ask students to explain or justify their decisions when they are correct and also when they have not made the best choice
encourage students to ask questions in classroom setting
activities that foster thinking skills in class
scenarios and simulations
case studies
discussion
journaling and writing
debates
position papers
on-line chat boards or discussion groups
research presentations
oral presentations
current event discussions
bibliographic references
ausubel, d., novak, j. d. & hanesian, h. (1978). educational psychology: a cognitive view. new york: holt, rinehart, and winston.
beyer, b. (1997). improving student thinking: a comprehensive approach. boston: allyn and bacon.
browne, m., & keeley, s. (1998). asking the right questions: a guide to critical thinking (5th ed.). englewood cliffs: prentice-hall.
chickering, a. w. & gamson, z. f. , eds. (1991). applying the seven principles for good practice in undergraduate education. new directions for teaching and learning. san francisco: jossey-bass.
dalton, a. (1996). enhancing critical thinking in paramedic continuing education. prehospital and disaster medicine, 11(4), 246-53.
diestler, s. (1998). becoming a critical thinker (2nd ed.). upper saddle river: prentice-hall.
ennis, r. (1996). critical thinking. upper saddle river: prentice-hall.
halpern, d. (1996). thought and knowledge: an introduction to critical thinking. hillsdale: lawrence erlbaum.
langer, e. (1997). the power of mindful learning. reading: addison-wesley.
manning, b., & payne b. (1996). self-talk for teachers and students: metacognitive strategies for personal and classroom use. boston: allyn and bacon.
novak, j. (1998). learning, creating using knowledge. hillsdale: lawrence erlbaum associates.
parnes, s. (1997). optimize the magic of your mind. buffalo: bearly limited.
springer, stanne & donovan. (1999). review of educational research.
tishman, s., perkins, d., & jay, e. (1995). the thinking classroom: learning and thinking in a thinking culture. boston: allyn and bacon.
treffinger, d. (1995). creativity, creative thinking, and critical thinking: in search of definitions. sarasota: center for creative learning.
treffinger, d., feldhusen, j., & isaksen, s. (1996). guidelines for selecting or developing materials to teach productive thinking. sarasota: center for creative learning.
treffinger, d., isaksen, s., & dorval, k. (1996). climate for creativity and innovation: educational implications. sarasota: center for creative learning, inc.
module 17: teaching psychomotor skills
cognitive goals
at the completion of this module the student-instructor should be able to:
define psychomotor skills
explain the relationship between cognitive and affective objectives to psychomotor objectives
describe teaching methods appropriate for learning a psychomotor skill
describe classroom activities used to teach and practice psychomotor skills
list methods to enhance the experience of psychomotor skill practice in the classroom
psychomotor goals
at the completion of this module the student-instructor should be able to:
demonstrate proper facilitation technique when demonstrating ems skills
demonstrate the use of corrective feedback during a skill demonstration
create a skill session lesson plan which maximizes student practice time
create a skill scenario which enhances realism
affective goals
at the completion of this module the student-instructor should be able to:
acknowledge the need to teach the mechanics of a skill before students can apply higher level thinking about the process
value the need for students to practice until they attain mastery level
model excellence in skill performance
declarative
why this module is important
psychomotor skill development is crucial to good patient care by the ems provider
psychomotor skills are used to provide patient care and also to ensure the safety of the members of the team
there are many ways to perform medically acceptable skills behaviors
need to know steps of skills performance in order to effectively apply critical thinking skills in situations they will face in the field setting
instructors plan their approach to teaching students how to perform skills in order to maximize the students abilities
understanding the psychomotor domain
definitions
the psychomotor domain involves the skills of the ems profession
skill, action, muscle movement and manual manipulation
five levels of psychomotor skills
imitation
student repeats what is done by the instructor
"see one, do one"
avoid modeling wrong behavior because the student will do as you do
some skills are learned entirely by observation, with no need for formal instruction
manipulation
using guidelines as a basis or foundation for the skill (skill sheets)
may make mistakes
making mistakes and thinking through corrective actions is a significant way to learn
perfect practice makes perfect
practice of a skill is not enough, students must perform the skill correctly
the student begins to develop his or her own style and techniques
ensure students are performing medically acceptable behaviors
precision
the student has practiced sufficiently to perform skill without mistakes
student generally can only perform the skill in a limited setting
example: student can splint a broken arm if patient is sitting up but cannot perform with same level of precision if patient is lying down
articulation
the student is able to integrate cognitive and affective components with skill performance
understands why the skill is done a certain way
knows when the skill is indicated
performs skill proficiently with style
can perform skill in context
example: student is able to splint broken arm regardless of patient position
naturalization
mastery level skill performance without cognition
also called "muscle memory"
ability to multitask effectively
can perform skill perfectly during scenario, simulation, or actual patient situation
teaching psychomotor skills
whole-part-whole technique is useful
requires that the skill be demonstrated 3 times as follows:
whole: the instructor demonstrates the entire skill, beginning to end while briefly naming each action or step
part: the instructor demonstrates the skill again, step-by-step, explaining each part in detail
whole: the instructor demonstrates the entire skill, beginning to end, without interruption and usually without commentary
this technique provides an accurate example of the skill done in repetition
if students were not completely focused on the skill demonstration one time there are two other opportunities for them to watch the presentation
this technique provides a rationale for how the skill has been performed
students may or may not be allowed to interject questions as the demonstration is going on, but generally discussion is allowed during the middle, step-by-step "part" demonstration
this technique works well for both analytic and global learners
analytic learners appreciate the step-by-step presentation and global learners appreciate the overview
module 7: learning styles has more information on analytic and global learners
progressing through the psychomotor domain levels of skill acquisition
novice to expert
allow students to progress at their own pace
if you move students too quickly they may not understand what they are doing and will not acquire good thinking skills
although the demonstration may provide information on the performance of the entire skill from start to finish, students should be allowed to learn the individual parts of the skill before pulling it all together and demonstrating the whole skill
students should master individual skills before placing them in context of a scenario or simulation
students should be allowed ample time to practice a skill before being tested
the need for constant direct supervision should diminish as practice time and skill level increases
from novice to mastery level
demonstrate the skill to students
students practice using a skills check sheet
students memorize the steps of the skill until they can verbalize the sequence without error
students perform the skill stating each step as they perform it
students perform the skill while answering questions about their performance
students perform the skill in context of a scenario or actual patient situation
providing feedback during psychomotor skill development
interrupt and correct the wrong behavior in beginners to prevent mastery (muscle memory) of the wrong technique
practice sessions should end on a correct performance or demonstration of the skill
allow advanced students to identify and correct their own mistakes under limited supervision
adult learners need encouragement and positive feedback to reinforce the correct behaviors
adult learners need good role models of correct technique
primary instructors, secondary instructors, skills instructors, clinical faculty and preceptors are all important in developing students and these individuals should be carefully selected for suitability to their individual roles
allow adults to develop their own style of the standard technique after mastery has been achieved
there are numerous ways to do things right
focus on what is considered medically acceptable behaviors instead of demanding rote performance or parroted skills
spend time helping students develop high level thinking skills so they can differentiate between options and adequately solve problems
improving psychomotor skill development during a skills session
have all necessary equipment set up before session begins
use realistic and current equipment that is in proper working order
use standardized skills sheets
allow ample practice time in class, at breaks and during other times
always model correct psychomotor skills behavior
keep students active and involved
insist students respect equipment and skills
ensure competence in the individual skills before using scenarios
adding realism
place need for skill in context with a real life scenario or simulation
limit objectives of the scenario to three learning points
as students become more sophisticated using critical thinking skills you can add more dimensions to the scenarios
make the scenario realistic
use actual equipment
consider moulage, props, background noises, etc.
maximizing skill session time
assign students in a skill group to each of the following roles according to the size of group
evaluator: uses a skill sheet or records steps as they are performed
videotape and audiotape may also be helpful in creating a record
allowing several students to critique and provide feedback will illustrate how easy it is for observers to miss steps students may perform
this technique also allows students to improve their own skills performance as they watch the skill being repeated
information provider: uses a script and supplies information as it is requested
team leader: primary patient care provider
partner or assistant: performs care as directed by team leader
patient: faithfully portrays signs and symptoms according to scenario
bystander #1: acts as a distractor or helper
bystander #2: acts as a distractor or helper
distribute a written scenario to be practiced
can use real calls to create scenarios
medical textbook publishing companies have books of scenarios
most textbooks have scenarios in each chapter
ems professional organizations websites have scenarios
begin scenario with the reading of the dispatch information
do not interrupt the scenario
mastery of individual skills should have already been obtained
can comment on timing and decision making later
safety compromises may necessitate your intervention, but do not interfere if it is not a clear safety danger
group performance evaluation
utilize a positive-negative-positive format
begin with positive statements and general comments
move into constructive feedback and areas for improvement
end with positive reinforcement
patient care leader should comment on what he or she did correctly, then what needs improvement
remember that students are often their greatest critics; encourage them to look for positive aspects of their performance
assistant critiques the teams performance
patient comments on how he or she was treated
bystanders add their observations
evaluator comments on timing, sequencing, prioritization, and skills performance
students should rotate through each role then begin another scenario
this method keeps everybody active and involved in the skills practice time
bibliographic references
burke, j. ed. (1989). competency-based education and training. new york: the falmer press.
kolb, d. a. (1984). experiential learning. (1984). new york: simon & schuster trade.
millis, b., & cottello, p. (1998). cooperative learning for higher education faculty. phoenix: oryx press.
watson, a., (1980). learning psychomotor skills in tafe. educational psychology for tafe teachers.
module 18: affective domain
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to provide a definition of the affective domain of learning
give examples of student behaviors that illustrate desired behaviors or changes in behavior in the affective domain
within the context of ems practice, identify examples of affective domain behaviors
list classroom activities that support development of the student's affective domain
psychomotor goals
there are no psychomotor objectives for this module
affective goals
at the completion of this module the student-instructor should be able to:
acknowledge the need to teach to the affective domain
support activities that teach and evaluate the affective domain
value the affective domain of performance for the ems professional
declarative
why this section is important
the affective domain deals with personal issues: attitudes, beliefs, behaviors and emotions
educators believe it is one of the most difficult areas of thinking to influence
some educators believe that we cannot influence students in this area
educators must careful cultivate the ethics and values of our profession while setting aside our personal beliefs and emotions
educators must understand the degree of responsibility we accept when we step into the classroom
we have a strong influence on our students
they learn from and model our behaviors
terminology and descriptions of the affective domain
definition of affective domain
the development of judgment used to determine how one will act
the area of education and performance concerned with attitudes, beliefs, behaviors and emotions
words that describe the affective domain
defend
appreciate
value
model
tolerate
respect
importance of affective domain in ems education
the affective domain helps develop professional judgment
judgment often determines excellence
ability determines capability and attitude determines performance
the affective domain skills often make up the patients perception of the quality of care received
ideal characteristics include:
kindness
honesty
compassion
knowledgeable
every patient and professional encounter in ems uses all three domains, including affective
for example:
appreciating patients pain level and requesting a morphine order
respecting patients modesty and covering him or her with a sheet
defending or respecting patients right to refuse care
modeling responsible behavior given the autonomous setting of prehospital care
levels of understanding within the affective domain
receiving
awareness of the information or value you are presenting
willingness to receive the information
attention to the information
responding
a command response involves doing what is asked when required, a recall or regurgitation of the right answer according to what was taught
a willingness response involves doing the right thing the right way when asked or when given other choices
satisfaction in response is when the student voluntarily does what is right and feels satisfaction
valuing
acceptance of a value shows that the student is aware that the behavior has worth
a preference for a value shows that the student selects this behavior over others when given a choice
a commitment to a value means that the student always behaves this way and can defend or encourage this value in others
organization
the integration of different beliefs based on experience
good judgment comes from experience
experience often develops out of bad judgment or poor decisions
characterization
behavior patterns are so ingrained that they are part of the students lifestyle
consistency means that given a number of situations involving the same value, the reaction will be automatic, consistent, and defensible
characterization is when the person is so closely associated with the value that people may use the name of that value to describe the person
the affective domain in the ems classroom
see appendix for an affective domain evaluation tool
instructors are role models
provide mentors for students
be aware constantly of being observed by students
choose adjunct, skills and clinical instructors carefully to be sure they model good values
model values that you want your students to emulate
fairness
compassion
honesty
punctuality
dependability
preparedness
competence
professionalism
pride
use presentation styles appropriate to the domain
case study
audio tapes of 911 call
discussion
debate
role-play
scenario
present to students the relevance of this information and allow them to attach the value
give examples of when the value was clearly right
give examples of when the value improved patient care
give examples of when the value improved someones career
use both ems and real-life examples the student can relate to
use case studies that are appropriate to the field and will be encountered in their professional career
insist students meet the affective objectives of the curriculum
establish classroom policies that support the affective objectives
include affective objectives in assessment and grading criteria
correct behaviors that do not model values during simulations and role play
assign students mentors and clinical faculty who also value the affective domain
bibliographic references
archer, patricia. (1979). student behavior and attitudes: the affective domain. texas.
belcher, a., & sibbald, r. (1998). mentoring: the ultimate professional relationship. ostomy and wound management, 44:4.
eiss, a. f., harbeck, m. b. (1969). behavioral objectives in the affective domain. washington, dc: nea publication sales.
goleman, daniel. (1998). working with emotional intelligence. new york: bantam books.
main, r. g. (1992). integrating the affective domain into the instructional design process.
pike, robert w. (1994). creative training techniques handbook (2nd ed.). minneapolis: lakewood books.
price, e. a. (1998) instructional systems design and the affective domain. educational technology, v38 n6, 17-28.
walsh, a., & borkowski, s. (1999). mentoring in health administration: the critical link in executive development. journal of healthcare management, 44:4.
module 19: discipline
cognitive goals
at the completion of this module the student-instructor should be able to:
identify unacceptable classroom behaviors
articulate the cost and consequences of uncontrolled classroom environments
discuss possible causes of behavior problems
describe three strategies for preventing unacceptable behavior
describe how to create a progressive discipline policy within institutional guidelines
given a behavior problem scenario describe an appropriate disciplinary action for the situation
psychomotor goals
at the completion of this module the student-instructor should be able to:
role play a scenario involving a discipline problem by modeling the steps of progressive discipline described in this module
affective goals
at the completion of this module the student-instructor should be able to:
appreciate the underlying causes of behavior problems
respect the students dignity when delivering discipline
value the need to apply discipline in a safe, fair and consistent manner
declarative
why this module is important
unacceptable classroom behaviors disrupt the learning process and may pose physical danger to the instructor or students
instructors and training institutions may have legal liability in providing an appropriate classroom environment
depending upon the infraction, disruptive students may still have legal rights and it is important for instructors to learn how to appropriately handle classroom and student problems
unacceptable classroom behaviors
may be grouped into those behaviors that are considered illegal (criminal or tort) and uncomfortable (disruptive or undesirable but not clearly criminal or tort)
illegal behaviors
violence
threats of violence
sexual harassment
hazing
discrimination
destruction of property
uncomfortable behaviors
foul language
loud voices
angry tone
sleeping
non-participation
cost of uncontrolled classrooms
behavior management is the leading cause of career stress for teachers
behavior management issues are the most common reason teachers leave the profession
classroom management affects how others perceive our competence as an instructor
students
parents
colleagues
administrators (fire chief, operations manager, dean)
an uncontrolled classroom limits our time to teach and learn
an uncontrolled classroom leads to an unsafe and negative learning environment
some possible causes of behavior problems
the following are causes of behavior problems:
poor parenting
lack of societal values
anonymity in large schools and departments
boredom
substance abuse
economic situations
lack of recognition for an otherwise high achiever
family stress
poor coping skills
poor communication skills
lack of social skills
weak institutional policies and penalties
correlations between behavior and cause
if you are annoyed, the student is probably seeking attention
if you feel threatened, the student is probably seeking power
if you feel hurt, the student is probably seeking revenge
if you are powerless, the student is probably seeking adequacy
examples of correlations
seeking attention
calling out
asking irrelevant questions
giving excessive examples
seeking power
tantrum-like behavior
arguing
lying
refusing to follow directions
seeking revenge
cruelty to others
trying to get punished
daring you to punish
pranks
vandalism
feeling inadequate
passively refusing to participate
sitting silently
not answering when called on
asking not to be included
creating positive behavioral changes
prevention and pre-planning
have rules in writing that tell students what is expected
include rules in the student manual
be sure your rules do not contradict other rules (facility, program, state, etc.)
submit your plan to administration for approval to ensure you have their support when you need to enact the final phases of discipline
list all consequences, from mild penalties to removal from the classroom or program
share this information with the students in the beginning of the course or program and revisit it periodically if problems arise
via a student manual, syllabus, code of conduct document, etc.
require students sign documentation of receipt
give student a copy
maintain original document in student's file
include information on grievances
students need to understand their rights as well as their responsibilities
steps to take in the classroom
begin with strict (and fair) rules and regulations
it is easier to lighten up than tighten up
do not allow yourself to be intimidated by students and avoid disciplining them as a result of that intimidation
watch for opportunities to reward good behavior
utilize class leaders for peer policing of unacceptable behavior
be a good role model of courteous and respectful behavior
be organized and prepared for each class to minimize distractions and waiting time
see the humor in situations and laugh sometimes
do not plead with students to behave
if the behavior is out of the normal character of an established class
intervene immediately take a break, change topics, stop instruction and address the issue, etc. the situation may dictate the appropriate action to take
try to identify what is causing the behavior before acting to correct it
gather facts before jumping to conclusions about the incident
delivering discipline
consistently enforce rules by moving through the consequences in progression
seek assistance from other members of the education team
program administrator or coordinator
medical director
other faculty: clinical, primary and secondary instructors
consult with your mentor
utilize the principles of progressive discipline
start with mild punishment and if needed, continue to removal of the student from the class or program
certain situations involving illegal activity or threatening safety of others necessitate immediate removal from classroom setting
actions to take might include a reminder, verbal reprimand, counseling session, removal of privileges, written warning, suspension and then termination
respect a students right to due process
legal representation and to present an alternate perspective
discipline in private
individuals being disciplined still have a right to privacy
document all infractions to establish a pattern
time and date
any appropriate witnesses (fellow faculty members)
description of the incident or events
unacceptable behavior
corrective action taken
provide documentation to the student and inform them who will receive copies of this information
full disclosure is the fairest method and may be enough to stop the behavioral problem
protect the privacy of the individual involved
attempt to discover the cause of the behavior problem to address the real issue, not just focusing on the symptoms
when appropriate, utilize services to address the cause of the problem:
employee assistance program
counselor
physician
tutor
student health services
behavior management involves all members of the education team
administrator
medical director
primary instructor
secondary instructor
adjunct faculty
clinical instructor
preceptor
support staff
the students supervisor or employer (in an on-the-job-training setting)
module 20: remediation
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to define and describe remediation
describe the steps of the remediation process
describe the critical components to include when performing an assessment of a problem requiring remediation
list skills critical to student learning success
psychomotor goals
at the completion of this module the student-instructor should be able to:
role play a front end assessment to identify and explore the causes of a problem requiring remediation
affective goals
at the completion of this module the student-instructor should be able to:
value the need to assist student in becoming independent self-directed learners
declarative
why this module is important
remediation is needed when students do not perform as expected in any of the three domains of learning
students need learning strategies and skills for success in educational situations
instructors can assist students in developing these skills
instructors need a systematic plan to determine what the problem is that is associated with the need for remediation
what is remediation?
a deliberate educational activity designed to correct deficits identified during formal and informal evaluations
what causes the need for remediation?
failure of a student to perform as expected on cognitive, affective or psychomotor content
remediation process follows a systematic plan
identify the problem
evaluate possible causes for the problem
identify where the deficits came from: student or educational program
retrain the student
re-evaluate the student
critical skills for student success
students need cognitive, metacognitive and motivational skills to adequately problem solve
strategies that lead to successful learning
interest and motivation
self-efficacy and self-management
adequate knowledge base
cognitive monitoring
attribution
interest and motivation
intrinsic motivation from within
extrinsic motivation from without
instructor should monitor for intrinsic and extrinsic motivators
help students identify intrinsic motivators and recognize their value
provide extrinsic motivators to student
self-efficacy and self management
encourage students towards independent learning by providing collaborative and self-directed learning opportunities in the classroom
contextual control
provide students with control of their learning whenever possible
adequate knowledge base
students should work through each level of sophistication with each domain of learning to move towards metacognitive strategies
instructor role:
provide learning opportunities to best facilitate this
encourage independent and self-directed learning
metacognition: active monitoring, self-regulation and reflection of personal mental activities
metacognition helps learner:
analyze their own comprehension and needs
use instructional components according to analyzed needs
find hints for correct solutions to problems
actively problem solve
transfer concepts to other contexts to further learning
cognitive monitoring
students need to be active readers, writers, planners and listeners
instructors can facilitate the development of any skills that are lacking or inadequate
provide study strategies
plan and organize study time
steps to start and complete complex assignments
previewing resources and identifying important topics
comprehension of material
use of mnemonics and other memory strategies
highlighting and note taking
active listening during lectures and discussions
preparing for exams
utilize a strategic process to facilitate learning
strategic process goals
regulate strategies used to develop self
understand personal learning style and preferences
observe strategies that enhance success
keep performance records
for reflection and review of progress
evaluate progress
reflect upon successes
redirect as needed
attribution
what does student attribute as the cause for failure?
attribution plays a very important role in whether or not the student accepts responsibility for learning
does the student think or feel they are a victim of circumstances?
does the student blame the instructor or program for their failure?
what does instructor attribute as the cause for failure?
insufficient instruction
correct with better designed strategies that target student learning styles and facilitate self-directed learning
low expenditure of effort by student
determine if student is willing to spend additional energy to learn
provide extrinsic motivation
poor strategy for learning
provide help with developing learning skills
student's lack of ability
consider this possibility after you have considered all other possible causes
prerequisites and developmental opportunities may help diminish the frequency of this as a cause of failure
development of inadequate or absent learning strategies may mitigate this as a cause
the steps of remediation
identify the problem
front end assessment is crucial
if you jump to a solution before fully understanding the problem you may not have the correct solution
ask the right questions
was the problem with student's performance due to a problem with their education or training?
did the student perform correctly previously?
no: it may be a knowledge deficit
yes: it may be a motivation deficit
can you describe the problem?
understand the interrelationship between education, performance, environment and needs
complex relationship that may not be initially obvious
take time to explore all areas thoroughly
identify where the deficits came from: educational program or student
look for attributions
insufficient instruction
low expenditure of effort by student
poor strategy for learning
student's lack of ability
retrain student
use the information gathered from the assessment of the problem to design a strategy for improvement
social contracts are critical to successful remediation
student agrees to work towards change
instructor agrees to help facilitate change process for student
help improve student learning strategies
monitor student's progress in applying these new skills
provide correct instruction and adequate time for practice
involve other members of the educational team
re-evaluate student
repeat remediation process until successful outcome is achieved or logical stop point is reached
program guidelines, rules and regulations should address consequences for failure to perform at expected level following remediation
students should have written documentation that is provided on first class session outlining expectations for success
bibliographical references
cicchetti, george. (1990). cognitive modeling and reciprocal teaching of reading and study strategies. watertown: cicchetti associates.
collinson, vivienne. (1996). reaching students teacher's ways of knowing. thousand oaks: corwin press, inc.
mayer, r. e. (1998). cognitive, metacognitive and motivational aspects of problem solving. instructional science, v. 26, number 1-2, 49-63.
robinson, d. g., & robinson, j. c. (1996). performance consulting moving beyond training. san francisco: berrett-koehler publishers.
module 21: cultural awareness
cognitive goals
at the completion of this module the student-instructor should be able to:
use his or her own words to define and describe cultural awareness
understand various ethnic and religious values and traditions that may affect a students behavior
explain the behaviors an ems instructor can model to show awareness of cultural issues in their classroom
describe aspects of cultural awareness that are important to instill in students in the classroom setting
psychomotor goals
there are no psychomotor objectives with this module
affective goals
at the completion of this module the student-instructor should be able to:
defend the need to consider cultural awareness issues when designing and developing instructional plans and curriculum
display behaviors that indicate consideration of cultural awareness issues when dealing with students
share your knowledge of cultural awareness by modeling cultural sensitive behaviors to your students in the classroom
declarative
why this module is important:
united states is a country of immigration
1940 70% of immigrants from europe
1992 37% from asia; 44% from latin america and caribbean; only 15% from europe
many individuals embrace their culture and do not wish to surrender it
resulting in cultural pluralism
the nation profits from contributions different groups make to society
cultural diversity in the united states
at least 106 ethnic and over 500 american indian groups
it is difficulty to set aside strongly held beliefs or values
individual may not even be aware they have a bias
understanding age
era in which one grows up puts an indelible imprint on ones values and expectations
age at which individual is considered an adult and capable of making adult decisions varies within groups
understanding gender
gender roles (female physician or paramedic, male nurse)
men and women communicate differently
women interact to form relationships
men establish hierarchy of order
understanding ethnicity
ethnic background includes native language and cultural norms (holiday observances, food preferences, social affiliation, health care beliefs and preferences)
while some americans are comfortable with self-reliance and independence, this is not the case for all cultures in america
interdependence with relatives and friends
family/extended family are very important
one may not be comfortable speaking out in a group that is not family
may be perceived as aggressive
may bring shame and embarrassment to family
some ethnic cultures are non-aggressive and non-confrontational
some may not be comfortable making eye contact when conversing with a person in authority (e.g., teacher, physician, nurse, etc.)
many cultures address persons of authority formally (by title or surname) until receiving permission to do otherwise
gestures and speech patterns do not have universal meaning
smile or nod may be a sign of not understanding or not wishing to disagree with authority
snickering may be a sign of embarrassment and confusion
"yes" may mean, "i heard you" rather than "i agree"
some ethnic groups value silence as a sign of respect and attentiveness; for others it may be a sign of disagreement
humor (particularly sexual in nature) and gestures is offensive to various cultures
understanding physical ability
approximately 43 million americans have a physical disability
report being frequently ignored when in a group
gauge to what level the individual desires or needs your assistance before offering assistance
understanding sexual orientation
non-heterosexuals are often assumed to be infected with the aids virus
understanding race
some races are more stereotyped than others
understanding religion
student may be unavailable for class assignments
for seventh day adventists and jews saturday is the sabbath
muslims pray five times each day
student will not be available for class assignments during prayer times
jehovahs witnesses forbid celebrations, with the exception of the wedding anniversary
student may not attend birthday, graduation, or holiday parties
christian scientists and jehovahs witnesses may not administer blood or blood products
mormons fast for 24 hours once a month
religious mandates may impose specific dress codes that conflict with field or clinic settings
understanding education
students with less formal education may feel intimidated or be less articulate in the classroom
may feel less entitled to ask questions
understanding marital status
may hinder or enhance students commitment to obligations of the class
the cultural or ethnic group may place a great deal of importance on the marriage and decisions regarding student issues may be made by family members
understanding income
can limit access to education, transportation, and additional class expenses
understanding parental status
child care issues can interfere with scheduled student responsibilities
understanding appearance
can affect ones perception of a students commitment to the education program and a career as a healthcare professional
religious convictions may impact upon appearance as certain clothing may be required or a certain hairstyle may be imposed upon the individual by their religion or culture
individual rights may conflict with dress codes in field or clinic settings
understanding personal habits
things like smoking, drinking and exercising can build or hinder collegial relationships
personal choices, ethics, morals and convictions may prohibit some students from participating in group activities
understanding geographic location
students from other areas may not feel welcome in the classroom setting
realities of cultural diversity
culture is not overt
it has a powerful influence but is subtle
we are all essentially ethnocentric beings meaning we place a great deal of value in our own culture and consider it normal behavior
we rarely question our own cultural identity, and naturally assume our rules, values and beliefs to be correct
we tend to judge negatively those who are different
we observe, interpret, then act
based on our own cultural programming, we attach meaning to behaviors
we may not know when we are offending others
communication and respecting diversity
50 90% of all communication is non-verbal
pay attention to body language, facial expressions, and other behavioral cues
try not to use idioms and slang
do not take others behavior personally
we walk a fine line between understanding and stereotyping
be careful not to label individuals simply because you have a given expectation of their cultural values and traditions
remember that we are all different
this includes various educational experiences and ways of learning
bibliographical references
andrews, m.m., & boyle, j.s. (1995). transcultural concepts in nursing care (2nd ed.). boston: scott, foresman.
bullock, k.a. (1997). shades of the rainbow. emergency medical services (october): 28-33.
galanti, g. (1997). caring for patients from different cultures: case studies from american hospitals. (2nd ed.). philadelphia: university of pennsylvania press.
gardenswartz, l., & rowe, a. (1998). managing diversity in health care. san francisco: jossey-bass.
gardenswartz, l., & rowe, a. (1999). managing diversity in health care manual: proven tools and activities for leaders and trainers. san francisco: jossey-bass.
gropper, r.c. (1996). culture and the clinical encounter: an intercultural sensitizer for the health professions. yarmouth: intercultural press.
leininger, m. (1978). concepts, theories, and practices. new york: john wiley.
oosterwahl, g. (1995). community in diversity: a workbook. benton harbor: patterson.
paniagua, f.a. assessing and treating culturally diverse clients: a practical guide.
spector, r.e. (1996). guide to heritage assessment and health traditions. stamford: appleton and lange.
spector, r.e. (1996). cultural diversity in health and illness. (4th ed.). stamford: appleton and lange.
module 22: teaching resources
cognitive goals
at the completion of this module, the student-instructor should be able to:
discuss the importance of mentors for the development of a professional ems instructor
discuss the importance of working with various allied health personnel, including state ems agency personnel, area hospital personnel (er physicians, nurses, respiratory therapists, pharmacists, etc), non-hospital affiliated physicians and area paramedic program faculty (e.g., college and university)
discuss the importance of validity, utility and the effective use of resources in delivering content in a program
discuss the importance of attending professional development opportunities (e.g., ems and education conferences and workshops)
discuss the usefulness of a library in developing educational content
discuss the importance of research for each of the following:
when developed for a specific organizational need
used when participating in larger multi-organizational projects
as a contribution to the body of knowledge
discuss the importance of developing a support network with each of the following:
local political officers (e.g., county council, mayor, city manager)
physicians
publishers
area ems instructors
area paramedic program faculty (e.g., college and university)
other faculty within your agency
discuss the importance of using community service as a means of developing teaching skills
through presentations to public groups (e.g., scouts, schools, civic groups)
assisting with area ems courses
psychomotor goals
at the completion of this module, the student-instructor should be able to:
given a specific ems instructional setting (with audience, teaching site, and course type provided) the student-instructor should be able to take specific ems course content resources (provided to them) and evaluate that resource for validity, utility and effectiveness in the described setting
use the resources described in this module to enhance lesson plan content
affective goals
at the completion of this module, the student-instructor should be able to:
describe why it is important for ems instructors to seek a mentor
explain the importance of critical evaluation of teaching resources
value the importance of developing methods designed to enhance personal growth and life-long learning
declarative
why this module is important
one of the greatest challenges of an ems instructor is finding high quality resources for teaching
a mentor is a valuable resources to any instructor, not just a novice one
they can help direct your continuing personal and professional development
they can serve as a resource for problem solving instructional issues
the importance of mentoring in the development of ems instructors
mentors are an excellent resource for content and teaching methods and techniques
mentors provide
guidance
a good example to model yourself after
constructive criticism to help you grow (personally and professionally)
insight from their experiences
mentors may be
ems educators
educators from other allied health fields
physicians
nurses
other healthcare professionals
respiratory technicians, physical therapists, etc.
educators from other academic settings
colleges of education
programs specializing in rescue, fire and law enforcement
other individuals
where to find mentors
mentors can come from a variety of fields, not just ems or allied health (politicians, clergy, business leaders, lawyers, managers, etc)
the key is that they are truly concerned with the success of the student and with your development as an instructor
do not limit your opportunities to grow and develop, pick mentors from the political, administrative, legal, financial or other fields
media as a resource
media takes many forms and comes in many price ranges
expensive is not necessarily better
add a variety of media to your presentations to keep students interested and to maximize various student learning styles and preferences
media should be evaluated to determine that it is:
appropriate for the audience
professionally presented
targeting students reading and comprehension levels
covering an appropriate depth of information
accurate
containing current information, including trends and updates
promoting good behavior and practices in students (example: wearing gloves while attending to patients)
easy to use
determine what you need to use the selected media
computers, overheads, white boards, etc.
it should fit well into the environment you will use it in
if it malfunctions, can you fix it quickly?
do you have a back-up plan in case of problems?
media should be defendable and credible
from refereed journal or a peer-reviewed internet site
do not assume because it was commercially prepared that it is designed well or the content is accurate
closely scrutinize any media before you use it
conferences, workshops and continuing professional development opportunities
current science is reviewed or presented
expanding your background knowledge
teaching methodology and pedagogy is presented
observing others teach helps you teach better
sharing tips, ideas and techniques
opportunities for networking (building support groups)
exposure to vendors who present new products
often they provide free samples of merchandise or books
they may have training materials (models, or content) for you to use in your courses
opportunities to maintain your own certification as a provider as well as enhance your instructor abilities
the library as a resource
public
generally easily accessible
often will have free access to a limited sample of medical databases
may offer some technical support for performing on-line and non on-line information searches
generally found in most communities
academic based (college or university)
may have content specific materials and access to more scientific material than a public library
may have more liberal hours of operation (especially during finals week)
medical school libraries have large collections of allied health materials as well
will have staff who specialize in research strategies
may require users to be affiliated with the institution
computerized databases offered within standing libraries or via the internet
general databases: cinahl, nexus/lexus, etc.
databases are available in both public and private libraries
educational focused: eric, etc.
medical focused: medline, greatful med, etc.
many have free internet access
many offer free or inexpensive resources
may have links with other libraries for borrowing materials
may be available to be used as a test-proctoring site
may provide free or low cost interlibrary loan system
often contain archived material
research as a resource
access to and opportunities for research are critical to the development of the ems profession
research is considered one aspect of professional growth and development
research can be done to address a specific need for an organization (e.g., intubation success, on-scene times, etc.)
once completed a problem may be solved, a process changed, or training program developed
it may be done in collaboration with other institutions to address a profession-wide issue (e.g., effectiveness of teaching ekg via distance learning for paramedic students)
it provides a basis for further study and future projects
it helps us demonstrate our value to the medical community
the value of professional groups for ems instructors
provide mentoring and support for other instructors
provide access to guidance when dealing with political issues (e.g., county funding for a certification course)
provide examples of excellent teaching
organizations and groups that are potential sources of information
american society for testing and materials (astm)
this organization develops standards
department of labor
ems task analysis
some standards and guidelines
curricula
department of energy
curricula: transportation of hazardous materials and radioactive materials
centers for disease control
for infectious disease (id) curricula materials
many provided as text, powerpoint and adobe acrobat files as free non-copyrighted materials
email listservers provide access to updated reports and news items free of charge
occupational safety and health administration
for id and worker safety standards and guidelines
curricula
federal emergency management agency
standards and guidelines
curricula: disaster management, mass casualty, etc.
department of transportation: national highway traffic safety administration (nhtsa)
national standard curricula for all levels of ems provider including refresher training and instructor training curricula
many resources provided as text, brochures and computer based presentations
many provided free of charge
us department of health and human services
pediatric curricula
family support services materials
general health data and epidemiological resources
emergency medical services for children
pediatric curricula (pepp and others)
national clearinghouse for pediatric resources
many resources provided as text, brochures and computer based presentations
many provided free of charge
national registry of emts
private organization that is a national licensing body for ems that many states participate in
practical skills sheets that detail many ems skills
available on-line free of charge
practice tests (computerized and "correspondence type")
allies or mentors may be found within other public service agencies
fire service based
national fire academy
international fire service training instructors
police based
nfpa
national ems professional associations
naemt
unions accepting ems workers
national ems educational organizations
naemse
sub-groups within other ems organizations
groups focusing on ems administration
nasemstc
national ems state directors
aaa american ambulance association
other groups that may be useful sources of information
physician based groups
nursing and allied health groups with ems focus
individual state ems educators association
groups with established training programs (continuing education)
aha: acls, bcls, pals, aed
arc: bls, aed
atls
btls international: btls, pbtls, access
wilderness medic
farmedic
amls
phtls (including combat medic module)
pediatric education for prehospital professionals (pepp)
traumatic brain injury program
other programs also exist and more are being added all the time
many of these programs, or parts of these programs may be available for you to use even if you are not offering the course for certification
accrediting bodies
caahep commission for the accreditation of allied health education programs
coaemsp committee on accreditation of ems programs
cecbems continuing education coordination board for ems
college and university accrediting boards and groups
accreditation for internet based programs and schools
scrutinize these groups closely to determine who they are
college and university accrediting bodies may know of these groups
internet based resources
evaluate site for bias, quality, and age of the material
list of internet addresses with free resources (attachment 3)
medical and ems trade journals and magazines
peer reviewed is generally the most scientific
many are devoted to sub-specialties of ems like rescue, administration, legal issues, etc
continuing education resources
refer to previous list
cecbems is one of several organizations that accredits continuing education offerings by organizations
state ems agency may have a process or standard in place for quality assurance
refresher training
nremt has a standard in place that many states follow
publishers of ems and health related materials have resources
test banks - may be provided when an institution purchases a large volume of texts
instructor resource guides - often include lesson plans, outlines, lecture aids (e.g., computerized presentations, handouts, overheads, etc.)
skill sheets
may accompany textbooks
downloadable from some websites (e.g., nremt)
computerized and multimedia resources
realistic looking and reacting manikins
videotapes
audiotapes
cd-rom, dvd, and other technology based programs with case studies, simulations, games, and learning content
moulage kits
available from medical appliance manufacturers
build your own
keep an eye out for old clothes, toys and discarded items to use in your own kit
yard and garage sales, and thrift shops
buy make-up from a clearance bin or after holidays like halloween when it is significantly marked down
attend a class on theatrical make-up or moulage techniques
develop a relationship with a local theatre group
local mortuary may be a resource for make-up and a make-up artist
your medical director is one of your best resources
he or she should be involved in your program and course design and development
he or she should be visiting regularly with your students
he or she may also be called upon to teach in your program, but remember, being a medical director does not mean instructional ability
other faculty members in your program
a team approach leads to the best students
other instructors help solve problems and may have a better perspective on an issue
they may have resources to share or teaching tips and tricks
your clinical preceptors as a resource
the integration of the clinical aspects of your program with the didactic is critical to a successful program
provide preceptors with a written feedback tool
use preceptors opinions as a measure of the success of the delivery of content
invite preceptors to participate in meetings and decision making
affective domain evaluations on students should be completed by preceptors
your program advisory board
you may have access to the members of your programs advisory board (or some other group of individuals who have been brought together to provide guidance to your program)
these individuals are generally representing groups and agencies that work closely with your students
they can be valuable sources of information for you as you plan instruction or can provide feedback on how your students are performing on the job
this group should meet at least annually to review the success of the program (e.g., review testing results) and should recommend curriculum changes when appropriate
graduated students and communities of interest surveys
surveys allow graduates to provide anonymous feedback about the program
did the program adequately prepare them for testing and working as a paramedic?
surveys of ems agencies in your service area allow employers to provide anonymous feedback about interns and graduates now employed by them
the role of community service in professional development
fulfills the mission of the ems agenda for the future
provides public education on injury prevention
providing presentations to public groups allows you to hone your presentation skills in a less threatening environment than the ems classroom
provides growth opportunities for students as well
provides an opportunity to educate the public about our mission
helps us develop or maintain a positive image with the public
you have the opportunity to "give something back" to the ems community when you volunteer to help out at an ems course
may develop new markets for ems by making the public aware of the depth and breadth of knowledge in ems
module 23: research
cognitive goals
at the completion of this module, the student-instructor will be able to:
describe the nature and characteristics of research as it relates to the practice of ems
understand the common types and methods of conducting research
distinguish between the different types of research commonly conducted in the ems setting
understand how research studies are designed and conducted
describe methods used to read the research literature with understanding
identify sources for locating relevant research materials and findings
psychomotor goals
there are no psychomotor objectives for this section
affective goals
at the completion of this module, the student-instructor will be able to:
defend the importance of teaching research methods in the curriculum
value the importance of research in the clinical and educational settings of ems
value the need to assist in the research process and data collection activities
explain the value of research to the ems provider and the ems educator
declarative
why this module is important
the professional literature of ems is expanding every year
most of that literature deals with research results
historically, ems have relied on observation and common sense approaches to treatment and clinical interventions
currently the focus is on scientific evidence to determine the efficacy of treatment and clinical interventions
ems educators should design and conduct educational research that forms a scientific basis for instructional methodologies and interventions dealing with ems education settings
ems providers and educators should be familiar with research
should participate in research
possess an understanding of the basic tenets of the research process
instill knowledge about and appreciation for the research process in students
model appreciation of benefits of research
participating in and design research projects for clinical and education practice
research is a tool
allows our profession to expand and provides for meaningful advancement of knowledge in ems education and practice
responsibility of professional ems educators to strive to understand what leads to students success, retention of information, retention of skills and transference of classroom experiences into successful clinical experiences and career satisfaction
overview of ems research
ems agenda for the future
revision of bls and als curricula
naemse educator nsc development
the nature of research
research should be empirical, valid, reliable and follow a scientific method
empirical
empiricism is the doctrine that all knowledge is derived from experience
evidence derived from research is in the form of some type of data
research is directed towards one of two outcomes
extension of existing knowledge
the solution of an existing problem
validity
internal validity: the extent to which the results can be accurately interpreted external validity: the extent to which the results can be generalized to populations
reliable
consistency of the study
ability of other researchers to replicate the study
necessary for validity
systematic in approach
scientific method
identification of problem
reviewing of existing information related to problem
collecting data
analyzing data
drawing conclusions from data
ems research should be systematic
systematic research increases both the reliability and validity of the findings
activities in the research process
identification of the research problem
hypothesis are generated (tentative guesses about what is being studied)
review of the existing literature (to determine what others have done and how they designed their research)
identification of what data will be collected (variables of the study)
data collection
the experiment is conducted at this point and observations are made
data is assembled and prepared for analysis
analysis
data are summarized
statistical analysis is conducted
summarize results and draw conclusions
conclusions drawn as to how the results relate to the research problem
conclusions drawn as to how the results relate to the existing knowledge
possible explanations of the results are provided
classification of research
basic research
primary purpose is the extension of knowledge
applied research
primary purpose is the solution of an immediate problem
qualitative research
conducted for the purpose of understanding social phenomena
relies on the researcher inclusion in the situation being studied
relies on narrative descriptions
quantitative research
conducted to determine the relationship and effects and causes of the relationship
relies on statistical results represented as numbers
this is the type of research most often conducted in ems clinical and educational settings
experimental research
a type of quantitative research
involves situations in which at least one variable is deliberately manipulated or varied by the researcher to determine the effects of the variation
the researcher determines the variable and the extent to which it will be varied
possible to have more than one variable in an experiment
participants are randomly assigned to groups
researcher controls all of the factors that could bias or slant the outcome of the experiment
considered the "gold standard" for clinical research design
virtually impossible to conduct in true emergency settings, since it requires withholding of standard treatment from a randomly selected patient
this research design has a high probability of producing valid and correct findings
quasi-experimental research
similar to experimental research, but the participants are in naturally assembled groups, for example, a paramedic class
not conducted in a laboratory but in a natural setting
results are less straightforward than true experimental research and more susceptible to ambiguity when interpreted
survey research
deals with the incidence, distribution and relationships between educational, psychological and sociological variables
no experimental variables are manipulated
variables are studied as they exist in a natural situation
understanding the components of a research article
introduction section
defines the topic being investigated in clear specific terms
terms used in describing the research problem are defined
review of the literature
provides the background and context for the research problem
establishes need for further research in the area
establishes that the researcher has a good understanding of the topic to be researched
methods
the heart of the research project
describes the measurement instruments used or developed.
describes the individuals participating in the research (subjects.)
describes the sample (design and numbers.)
describes the data collection methods
describes the specific data analyses methods used
results
the products of the data analyses
descriptive statistics
conclusions
identifies all noteworthy results
interprets results relative to the research problems and in the context of related research and theory to draw conclusions
explains any inconsistency
discusses the limitations of the study
identifies directions for future research
address the degree to which the results of the study can be generalized to a larger population or group
the role of statistical analysis in the research process
descriptive statistics
summarize or describe the characteristics of a set of data in a clear and convenient manner
example: your grade point average is a convenient summary of all the grades you received in school
inferential statistics
makes it possible to draw inferences about what is happening in the entire population based on a sample from the population
a population is defined an entire group of people, objects, or events having at least one characteristic in common
populations are typically very large
a sample is a subgroup selected from the complete population
a sample must be selected in such a manner that it is representative of the entire population
use of random selection processes makes certain the every person, object or event from the population has an equal chance of being included in the sample
in this way, inferences can be drawn from sample regarding the population
this is referred to as the ability to "generalize" the results of research conducted on a sample to the entire population
using the techniques and mathematics of inferential statistics it is possible to be reasonably confident that the results are representative of the entire population
statistics help the researcher decide if the results are true differences or just coincidences
the value of understanding research methods and literature
three major reasons why knowledge of research methods is essential for ems providers and educators
to understand the professional literature
to understand the rationale underlying research in ems
ability to comprehend the essential nature of the strengths and weaknesses of the techniques used to collect information and draw conclusions
to conduct or to assist in the conduction of research projects
can influence change in professional standards and practice
bibliographic references
ary, d., & l. jacobs. (1976). introduction to statistics: purposes and procedures. new york: holt, rinehart and winston.
babbie, e. (1973). survey research methods. california: wadsworth publishing co. inc.
bledsoe b, r. porter, et al. (2000). paramedic care: principles and practice introduction to advanced prehospital care. upper saddle river: brady prentice hall health.
dalton, a. (1996). enhancing critical thinking in paramedic continuing education. prehospital and disaster medicine 11(4), 246-53.
gall, m.d., borg, w. r., & gall, j. p. (1995). educational research: an introduction. new york: longman publishing group.
hinkle, d., & w. wiersma, et al. (1988). applied statistics for the behavioral sciences. boston: houghton mifflin co.
meltzoff, j. (1998). critical thinking about research: psychology and related fields. washington, dc: american psychological association.
ruple, j. a. (2000). understanding probability--the backbone of inferential statistical analysis. domain3, summer issue, 2-3.
ruple, j. a., & mcbeth, r. (1992). taking chances: statistics and probability. journal of emergency medical services 18(12), 66.
ruple, j. a., & mcbeth, r. (1992). do statistics really prove anything? an ems consumer's guide to understanding research literature. journal of emergency medical services 18(12), 62-65.
sanders, m. (2000). mosby's paramedic textbook. st. louis: mosby lifeline.
the national association of ems educators. (2002). research agenda for the future.
united states department of transportation, national highway traffic safety administration, et al. (2000). emergency medical services education agenda for the future: a systems approach.
vockell, e. l., & asher, j. w. (1994). educational research. new york: simon and schuster trade.
wiersma, w. (1986). research methods in education: introduction. boston: allyn and bacon inc.
appendix i: action verbs useful for writing objectives
cognitive domain
knowledge:arrange, define, describe, identify, label, list, name, identify, match, memorize, order, recognize, recall, recite, repeatcomprehension:classify, discuss, distinguish, explain, identify, indicate, locate, review, rewrite, summarize, tell, translateapplication:apply, choose, compute, demonstrate, operate, practice, prepare, solveanalysis:analyze, calculate, compare, contrast, criticize, diagram, differentiate, distinguish, examine, experiment, evaluate, relate, separate, selectsynthesis:assemble, compose, construct, create, combine, design, formulate, organize, prepare, set up, summarize, tell, writeevaluate:appraise, evaluate, judge, scorepsychomotor domain
imitation: repeat, mimic, follow
manipulation: practice with minimal assistance, create, modify
precision: perform without error, perform without assistance
articulation: demonstrate proficiency, perform with confidence, perform with style or flair
naturalization: perform automatically
affective domain
receiving: accept, attempt, willing
responding: challenge, select, support, visit
valuing: defend, display, offer, choose
organization: judge, volunteer, share, dispute
characterization: consistently, join, participate
action verbs for writing goals
know
realize
enjoy
believe
understand
appreciate
value
comprehend
aware
tolerate
be familiar with
desire
feel
write
appendix ii: academic honesty college procedure
title: 10.02.01 academic honestycollege policy number/title: 10.02/academic honestygeneral statement
academic honesty is a matter of concern to anyone connected with howard community college. a clearly and carefully thought-out policy and set of procedures can guide students and faculty members toward the accomplishment of academic honesty. communication of these procedures will be accomplished through the following sources:
1. all catalogues, class schedules and course outlines will contain at least the statement:
"academic honesty, as defined in the student handbook, is expected of all students."
2. a statement of policies and procedures will be contained in the faculty and student handbooks.
b. definition
1. academic honesty means the use of one's own thought and materials in the writing of papers, taking of tests, and other classroom related activities. any students intentionally aiding another student in any infraction of the academic honesty policy is considered equally guilty.
2. students are expected to give full credit for the borrowing of other's words or ideas. intentional or unintentional use of another's words or ideas without acknowledging this use constitutes plagiarism.
there are four common forms of plagiarism:
the duplication of an author's words without quotation marks and accurate references or footnotes.
the duplication of an author's words or phrases with footnotes or accurate references, but without quotation marks.
the use of an author's ideas in paraphrase without accurate references or footnotes.
submitting a paper in which exact words are merely rearranged even though footnoted.
3. misrepresentation is the submission of materials for evaluation that are not the student's own.
4. unauthorized use of notes or another individuals materials, copying, using another individuals materials, or unauthorized prior knowledge of the contents of tests, quizzes or other assessment instruments shall be considered a violation of the academic honesty policy.
c. penalties
as the college expects academic honesty, there must be procedures for dealing with intentional infractions of the academic honesty policy.
first infraction
for the first infraction of the academic honesty policy the faculty member shall give the student an "f" or its equivalent on the paper, examination, or presentation in question. the faculty member will notify the student and explain the reason for the grade. this action could result in a lower final grade. the appropriate division chairperson will be informed of the infraction in writing and the vice president of student services will notify the student in writing of the consequences and implications of this infraction.
second infraction
a second infraction of academic dishonesty, either in the same course or in another course, will result in an automatic "f" in the course in which the second infraction occurred. the student will be dropped from the course and barred from further class participation. the appropriate division chairperson will be informed of the incident in writing and will notify the vice president of student services. in cases where the second infraction occurs in the same course, the faculty member will notify the student and explain the reason for the "f" in the course. in other cases, the vice president of student services will notify the student of the "f" in the course. the vice president of student services will notify the director of records and registration that the student is to receive an "f" grade for the course. the vice president of student services will meet with the student involved and apprise the student of the implication of this second infraction.
third infraction
a third infraction of academic dishonesty, either in the same course or in another course, will result in an automatic "f" in the course in which the third infraction occurred. the student will be barred from further class participation. the appropriate division chairperson will be informed of the incident in writing and will notify the vice president of student services. in cases where the third infraction occurs in the same course, the faculty member will notify the student and explain the reason for the "f" in the course. otherwise, the vice president of student services will notify the student of the "f" in the course. the vice president of student services will notify the director of records and registration that the student is to receive an "f" grade for the course. a third instance of plagiarism or any behavior involving an infraction of the academic honesty policy will result in disciplinary action as determined by the student judicial process
appendix iii: classroom behavior, "a practical guide for faculty"
classroom disruption is a disciplinary offense
the term "classroom disruption" means behavior a reasonable person would view as substantially or repeatedly interfering with conduct of a class. examples range from persisting to speak without being recognized, to resorting to physical threats or personal insults.
academic freedom
college policies on classroom disruption cannot be used to punish lawful classroom dissent. the lawful expression of a disagreement with a teacher or other students is not itself "disruptive behavior."
rudeness, incivility, and disruption are often distinguishable, even though they may intersect.
in most instances, its better to respond to rudeness by example and suasion (e.g., advising a student in private that he or she appears to have a habit of interrupting others.) rudeness can become disruption when it is repetitive, especially after a warning has been given.
strategies to prevent & respond to disruptive behavior
clarify standards for the conduct of your class. for example, if you want student to raise their hands for permission to speak, say so.serve as a role model for the conduct you expect from your students.if you believe inappropriate behavior is occurring, consider a general word of caution, rather than warning a particular student (e.g., "we have too many contemporaneous conversations at the moment; lets all focus on the same topic.")if the behavior is irritating, but not disruptive, try speaking with the student after class. most students are unaware of distracting habits or mannerisms, and have no intent to be offensive or disruptive.there may be rare circumstances when it is necessary to speak to a student during class about his or her behavior. do so in a firm and friendly manner, indicating that further discussion can occur after class.a student who persists in disrupting a class may be directed by the faculty member to leave the classroom for the remainder of the class period. the student should be told the reason(s) for such action, and given an opportunity to discuss the matter with the faculty member as soon as practicable. prompt consultation should be undertaken with the department chair and the dean of students. suspension for more than one class period requires disciplinary action, in accordance with the code of student conduct.if a disruption is serious, and other reasonable measures have failed, the class may be adjourned, and campus security should be summoned.
code of conduct violation
disruptive classroom behavior is a disciplinary violation under the hccs student code of conduct. as such, students accused of this type of violation are subject to a disciplinary conference or hearing, depending upon the nature and frequency of the disruption.
procedural protections
students accused of disciplinary violations are entitled to the following procedural protections:
to be informed of the specific charges against them, and the identity of the complainant.to be allowed to request an informal resolution of the case.to be allowed reasonable time to prepare a defense.to hear and respond to all evidence upon which a charge is based.to call and confront relevant witnesses.to be assured of confidentiality, in accordance with the terms of the family educational rights and privacy act of 1974.to be allowed to request that any person conducting a disciplinary conference, or serving as a discipline conference committee member or chair, be disqualified on the ground of personal bias.to be provided with a copy of these rights prior to any conference of discipline hearing.to be considered innocent of the charges until proven guilty by clear and convincing evidence.sources: hcc conduct code synfax weekly report, april 1, 1996
reprint permission granted by author/editor: gary pavela
appendix iv: student counseling report (sample)
this counseling report will be made part of the following students file.
student name: ____________________________ date: _______________
person issuing counseling: __________________ title: _______________
section i:
behavioral: the following deficiency has been noted in your behavior while participating in the emergency medical services program.
penalty: first offense will be met with a counseling. second offense will be met with a one-week suspension from participation in the program. third offense will be met with a failing grade in the course and the possibility of permanent discharge from the program. a first or second offense, if judged severe enough by the program coordinator, can lead to a failing grade in the course and the possibility of permanent discharge from the program.
integrity: being of sound moral principle; honesty and sincerity. ____________________________________________________________________________________________________________________________________
empathy: an understanding of another persons situation / illness.
____________________________________________________________________________________________________________________________________
self-motivation: the ability to show inner drive toward good intention.
__________________________________________________________________
__________________________________________________________________
appearance / personal hygiene: neat, clean and non-malodorous.
__________________________________________________________________
__________________________________________________________________
teamwork and diplomacy: working in a cooperative manner with respect for others.
respect: to show consideration with deference or courtesy.
__________________________________________________________________
__________________________________________________________________
patient advocacy: acting in the best interest of / for the patient.
__________________________________________________________________
section ii:
conduct: the following action(s) has / have been noted as unacceptable while participating in the emergency medical services program.
penalty: a group i offense will be met with a failing grade in the course and the possibility of permanent discharge from the program. a group ii offense will be met with the rules as stated in penalty of section i.
group i
obtaining, possessing, selling or using marijuana, unprescribed narcotics or alcohol while within the confines of the program. reporting to class, lab or a clinical site under the influence of any of these substances.
theft, abuse, misuse or destruction of any property or equipment of any patient, visitor, student, college employee, clinical employee, the college or clinical sites.
disclosing confidential information without proper authorization.
immoral, indecent, illegal or unethical conduct.
possession, wielding or threatening to use any weapon while within the confines of the program.
assault and/or battery on any patient, visitor, student or faculty.
misuse or falsification of patient, student or official records.
removal of patient, student or official records without prior authorization.
cheating on any test, form or official record of the program.
the following group i offense(s) has/have occurred: # ____, ____, ____, ____
explanation:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
group ii
engaging in disorderly conduct that could ultimately threaten the physical well being of any patient, visitor, student, faculty or clinical site employee.
leaving class, lab or a clinical area without proper authorization.
sleeping during class, lab or scheduled hospital clinical.
restricting or impeding clinical output.
insubordination and/or refusal to obey the orders of any faculty, administrative representative of the college or clinical site employee.
inconsiderate treatment of patients, visitors, students, faculty or clinical site employees.
excessive absences.
failure to be ready for a clinical assignment at the starting time.
failure to perform or to exercise reasonable care in the performance of responsibilities.
violation of safety regulations or failure to use safety equipment
provided.
misuse of clinical time.
unauthorized use of equipment.
smoking in restricted areas.
unauthorized posting, removing, or tampering with bulletin board notices.
unauthorized soliciting, vending, or distribution of written or printed material.
creating or contributing to unsafe or unsanitary conditions.
threatening, intimidating or coercing other students, patients, visitors, faculty or clinical site employee.
individual acceptance of gratuities from patients.
inappropriate dress or appearance based on program regulations.
other as deemed necessary by college personnel.
the following group ii offense has occurred: # ____, ____, ____, ____, ____
explanation:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
follow up: (include specific expectations, clearly defined positive behavior, actions that will be taken if the behavior continues, dates of future counseling sessions, etc.):
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
edison college personnel (printed): ________________________________
title: ________________________________
signature: ________________________________
i have read this notice, have spoken with my instructor and have had a chance to discuss this. i understand this report and agree to abide by the rules of the college and the program.
student name (printed): _________________________________________
signature: _________________________________________
comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
i have reviewed this counseling record.
coordinator: ___________________________ date: ___________
medical director: _______________________ date: ___________
comments: ________________________________________________________________________________________________________________________________________________
appendix v: affective domain evaluation tools
(excerpt from 1998 emt-p: nsc)
instructions for affective student evaluations
there are two primary purposes of an affective evaluation system: 1) to verify competence in the affective domain, and 2) to serve as a method to change behavior. although affective evaluation can be used to ultimately dismiss a student for unacceptable patterns of behavior that is not the primary purpose of these forms. it is also recognized that there is some behavior that is so serious (abuse of a patient, gross insubordination, illegal activity, reporting for duty under the influence of drugs or alcohol, etc) that it would result in immediate dismissal from the educational program.
the two forms included in the emt-paramedic: national standard curricula were developed by the joint review committee on educational programs for the emt-paramedic. they represent extensive experience in the evaluation of students affective domain. the nature of this type of evaluation makes it impossible to achieve complete objectivity, but these forms attempt to decrease the subjectivity and document affective evaluations.
in attempting to change behavior it is necessary to identify, evaluate, and document the behavior that you want. the eleven affective characteristics that form the basis of this evaluation system refer to content in the roles and responsibilities of the paramedic unit of the curriculum. typically, this information is presented early in the course and serves to inform the students what type of behavior that is expected of them. it is important that the instructor is clear about these expectations.
cognitive and psychomotor objectives are relatively easy to operationalize in behavioral terms. unfortunately, the nature of the affective domain makes it practically impossible to enumerate all of the possible behaviors that represent professional behavior in each of the eleven areas. for this reason, the instructor should give examples of acceptable and unacceptable behavior in each of the eleven attributes, but emphasize that these are examples and do not represent an all inclusive list.
the affective evaluation instruments included in this curriculum take two forms: a professional behavior evaluation and a professional behavior counseling record. the professional behavior evaluation should be completed regularly (i.e. every other week, once a month, etc.) by faculty and preceptors for each student. it is recommended that as many people as practically possible complete this form and that it becomes part of the students record. the more independent evaluations of the student, the more reliable are the results.
the only two options for rating the student on this form are "competent" and "not yet competent". for each attribute, a short list of behavioral markers is listed that indicates what is generally considered a demonstration of competence for entry-level paramedics. this is not an all-inclusive list, but serves to help the evaluator in making judgments. clearly there are behaviors that warrant a "not yet competent" evaluation that are not listed. any ratings of "not yet competent" require explanation in the space provided.
establishing a cut score to use in conjunction with the professional behavior evaluation instrument is important. a cut score can be established by judgment of the local programs community of interest. the question the community should ask is, "what percent score do we expect of graduates of our education program to achieve in the affective domain in order to demonstrate entry-level competency for an (first month, second semester, graduate, etc.) entry-level student?"
when the cut score judgment is made on acceptability or deviation of competent behavior for each characteristic a percent score can be achieved. for example, a student may have received 10 competent checks out of 11 (10 of 11 = 91%), or 5 of 7 (because 4 areas were not evaluated) for a score of 71%. this student may then continue to obtain scores of 91%, 91% 82%, etc and have a term grade of 86% in the affective domain. each student in the program would receive an average score. results of multiple evaluations throughout the program would indicate if the score set by the community of interest were too high or too low. when a number of evaluations had evolved adjustments in acceptable score would yield a standard for the community. this standard coupled with community of interest judgments based upon graduate student and employer survey feedbacks would identify additional validity evidence for the cut score each year. a valid cut score based upon years of investigation could then be used as a determining factor on future participation in the education program.
for all affective evaluations, the faculty member should focus on patterns of behavior, not isolated instances that fall outside the students normal performance. for example, a student who is consistently on time and prepared for class may have demonstrated competence in time management and should not be penalized for an isolated emergency that makes him late for one class. on the other hand, if the student is constantly late for class, they should be counseled and if the behavior continues, rated as "not yet competent" in time management. continued behavior may result in disciplinary action.
the second form, the professional behavior counseling form is used to clearly communicate to the student that their affective performance is unacceptable. this form should be used during counseling sessions in response to specific incidents (i.e. cheating, lying, falsification of documentation, disrespect/insubordination, etc.) or patterns of unacceptable behavior. as noted before, there is some behavior that is so egregious as to result in immediate disciplinary action or dismissal. in the case of such serious incidents, thorough documentation is needed to justify the disciplinary action. for less serious incidents, the professional behavior counseling form can serve as an important tracking mechanism to verify competence or patterns of uncorrected behavior.
on the professional behavior counseling form, the evaluator checks all of the areas that the infraction affects in the left hand column (most incidents affect more than one area) and documents the nature of the incident(s) in the right hand column. space is provided to document any follow-up. this should include specific expectations, clearly defined positive behavior, actions that will be taken if the behavior continues, and dates of future counseling sessions.
using a combination of these forms helps to enable the program to demonstrate that graduating students have demonstrated competence in the affective domain. this is achieved by having many independent evaluations, by different faculty members at different times, stating that the student was competent. these forms can also be used to help correct unacceptable behavior. finally, these forms enable programs to build a strong case for dismissing students following a repeated pattern of unacceptable behavior. having numerous, uncoberrated evaluations by faculty members documenting unacceptable behavior, and continuation of that behavior after remediation, is usually adequate grounds for dismissal.
professional behavior evaluation
students name: __________________________________________________________________________
date of evaluation: _________________________________________________________________________
1. integritycompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: consistent honesty; being able to be trusted with the property of others; can be trusted with confidential information; complete and accurate documentation of patient care and learning activities.2. empathycompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: showing compassion for others; responding appropriately to the emotional response of patients and family members; demonstrating respect for others; demonstrating a calm, compassionate, and helpful demeanor toward those in need; being supportive and reassuring to others.3. self - motivationcompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving for excellence in all aspects of patient care and professional activities; accepting constructive feedback in a positive manner; taking advantage of learning opportunities4. appearance and personal hygienecompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.5. self - confidencecompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: demonstrating the ability to trust personal judgement; demonstrating an awareness of strengths and limitations; exercises good personal judgement.6. communicationscompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: speaking clearly; writing legibly; listening actively; adjusting communication strategies to various situations7. time managementcompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: consistent punctuality; completing tasks and assignments on time.8. teamwork and diplomacycompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: placing the success of the team above self interest; not undermining the team; helping and supporting other team members; showing respect for all team members; remaining flexible and open to change; communicating with others to resolve problems.9. respectcompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the profession.10. patient advocacycompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: not allowing personal bias to or feelings to interfere with patient care; placing the needs of patients above self interest; protecting and respecting patient confidentiality and dignity.11. careful delivery of servicecompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.
use the space below to explain any "not yet competent" ratings. when possible, use specific behaviors, and corrective actions.
- faculty signatureprofessional behavior evaluation
students name: janet l.
date of evaluation: september 1998
1. integritycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: consistent honesty; being able to be trusted with the property of others; can be trusted with confidential information; complete and accurate documentation of patient care and learning activities.2. empathycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: showing compassion for others; responding appropriately to the emotional response of patients and family members; demonstrating respect for others; demonstrating a calm, compassionate, and helpful demeanor toward those in need; being supportive and reassuring to others.3. self - motivationcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving for excellence in all aspects of patient care and professional activities; accepting constructive feedback in a positive manner; taking advantage of learning opportunities4. appearance and personal hygienecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.5. self - confidencecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: demonstrating the ability to trust personal judgement; demonstrating an awareness of strengths and limitations; exercises good personal judgement.6. communicationscompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: speaking clearly; writing legibly; listening actively; adjusting communication strategies to various situations7. time managementcompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: consistent punctuality; completing tasks and assignments on time.8. teamwork and diplomacycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: placing the success of the team above self interest; not undermining the team; helping and supporting other team members; showing respect for all team members; remaining flexible and open to change; communicating with others to resolve problems.9. respectcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the profession.10. patient advocacycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: not allowing personal bias to or feelings to interfere with patient care; placing the needs of patients above self interest; protecting and respecting patient confidentiality and dignity.11. careful delivery of servicecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.use the space below to explain any "not yet competent" ratings. when possible, use specific behaviors, and corrective actions.
janets run reports, written case reports, and home work are illegible and
disorganized. she has numerous spelling and grammatical errors.janet repeatedly hands in assignments after due dates. she does not complete
clinical time in a organized, organized manner. she did not report for five
scheduled clinical shifts this semester and reported to medic 6 twice
when she was not scheduled. janet has not completed the required
clinical for this semester.
john brown- faculty signature
professional behavior evaluation
students name: steve r,
date of evaluation: november 1999
1. integritycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: consistent honesty; being able to be trusted with the property of others; can be trusted with confidential information; complete and accurate documentation of patient care and learning activities.2. empathycompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: showing compassion for others; responding appropriately to the emotional response of patients and family members; demonstrating respect for others; demonstrating a calm, compassionate, and helpful demeanor toward those in need; being supportive and reassuring to others.3. self - motivationcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving for excellence in all aspects of patient care and professional activities; accepting constructive feedback in a positive manner; taking advantage of learning opportunities4. appearance and personal hygienecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.5. self - confidencecompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: demonstrating the ability to trust personal judgement; demonstrating an awareness of strengths and limitations; exercises good personal judgement.6. communicationscompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: speaking clearly; writing legibly; listening actively; adjusting communication strategies to various situations7. time managementcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: consistent punctuality; completing tasks and assignments on time.8. teamwork and diplomacycompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: placing the success of the team above self interest; not undermining the team; helping and supporting other team members; showing respect for all team members; remaining flexible and open to change; communicating with others to resolve problems.9. respectcompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the profession.10. patient advocacycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: not allowing personal bias to or feelings to interfere with patient care; placing the needs of patients above self interest; protecting and respecting patient confidentiality and dignity.11. careful delivery of servicecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.use the space below to explain any "not yet competent" ratings. when possible, use specific behaviors, and corrective actions.
#2, 5, 6, 8, & 9 steve has demonstrated inappropriate classroom behavior bymonopolizing class time, answering questions intended for other students, and makingsarcastic remarks about other students answers. steve demonstrates a superioritycomplex over fellow classmates belittling and has repeatedly belittled their experience,while boasting and exaggerating about his field experience.
t. jones- faculty signature
professional behavior evaluation
student s name: steve r.
date of evaluation: december 1999
1. integritycompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: consistent honesty; being able to be trusted with the property of others; can be trusted with confidential information; complete and accurate documentation of patient care and learning activities.2. empathycompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: showing compassion for others; responding appropriately to the emotional response of patients and family members; demonstrating respect for others; demonstrating a calm, compassionate, and helpful demeanor toward those in need; being supportive and reassuring to others.3. self - motivationcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: taking initiative to complete assignments; taking initiative to improve and/or correct behavior; taking on and following through on tasks without constant supervision; showing enthusiasm for learning and improvement; consistently striving for excellence in all aspects of patient care and professional activities; accepting constructive feedback in a positive manner; taking advantage of learning opportunities4. appearance and personal hygienecompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: clothing and uniform is appropriate, neat, clean and well maintained; good personal hygiene and grooming.5. self - confidencecompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: demonstrating the ability to trust personal judgement; demonstrating an awareness of strengths and limitations; exercises good personal judgement.6. communicationscompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: speaking clearly; writing legibly; listening actively; adjusting communication strategies to various situations7. time managementcompetent []not yet competent [ ]examples of professional behavior include, but are not limited to: consistent punctuality; completing tasks and assignments on time.8. teamwork and diplomacycompetent [ ]not yet competent []examples of professional behavior include, but are not limited to: placing the success of the team above self interest; not undermining the team; helping and supporting other team members; showing respect for all team members; remaining flexible and open to change; communicating with others to resolve problems.9. respectcompetent [ ]]not yet competent []examples of professional behavior include, but are not limited to: being polite to others; not using derogatory or demeaning terms; behaving in a manner that brings credit to the profession.10. patient advocacycompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: not allowing personal bias to or feelings to interfere with patient care; placing the needs of patients above self interest; protecting and respecting patient confidentiality and dignity.11. careful delivery of servicecompetent [ ]not yet competent [ ]examples of professional behavior include, but are not limited to: mastering and refreshing skills; performing complete equipment checks; demonstrating careful and safe ambulance operations; following policies, procedures, and protocols; following orders.use the space below to explain any "not yet competent" ratings. when possible, use specific behaviors, and corrective actions.
#2 steve is constantly disrupting class with irrelevant questions. he is disrespectful
to guest instructors, classmates and the program.#5steve seems to have an impression that he is better than the others students because
he has more field experience. he is overconfident and overbearing.#6steve has not changed his communication skills despite verbal counseling.#8steves disruptions are destructive to the team environment by placing his needs
above those of the group.#9disruptions are disrespectful.
a. cox- faculty signature
professional behavior counseling record
students name:
date of counseling:
date of incident:
reason for counselingexplanation (use back of form if more space is needed):
integrity
empathy
self - motivation
appearance/personal hygiene
self - confidence
communications
time management
teamwork and diplomacy
respect
patient advocacy
careful delivery of service
follow-up (include specific expectations, clearly defined positive behavior, actions that will be taken if behavior continues, dates of future counseling sessions, etc.):
-faculty signaturei have read this notice and i understand it.
-student signature
-administrative or medical director review
professional behavior counseling record
students name: steve r.
date of counseling: december 14, 1998
date of incident: november and december 1999
reason for counselingexplanation (use back of form if more space is needed):
integritythis counseling session was in response to the two professionalempathybehavior evaluations file by instructors cox and jones.
self - motivationthey both indicated that steve has been disruptive in classes
appearance/personal hygiene(see attached)self - confidence
communications
time management
teamwork and diplomacy
respect
patient advocacy
careful delivery of service
follow-up (include specific expectations, clearly defined positive behavior, actions that will be taken if behavior continues, dates of future counseling sessions, etc.):
student was advised that his behavior is inappropriate and unacceptable. continuation of this behaviorwill result in dismissal from class. written warning from program director. instructors cox and jones to complete professional behavior evaluations bi-weekly throughoutnext semester
m. travis-faculty signaturei have read this notice and i understand it.
steve r.-student signaturedr. ohara-administrative or medical director review
professional behavior counseling record
students name: joe l.
date of counseling: february 23, 1999
date of incident: february 21, 1999
_reason for counselingexplanation (use back of form if more space is needed):
integrityjoe reported to a field rotation 16 minutes late, he was not wearing
empathy(nor did he have in his possession) a uniform belt and with
self - motivation"at least 2 days beard growth" according to field supervisor_appearance/personal hygienejohnson. when joe was approached regarding this situation
self - confidencehe became argumentative and told mr. johnson to
communications"...mind your own business." joe was asked to leave._time managementothers that witnessed this exchange were paramedics
teamwork and diplomacydavis and lawrence._respect
patient advocacy
careful delivery of service
follow-up (include specific expectations, clearly defined positive behavior, actions that will be taken if behavior continues, dates of future counseling sessions, etc.):
reviewed clinical policies and procedures manual section referring to personal appearance and hygiene,time management, and respect. i also reviewed the conduct at clinical rotations with joe. asked joe to write a letter of apology to field supervisor johnson, and paramedics davis and lawrence,which he agreed to do. i informed joe that any further display of disrespectful behavior will result in dismissal from the program.a continued pattern of poor time management and/or poor appearance/personal hygiene could also result in dismissal.
bill smith-faculty signaturei have read this notice and i understand it.
joe l.-student signaturedr. jones-administrative or medical director review
appendix vi: rubric affective domain tool
background
there are two primary purposes of an affective evaluation system: 1) to verify competence in the affective domain, and 2) to serve as a method to change behavior. although affective evaluation can be used to ultimately dismiss a student for unacceptable patterns of behavior that is not the primary purpose of these forms. it is also recognized that there is some behavior that is so serious (abuse of a patient, gross insubordination, illegal activity, reporting for duty under the influence of drugs or alcohol, etc) that it would result in immediate dismissal from the educational program.
the two forms included in the emt-paramedic: national standard curricula were developed by the joint review committee on educational programs for the emt-paramedic. these forms have been modified somewhat to meet the needs of the xx ems program. they represent extensive experience in the evaluation of students affective domain. the nature of this type of evaluation makes it impossible to achieve complete objectivity, but these forms attempt to decrease the subjectivity and document affective evaluations.
in attempting to change behavior it is necessary to identify, evaluate, and document the behavior that you want. the eleven affective characteristics that form the basis of this evaluation system refer to content in the roles and responsibilities of the paramedic unit of the curriculum. typically, this information is presented early in the course and serves to inform the students what type of behavior that is expected of them. it is important that the instructor is clear about these expectations.
for all affective evaluations, the faculty member should focus on patterns of behavior, not isolated instances that fall outside the students normal performance. for example, a student who is consistently on time and prepared for class may have demonstrated competence in time management and should not be penalized for an isolated emergency that makes him late for one class. on the other hand, if the student is constantly late for class, they should be counseled. continued behavior may result in disciplinary action.
the second form, the professional behavior counseling form is used to clearly communicate to the student that their affective performance is unacceptable. this form should be used during counseling sessions in response to specific incidents (i.e. cheating, lying, falsification of documentation, disrespect/insubordination, etc.) or patterns of unacceptable behavior. as noted before, there is some behavior that is so egregious as to result in immediate disciplinary action or dismissal. in the case of such serious incidents, thorough documentation is needed to justify the disciplinary action. for less serious incidents, the professional behavior counseling form can serve as an important tracking mechanism to verify competence or patterns of uncorrected behavior.
on the professional behavior counseling form, the evaluator checks all of the areas that the infraction affects in the left hand column (most incidents affect more than one area) and documents the nature of the incident(s) in the right hand column. space is provided to document any follow-up. this should include specific expectations, clearly defined expected positive behavior, actions that will be taken if the behavior continues, and dates of future counseling sessions.
using a combination of these forms helps to enable the program to demonstrate that graduating students have demonstrated competence in the affective domain. this is achieved by having many independent evaluations, by different faculty members at different times, stating that the student was competent. these forms can also be used to help correct unacceptable behavior. finally, these forms enable programs to build a strong case for dismissing students following a repeated pattern of unacceptable behavior. having numerous, uncorroborated evaluations by faculty members documenting unacceptable behavior, and continuation of that behavior after remediation, is usually adequate grounds for dismissal.
please rate the student according to your observations only. the categories identify professional behaviors described as desirable attributes of ems medical professionals. the descriptions within each category represent the behaviors generally expected for the individual.
each category will receive a score between 1 and 5. a score of 3 is considered average and represents the expected acceptable level of conduct for that category. if asked, you should be able to provide verification (as written or verbal proof as appropriate) for any score other than "3." if the individual you are evaluating is performing as an entry-level provider they should obtain scores of "3" in most categories.
student name: _____________________________________
affective domain evaluation: _________________________ date:_______________
integrity
your recommended score:
__________required attributes to obtain the recommended score1major infraction of 1 (or more) areas of #3 or many minor infractions in most areas of #3.2minor infractions of 1 area of #3 but otherwise compliant with all aspects described in #3.3consistent honesty, being able to be trusted with property and confidential information, complete and accurate documentation of patient care and learning activities.4consistent honesty, assists other classmates in understanding confidential issues and in developing their documentation skills.5always honest, leads by example and models exemplary behaviors regarding integrity. consistently turns in paperwork that is complete and accurate prior to due date.empathy
your recommended score:
__________required attributes to obtain the recommended score1being deliberately disrespectful of others, making fun of others, being condescending or sarcastic to others, clearly uncomfortable dealing with emotions of patients.2being uncompassionate to others or responding inappropriately to emotional responses because you are unconformable with their emotional displays. acting coolly towards patients in distress and not acting as a patient advocate.3showing compassion to others, responding appropriately to emotional responses by others, demonstrating respect to others, being supportive and reassuring.4able to show compassion and respond appropriately while maintaining professional demeanor, demonstrating a strong desire to advocate for the patient, can direct patients and their families to available community resources.5seeks out opportunities to serve in the community, when the situation arises can provide contact information on assistance agencies, has the ability to set troubled patients at ease and actively listens to their problems and concerns.
self-motivation
your recommended score:
__________required attributes to obtain the recommended score1consistently failing to meet established deadlines, unable to demonstrate intrinsic motivating factors requiring extra extrinsic motivation from instructors, failing to improve even after corrective feedback has been provided by faculty, requiring constant supervision to complete tasks or being asked to repeat a task that is incorrectly performed.2failing to meet 1-3 tasks as described in #3 but obviously making attempts to attain acceptable standards.3taking initiative to complete assignments, taking initiative to improve or correct behavior, taking on and following through on tasks without constant supervision, showing enthusiasm for learning and improvement, consistently striving for improvement in all aspects of patient care and professional activities, accepting constructive criticism in a positive manner, taking advantage of learning opportunities.4occasionally completing and turning in assignments before the scheduled deadline, volunteering for additional duties, consistently striving for excellence in all aspects of patient care and professional activities, seeking out a mentor or faculty member to provide constructive criticism, informing faculty of learning opportunities.5never missing a deadline and often completing assignments well ahead of deadlines, reminding other students of deadlines, supporting faculty in upholding the rules and regulations of the program, taking seriously opportunities to provide feedback to fellow students, seeking opportunities to obtain feedback, assisting faculty in arranging and coordinating activities.appearance and personal hygiene
your recommended score:
__________required attributes to obtain the recommended score1inappropriate uniform or clothing worn to class or clinical settings. poor hygiene or grooming.2appropriate clothing or uniform is selected for a majority of the time, but the uniform may be unkempt (wrinkled), mildly soiled, or in need of minor repairs, appropriate personal hygiene is common, but occasionally the individual is unkempt or disheveled.3clothing and uniform is appropriate, neat, clean and well-maintained, good personal hygiene and grooming.4clothing and uniform are above average. uniform is pressed and business casual is chosen when uniform is not worn. grooming and hygiene is good or above average.5uniform is always above average. non-uniform clothing is business-like. grooming and hygiene is impeccable. hair is worn in an appropriate manner for the environment and student is free of excessive jewelry. make-up and perfume or cologne usage is discrete and tasteful.
self-confidence
your recommended score:
__________required attributes to obtain the recommended score1does not trust personal judgment, is unaware of strengths or weaknesses, and frequently exercises poor personal judgment.2needs encouragement before not trusting personal judgment, is aware of strengths but does not readily recognize weaknesses, sometimes makes poor personal choices.3demonstrating the ability to trust personal judgment, demonstrating an awareness of strengths and limitations, exercises good personal judgment.4stands by his/her choices when challenged by an authority figure, aware of strengths and weaknesses and seeks to improve, exercises good personal judgment and often serves as a mentor for classmates.5stands by and can defend personal choices when challenged by an authority figure, actively seeks to improve on weaknesses, seeks out opportunities to assist other classmates in developing their self-confidence.communications
your recommended score:
__________required attributes to obtain the recommended score1unable to speak or write clearly and is unable to correct their behavior despite intervention by instructors, does not actively listen (requires instructions to be repeated or appears unable to follow directions,) resistant to learning new communications strategies.2needs work to speak or write clearly, knows how to actively listen although sometimes is unable to model good listening skills, able to identify alternative communication strategies needed in various situations but is still developing the skill to perform alternative strategies.3speaking clearly, writing legibly, listening actively, adjusting communications strategies to various situations.4working on improving speaking and writing abilities, models active listening skills, able to modify communication strategies easily in various situations and able to effectively communicate a message in these various settings.5working on self and assisting classmates in improving speaking and writing abilities, models and is able to demonstrate active listening techniques to other students, is comfortable utilizing a variety of communication styles, may have proficiency in another language, including sign language.time management
your recommended score:
__________required attributes to obtain the recommended score1often late to class or clinical sites, upon arrival needs additional time to be ready to begin (changing into uniform, gathering supplies, etc.), frequently late in turning in assignments, requires constant reminders about due dates and will blame others if a due date is missed.2occasionally late in arriving to class or clinical sites, occasionally late in turning in assignments or requires reminding about deadlines.3consistent punctuality, completing tasks and assignments on time.4seldom late to class or clinical, generally ready to begin class or clinical prior to the actual start time, completes tasks and assignments by due date (and occasionally in advance of due date) with minimal need for reminders of due dates.5punctual (or early) nearly 100% of the time, completes tasks and assignments prior to the due date, seldom requires reminding about deadlines or due dates, may assist instructor in reminding classmates about due dates.
teamwork and diplomacy
your recommended score:
__________required attributes to obtain the recommended score1manipulating the team or acting with disregard to the team, being disrespectful of team members, being resistant to change or refusing to cooperate in attempts to work out solutions.2sometimes acting for personal interest at the expense of the team, acting independent of the team or appearing non-supportive, being somewhat resistant to change or occasionally unwilling to work out a solution.3placing the success of the team above self interest, not undermining the team, helping and supporting other team members, showing respect for all team members, remaining flexible and open to change, communicating with others to resolve problems.4placing success of the team above self interest, supporting and holding up the team by shouldering additional responsibilities, actively seeking to include all members of the team in decision making processes were appropriate, welcoming change and remaining flexible, helping to open the lines of communication.5placing success of the team above self interest (even if that means a negative outcome to self,) taking a leadership role and using good management skills while leading, involving all appropriate team members in the decision making process, suggesting and implementing changes to benefit the team, seeking ways to keep communications and dialogue going.
respect
your recommended score:
__________required attributes to obtain the recommended score1disrespect of authority, being argumentative, using inappropriate words or outbursts of anger, deliberately undermining authority in words or actions or trying to provoke others, frequently unable to act in a professional manner.2being polite when required, occasionally overheard using demeaning or derogatory language but confining it to situations other than in patient care settings, occasionally acting unprofessional on the job.3being polite to others, not using derogatory or demeaning terms, behaving in a manner that brings credit to the profession.4being polite even when a situation is not going in his/her favor, always using respectful language when describing situations even when not in public areas, modeling good professional behaviors.5serving as a "peacemaker" in volatile situations, able to take abusive language or disrespect from patients without reacting negatively towards the individual, modeling good professional behaviors even when outside of the classroom or off of the job.
patient advocacy
your recommended score:
__________required attributes to obtain the recommended score1unable to deal with patients because of personal biases, actively demeaning or degrading patinets with words or deeds, unconcerned about patient rights, feelings or considerations, frequently takes shortcuts during care of patients because it is "easier" or "faster."2occasionally has difficulty dealing with patients because of personal bias or feelings, not always able to place the needs of the patient first,3not allowing personal bias or feelings to interfere with patient care, placing the needs of patients above self-interest, protecting and respecting patient confidentiality and dignity.4not allowing personal bias or feelings to interfere with patient care despite strong negative feelings or biases towards a patient or situation, actively advocating for patient rights, protecting confidentiality.5models patient advocacy and able to defend the need to advocate for patient rights, seeks out opportunities to help fellow classmates learn the principles of patient advocacy, when the opportunity presents itself can be called upon to follow through on an advocacy issue even if it means it on their off time.
careful delivery of services
your recommended score:
__________required attributes to obtain the recommended score1unable to perform skills at entry level or requiring constant monitoring or reinforcement to perform skills, required to recheck tasks because of omissions or inaccuracies in performance or documentation, unwilling to learn policies, procedures or protocols, deliberate unwillingness to follow the letter or spirit of rules or regulations.2occasionally performing skills below the entry-level, requiring monitoring to ensure completeness and accuracy in completing tasks, occasional minor breeches in policies, procedures or protocols attributed to lack of knowledge of it but willing to learn, may follow the letter of, but not always the spirit, of rules and regulations.3performing skills at an entry-level capacity a majority of the time, performing complete equipment and supply checks, demonstrating careful and safe ambulance operations, following policies and procedures and protocols, following orders.4can be trusted to function independent of all but minor supervision, does not need to be reminded to perform routine maintenance checks, follows the letter and spirit of all rules, regulations, policies and procedures.5functions independently and able to correct mistakes by self-reflection, able to assist in the development of rules, regulations, policies and procedures, will assist in monitoring fellow students in the completion of tasks and may be able to assist fellow students identify weaknesses and strengths.
general comments:
_______________________ _____________________
signature of person completing form date
________________________ _____________________
printed name title
________________________
student signature
student should sign form only if conference is held following evaluation. student agreement of ratings is not required for form to be completed and forms may be completed anonymously.
appendix vii: guidelines for activities and classroom exercises on ethical issues
activities and classroom exercises
sources of ethical issue material
internet sites
print based
current events
actual ems calls and scenarios
colleges and universities
ethical think tanks and centers
group discussion/debate
present a case or scenario of an ethical issue
divide the class into 6 groups and assign one of the theories just presented to a group for discussion
after 15-20 minutes have each group defend a particular ethical theory as it relates to a case or scenario you presented
case scenarios
provide several short case scenarios and ask students to do the following:
list decisions open to you in each scenario
state what decision you think is the right one
explain why you think your decision is the right one
explain what theory you are aligned with in making your decision
allow students 5-10 minutes to think about each scenario before comparing information with the class
role-playing
choose a case study and have volunteers role-play various sides of the issue to present "their side of the story"
the purpose of this is to help student gain perspective by attempting to learn another point of view
if you already have knowledge of students opinions on certain issues it may be helpful to have a student role-play an opinion that is diametrically opposed to their personal feeling and beliefs
debates
present a case and allow students some time to prepare their viewpoint on the issue.
conduct the session like a real debate and allow students to challenge and defend each others opinions
appendix viii: classroom arrangement strategies
traditional lecture
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theater style
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circle, square and rectangle open
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circle, square and rectangle closed
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partial with open area
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group work
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appendix ix: bloom's taxonomy of the domains of learning
figure 8-iii-a: bloom's taxonomy of the domains of learning by degrees of sophistication
cognitive domainpsychomotor domainaffective domainknowledgeimitationreceivingcomprehensionmanipulationrespondingapplicationprecisionvaluinganalysisarticulationorganizationsynthesisnaturalizationcharacterizationevaluation
figure 8-iii-b: bloom's taxonomy by level
levelcognitive domainpsychomotor domainaffective domainlevel 1: knowledge
(low level)knowledge
comprehensionimitation
manipulationreceiving
respondinglevel 2: application (intermediate level)applicationprecisionvaluinglevel 3: problem solving (high level)analysis
synthesis
evaluationarticulation
naturalizationorganization
characterization
appendix x: maslows hierarchy of needs
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appendix xi: lesson plan outline
audience description
pertinent needs assessment information and prerequisites
lesson goal(s)
cognitive objectives
psychomotor objectives
affective objectives
recommended list of equipment and supplies
recommended schedule
suggested motivation activity
content outline
appendix xii: unit #1 - pathophysiology and management of anaphylaxis
objectives
after this unit of study, the student should be able to:
1. describe the structures and functions associated with the immune system.
2. discuss antigens:
a. examples
b. four routes of introduction into the body.
3. explain the production of antibodies (the antigen/antibody reaction).
4. detail the physiology and pathophysiology of anaphylaxis.
5. explain the acid/base and electrolyte imbalances resulting from anaphylaxis.
6. discuss the effects of the pathological anaphylactic reaction on the following:
respiratory system
cardiovascular system
skin
central nervous system
gastrointestinal system
7. identify the two substances released by mast cells during anaphylaxis.
8. identify the signs and symptoms of a patient with pathological anaphylaxis as related to:
respiratory system
cardiovascular system
skin
central nervous system
gastrointestinal system
9. describe the assessment and history (including pertinent negatives) of the patient with anaphylactic shock.
10. identify the causes and treatments for anaphylaxis.
11. list the priorities of patient assessment and treatment for anaphylaxis.
12. complete a drug card and discuss the following aspects for epinephrine, benadryl, solu-medrol steroid, to include (*information for both pediatric and adult):
trade name
generic name
classification
actions
dosage and route(s)
indications
contraindications
precautions
side-effects
indications
toxic effects
define and explain the following terms:
anaphylaxis
antigen
antihistamine
bronchospasm
histamine
hives
immune system
mast cell
shock
steroid
urticaria
pathophysiology and management of anaphylaxis
lessontopic outlineassigned reading1review shock syndromeparamedic emergency carechapter 12,definition
parameters
aerobic metabolism
anaerobic metabolism
antigensparamedic emergency carechapter 25 (& other assigned readings)definition
examples
method of introduction2antibodiesphysiology for the health related professionschapter 3immune system
definition
productionanaphylaxisphysiology for the health related professionschapter 3pathophysiology
effects on systems
signs and symptoms
patient assessment
patient history
management3pharmacological agentsdrug cards and master fileoxygen
epinephrine
a) 1:1000
b) 1:10,000
diphenhydramine
4) aminophylline4skills practice
selecting medication
- epinephrine 1:1000 or 1:10,000
benadryl 25mgs or 50mgs
medication checklist
- right medication, right route, right patient, right dose, clarity, date, etc.
select site -
obtain informed consent -
administer medication - observe for action, reaction and side effects *note: these skills are taught in another course and are only to be practiced here
course schedule
emc 340
tuesdays & thursdays 09:15 - 11:30
spring 2000 dizney 234
(refer to complete syllabus for further details)
datelessontopicreading01/181anaphylaxis paramedic emergency care chapter 12 & 2501/202anaphylaxisparamedic emergency care chapter 12 & 2501/253anaphylaxisanaphylaxis paramedic emergency care chapter 12 & 2501/274anaphylaxis (skills)
appendix xiii: daily lesson plan - anaphylaxis unit (sample)
review shock syndrome
reason for lesson:
to review the basic pathophysiology of shock, hypoperfusion and hemodynamic instability
to review basic treatments for clinical conditions caused by shock, hypoperfusion and hemodynamic instability
points to be reviewed:
definition of shock, hypoperfusion and hemodynamic instability
clinical signs and symptoms that are the parameters for assessing / diagnosing shock, hypoperfusion and hemodynamic instability
describing the causes, methods of differential diagnosis and treatments for aerobic metabolism
describing the causes, methods of differential diagnosis and treatments for anaerobic metabolism
content and activities
contentactivities minutes00 - 20:00description of homeostasis, statistically normal vital signsstudents will be asked to explain the significance of each vital sign20:00 - 1:00:00
description of ph, aberrations of acid-base with metabolic and or respiratory etiologiesscenarios appropriate to either metabolic or respiratory acid-base problems will be presented, students will make differential diagnoses1:15:00 - 2:15:00descriptions of general treatments for acid-base with metabolic and or respiratory etiologiesafter correctly assessing the etiology of the acid-base problem, students will describe general treatments (e.g., fluid versus oxygen and airway control)2:25:00 - 3:00:00practical demonstration of medication selection, drug dose calculation and administration using manikins and orangessummarizing the above concepts:
evaluation: a simple quiz on the material covered above will be given. this quiz will include multiple choice and fill-in -the-blank items. each item will be associated with a scenario similar to the ones covered in class.
assignment: a set of 5 scenarios will be given for students to assess. these scenarios will include cases that acid-base problems that include both respiratory and metabolic components in each scenario.
appendix xiv: confined space rescue awareness (sample)
course description:
this course is designed to provide adequate education and training for personnel who have potential to be first responders to a confined space rescue incident. this course provides information on identification of confined spaces, common hazards associated with confined spaces, and operational limitations for the first responder.
course objectives
terminal objective:
to offer safe scene management and emergency operations during a confined space incident. this is designed to prevent injury or death to the rescue worker while operating within applicable laws and administrative policies.
enabling objectives:
upon completion of this course, the firefighter shall demonstrate the ability to:
related performance standards:
- nfpa 1001: 4-4.2 (1997 edition) - wac 296-305-05003 - wac 296-62-145, part m
course materials
suggested materials:
essentials of firefighting, ifsta 4th edition, chapter 7
applicable policies and procedures
video confined space rescue, first due rescue company; american safety video publishers
student handout confined space entry permit
confined space quiz and answer key
course overview
preparation
introduction/motivation15 minutesi. presentation
definitions/training levels
types of confined space
associated hazards
video-confined space rescue
roles and responsibilities
legal requirements
conclusion175 minutesii. application
discussion questions30 minutesiii. evaluation quiz (20 questions)20 minutes
i - preparation15 minutes1. introduction/motivation
introduce self, class, and any special concerns or conveniences.
cover course objectives. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image10.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image11.gif" \* mergeformatinet ii presentation90 minutesexplain:
1. define confined space and training levels
this tends to be a high risk / low frequency type of incident, however, with the area growth and vast amount of construction the potential for an incident is much greater.
technitian (40-60 hours training) - special skills and retrieval systems, patient evacuation, communications and command, familiarity with various types of confined spaces, monitoring-assessment-ventilation techniques. this is not you!!!
operation (several days training) - safe entry and rescue techniques, atmospheric monitoring, assess hazards and risks. this is not you!!!
awarness (few hours training) recognize, secure, and call for resources. this will be you!!! includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image12.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image13.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image14.gif" \* mergeformatinet
2. other key definitions
these are not the only definitions associated with confined space rescue, but are the critical ones you should know and understand. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image15.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image16.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image17.gif" \* mergeformatinet 3. types of confined space
trench / excavation: (be sure to cover trench in detail explaining to students that while considered by standards to be different from confined space techniques, awareness level roles and responsibilities remain the same.)
- all soils considered unstable for rescuers concern; after all, rescuers are most likely there because of a previous collapse
- trench defined as excavation deeper than it is wide
- > 4 depth requires shoring, >20 requires engineered shoring
- means of exit required w/in 25 of work area
- spoil pile must be >2 from excavation
- required shoring material is 6"x6" stock (rescue argues 4"x4"is acceptable).
vaults:
most common vaults in our area are underground utility and mechanical vaults.
manholes:
could be access to a vault but more common in our area to be access to sewer, water, and storm drain systems.
storage tanks:
above or below ground holding tanks for fuel, water, septic, or other.
building collapse:
being in an earthquake prone area and having older structures that have not been retrofitted, we have a good potential for structural collapse. explain how voids can be created within a fallen structure.
silos:
luckily we dont have many, if any at all, within our area. these are death traps with special considerations. used in grain and other such material storage.
caves or mines:
again, we dont have many to worry about. keep in mind atmospheric and collapse problems. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image18.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image19.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image20.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image21.gif" \* mergeformatinet hazards associated with confined space
atmospheric problems - this is the greatest reason for concern in most confined space situations and account for 60% of confined space deaths. in confined spaces, many gasses linger and present an idlh condition both in the form of inhalation dangers as well as flammable / combustible (lel) dangers. many of these gasses, which displace the oxygen, are colorless, odorless, tasteless, and deadly. discuss briefly some of the effects of gasses that may be present in a confined space such as co, co2, methane, and hydrogen sulfide.
fall hazards - most confined space configurations are below ground or elevated and are accessed by steep ladders. these ladders are usually slippery and are made with small foot surfaces (i.e. steps in a manhole)
electrical or mechanical hazards - vaults that store these items will create an extra hazard inside a confined space. if possible secure power to reduce risk.
engulfment danger - this is a special consideration in confined space where the area can be immediately filled or flooded with gas, liquid, or fire with little or no warning.
collapse potential - in trench rescue or building collapse scenarios where scene is already unstable (thus the reason for rescue), expect further deterioration of the area.
equipment limitations - bunker gear while being good heat protection is poor protection from chemical and/or corrosive agents. scbas are limited in confined space because of their bulkiness. need proper tools and equipment to ensure safe operation, including fall protection, which we may not have.
improper training / manpower - rescuers do not plan to die when trying to help those in need. these are good people with good intentions that lack understanding of the situation. they are unable to recognize all hazards and lack knowledge on potential risks. confined space emergencies are very labor intensive; make sure you have ample manpower. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image22.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image23.gif" \* mergeformatinet ii presentation, video
show video confined space rescue25 minutesii presentation, continued60 minutes5. roles and responsibilities of the first responder
ims
for a successful operation, it is imperative that command structure is developed early. start ims to handle the worst and downgrade as necessary for it is easier to reduce command structure than to expand it after operations begin.
evaluate
figure out if there is a confined space emergency to begin with, determine the number of patients (if any), and determine if it is rescue vs. recovery.
hazards
identify if any hazards are present, to what extent, and special considerations because of hazards. is there any type of contamination present or possible (hazmat)? if so, figure type, extent, and problems it may create like where contaminants are going.
handout
points / persons of interest
if possible, identify job foreman or someone else involved in incident prior to emergency and do not let this person go. they are a valuable source of information. identify msds, existing ventilation systems, points of entry, and if there is an entry permit. fire department can use their entry permit if available. if not, department can produce their own. in any case, one must be present before entry is made.
shut down / lock out
when performing shut down, be careful that it wont shut down or disable essential systems such as ventilation equipment.
ventilation
begin ventilation procedures if possible, the earlier the better. do not ventilate with pure o2.
secure / reduce hazards
establish hot, warm, and cold zones and stay out. restrict access by everyone, evacuate necessary areas, and shut off, move, or stabilize equipment around site. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image24.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image25.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image26.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image27.gif" \* mergeformatinet ii presentation, continued20 minutes6. legal requirements
these are in accordance with nfpa 1001 and wac 296 includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image28.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image29.gif" \* mergeformatinet iii application20 minutes1. review / recap
restate in summary the course objectives to confirm student understanding. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image30.gif" \* mergeformatinet discuss
2. suggested discussion questions
lead d a guided discussion based on the following photographs:
1. type = vault, manhole, tank; hazards = idlh atmosphere, fall, engulfment, mechanical; actions = identify, set up command, isolate.
2. type = trench; hazards = idlh atmosphere, fall, collapse; actions = identify, set up command, isolate.
3. type = well, manhole; hazards = idlh atmosphere, fall, engulfment; actions = identify, set up command, isolate. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image31.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image32.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image33.gif" \* mergeformatinet iii application, continuedlead a guided discussion based on safety systems in the following photographs:
1. ventilation, equipment, training levels.
2. shoring, equipment, training levels. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image34.gif" \* mergeformatinet
includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image35.gif" \* mergeformatinet 4. conclusion
if you leave this class with anything, the most important thing to remember is, first responders must not enter confined spaces!!! even if there are victims that may be rescued. includepicture "http://www.nhtsa.dot.gov/people/injury/ems/instructor/instructor_ems/image36.gif" \* mergeformatinet iii. evaluation20 minutes1. performance evaluation
have each student complete quiz.
appendix xv: use of safety gear inside a fire scene (sample)
instructor pre-planning:
lesson objective: by the end of this lesson, the student will be able to discuss at least four concepts involving safety inside a burning building, using case studies and role-play.
task analysis: concepts to be introduced include cal-osha mandates, exiting the fire scene when the vibra-alert sounds, activation of pass alarm prior to entering the building, and proper fastening of safety gear.
the lesson plan
warm up/ review: distribute roles for students to act out during the discussion. once students are ready to play their "part", introduce the safety lesson by preparing the participants for watching a video described below.
presentation or demonstration: play the video that presents the case studies of the two firefighters who were seriously injured during a fire.
student practice: after the video is completed, lead a whole group discussion about safety issues that were encountered by the firefighters. allow pros and cons to develop, but ensure that ultimately the message of mandatory safety practices is brought out.
evaluation/closure: to conclude this session, ask each participant of the discussion to answer a summary question based upon the task analysis. questions to be presented include:
who mandates our use of safety equipment during the fire scene?
when should one begin exiting the fire scene, in order to avoid potential problems with the scba equipment?
why should the pass alarm be activated prior to entering the fire scene?
how should the outer firefighter safety clothing be worn during the fire scene?
appendix xvi: ems student handbook sample
emergency medical technician - basic
training program
table of contents
1. mission statement 3
2. introduction 4
3. general information 5
4. program responsibilities 7
5. course schedule 10
6. chapter objectives 13
7. manipulative skills 22
8. appendix 52
mission statement
(place here)
the mission of the fire department is to:
protect the lives and property of the people of our area from fires, natural disasters, and hazardous materials incidents;
save lives by providing emergency medical services;
prevent fires through prevention and education programs; and,
provide a work environment that values cultural diversity and is free of harassment and discrimination.
introduction
welcome to the ems academy emt-basic training program. on july 1, 1997 the fire department assumed the role as the primary ems provider in this city and county. the ems division was created to:
receive all 911 requests for emergency medical service;
initiate appropriate response of personnel and response;
treat and stabilize prehospital emergencies;
alleviate pain and suffering of the sick and injured; and,
transport the ill and wounded in a safe and expeditious manner to the appropriate medical facility.
when you complete this program, you will join the 70% of the fire department uniform rank that make up the cornerstone of the ems division - the emergency medical technician - basic. of all of the calls for service the fire department handles annually, nearly 80% of them are for medical assistance. the emt-b will respond to a large proportion of these calls, will provide the bulk of the initial field care, and will assist the emt-paramedic in providing further medical intervention.
as the ems system evolves it will be likely that the role of the emt will expand in both scope and responsibility. therefore it is imperative that you become proficient in your skills and practice of prehospital medicine. the ems academy staff will support you in your education and practice; however they will not carry you! you must embrace this course as you would with all other courses at the fire college. this is an intensive course, and you must avoid falling behind. please read through these first few pages to determine what will be expected of you.
finally, recognize that being an emt-b fits in with the role of being a firefighter: this program will help prepare you for a rewarding, life long profession of providing protection and service to our citizens and visitors.
general information
location
the ems academy emt-basic program is (insert location here.)
hours
the emt-basic program will generally meet on mondays, beginning may 18, 1998. the hours of the program will be from 0800 to 1730 hours. a mandatory cpr class will be held on thursday may 14.
lunch will be from 1230 to 1310 hours, unless scheduling mandates a change.
in general the classrooms and labs are open monday through friday, from 0730 to 1700 hours. office hours for instructors will be listed.
daily schedule
the daily schedule will generally follow this format:
0700 - 0800 remediation (makeup period for quizzes, skills)
0800 - 0830 quiz
0845 - 0900 pretest
0900 - 1230 lectures
1230 - 1310 lunch
1310 - 1700 skills lab
1700 - 1730 house chores
the program schedule may be found beginning on page 14. this schedule lists the reading assignments and exam schedule for the program.
parking
you may park in the lot near the log cabin, found near the building. the us parks police department has asked everyone to not park in the front or side of their building.
attendance
this is a very intensive course, with large amounts of information and practice scheduled for each session. it is required by the state that each emt-b student must attend 110 hours of instruction. therefore it is imperative that you are punctual. class will begin on time; if you arrive more than 1 minute late you will marked as "tardy" for that day. if you arrive more than 30 minutes late you will be marked "absent without leave - awol". you may not miss more than two (2) classes during the didactic (classroom) phase. being marked absent from more than 2 sessions will result in being dropped from the program. you may not miss any sessions during the ride-a-long phase.
if you know that you will miss a class for the rare unforeseen emergency, i.e., "rules for recruit members #18 - injuries", you must contact the primary instructor prior to that class. all hours missed will need to be made up in the form of essays on the information presented that day. the test or exam must be made up during the remedial hour of the following week.
smoking
smoking is prohibited in the building.
chemical substance use
if you are seen or suspected of drinking alcohol or using illicit drugs during program hours, you will be immediately suspended from the program, pending investigation. you will be reported to the dot captain in charge of probationary training. refer to the department policy and procedure manual for further information.
discrimination
it is the policy of the ems academy to provide equal opportunity for training and education regardless of race, gender, sexual orientation, religion, age or ethnicity.
rules for recruit members
other division of training rules for recruit members will apply during the emt-basic training program.
staff and contact numbers
(your program contact information would be inserted here.)
program responsibilities
performance standards
tests - you must score 75% or better on each test to complete the program. you will be able to remediate tests or exams as necessary. remediation will be in the form of 1) a review session that identifies your weaknesses, and 2) a remediation test. each remediation must occur within one (1) week of the original test. the remediation test or exam may not be presented in the same format as the original test.
exams - you must score 75% or better on the midterm and final exam. the remediation policy is as listed above.
if you do not achieve a 75% or better on the remediation quiz or exam, you will be recommended for termination through the chief of the department.
you may also be recommended for termination if after three (3) original (not remediation) consecutive weekly tests, a score of 100% on the next quiz would be insufficient to attain a 75% average.
skills - you must score a 75% or better on every manipulative skill. if you fail to attain a passing grade on a given skill, you will be scheduled for re-evaluation. if, after two re-evaluations, you fail to attain a passing grade, you will be recommended for termination through the chief of the department.
you will accrue emt deficiency points for skill scores below 75%. the schedule is similar to the fire college schedule:
74% - 72% one (1) emt deficiency point
71% - 68% two (2) emt deficiency points
67% - 64% three (3) emt deficiency points
63% - 60% four (4) emt deficiency points
59% - below five (5) emt deficiency points
emt deficiency points are cumulative throughout the recruit training period. you will be sent to the deputy chief of administration for a conference when you accumulate a total of ten (10) emt deficiency points in any combination derived from substandard performance in manipulative skills. if you accrue a total of fifteen (15) emt deficiency points or more, you will be recommended for termination through the chief of the department.
whenever an emt deficiency point is assigned for substandard performance, a conference with the supervising captains will be scheduled.
textbook
the program will be using the eighth edition of emergency care, by brady publishing. the department will issue books before class begins. you are encouraged to purchase the book for your own reference. if you do not purchase the book, you must keep it in a neat and presentable condition. the textbook shall be returned to the program upon completion of the course.
ambulance ridealong
you will be required to attend one (1) ambulance ridealongs during the program. during the ridealong you will expected to participate in direct patient care activities. you will also be required to document at least two patient contacts per ridealong. these contacts will be documented on the clinical report forms, which may be found in the appendix of this handbook.
the paramedic will review your activities during the ridealong, and document his/ her comments on the student evaluation form. your hours of contact time must also be documented, on the verification form. this is also found in the appendix.
emergency department rotation
currently the program is not mandating observation time in the emergency department setting. however, if you would like to spend time in this setting, you may do so after completing the required immunizations and release forms. please contact the program staff if you are interested.
dress code
you are expected to wear your probationary firefighter uniform during the didactic phase of the program; however you are permitted to wear your pt clothing during class. during the ride-a-long phase you will wear blue pants, a white shirt, and dark shoes.
professional conduct
it is the intent of all instructors to provide you with an environment that is conducive to learning. conduct disrupting the classroom, or showing lack of respect for staff, guests, or other students will not be tolerated, and shall reported to the dot captain in charge of probationary training.
building maintenance
you are expected to clean the classrooms and common areas of the building at the end of each class. house chores will be done between 1700 - 1730 hours.
successful completion criteria
upon successful completion of this program, you will be eligible for the emt-b certification process as provided by the county ems agency. successful completion include all of the following:
attending all sessions of the program, or makeup of hours as assigned.
completing all assigned homework.
achieving a score of 75% or better over a three weekly test average.
achieving a score of 75% or better on the midterm and final exams.
achieving a score of 75% or better on all skill exams.
you will be issued a course completion certificate that will permit you to apply for emt certification in (insert your city/state information here.)
emergency medical technician - basic
training program
section 5: course schedule
97th class course schedule
week and datepretest will coverexam will coverreading preparationmaterials presentedskill(s) lab1: may 14, 1998
bls healthcare provider
bls healthcare provideraha bls text
brady pp. 797 - 823
introduction to course
cpr
cpr2: may 18
week 2 reading
nonechapters 1, 2, 3, 14, 15
appendix b: stress in ems
medical terms pp. 842 - 849
introduction to ems
well being of the emt
ethical/legal issues
communications
documentation
documentation
scenarios3: may 28
week 3 reading
week 2chapters 4, 5, 7,8, 9
pp. 826 - 837anatomy & physiology
vital signs and history
scene size-up
intro assessmentvital signs
lifting/moving
scene assess
initial assessment4: june 1
week 4 reading
week 3chapters 10, 11, 12, 13assessment - trauma
assessment - medical
assess.- pedi + geriatric
assessments5: june 8
week 5 reading
week 4chapter 6airway a&p
airway and ventilation
adjuncts and oxygen
intro advanced airway
basic airway
review assess.6a: june 15
week 6a reading
week 5chapters 25, 26
trauma a& p
bleeding and shock
soft tissue injuries
bleeding control
shock mgt.6b: june 18
week 6b reading
week 6achapters 27, 28
musculoskeletal care
head and spinal injuries
c/spine supine
c/spine seated
splinting
week and datepretest will coverexam will coverreading preparationmaterials presentedskill(s) lab7: june 22
week 7 reading
week 6breview 25 -28
major systems trauma
review for midterm
skills review
assessment review8: june 29
none
midterm 1-6b
none
skills examination
9: july 6
week 9 reading
week 7bchapter 16, 17general pharmacology
respiratory a&p
respiratory emergencies
respiratory
scenarios10: july 13
week 10 reading
week 9chapter 18
cardiac a&p
cardiac emergencies
cardiac
scenarios11: july 20
week 11 reading
week 10chapters 19, 20, 21
diabetic a&p
diabetic emergencies
allergies and poisoningsdiabetic/
allergies/
poisoning
scenarios12a: july 27
week 12a reading
week 11chapters 22, 23
environmental
behavioral
environmental/
behavioral12b: july 31
week 12b reading
week 12achapter 24
ob/gyn
ob/gyn
scenarios13: august 3
week 14 reading
week 12bchapter 29
pediatric emergencies
peds scenarios14: august 10
week 15 reading
week 13chapters 30, 31, 32ambulance operations
gaining access
overviews (mci, hazmat)
review for final
mci drill
review15: august 17
none
final 1 -14review 1 -32
all
skills exam
emergency medical technician - basic
training program
section 6: chapter objectives
chapter 1: introduction to emergency medical care
describe the brief history of ems development
be able to explain the various components of the ems system.
describe the role and function of the emergency medical technician - basic.
describe the responsibilities related to personal safety.
describe the process of quality improvement.
define the role of medical direction and medical control.
chapter 2: the well-being of the emt - basic
understand the reactions and changes that the emt-basic may feel when faced with stress.
describe the different stages people may go through when dealing with death and dying.
explain how the emt might recognize and deal with stress from within as well as from outside factors.
explain the importance of establishing scene safety.
describe the concept of body substance isolation.
describe the steps an emt should take for personal protection from airborne and bloodborne pathogens.
chapter 3: medical/legal and ethical issues
define and explain the following legal concepts: scope of practice, duty to act, negligence, and abandonment.
define and describe the following legal concepts: various forms of consent, refusal of medical care, role of minors, do not resuscitate orders.
describe the difference between assault and battery, and their implications to the emt.
explain the importance of maintaining patient confidentiality.
describe the steps an emt should take when protecting a crime scene.
explain when an emt is required to make notifications to law enforcement or other agencies.
chapter 4: the human body
identify various topographic terms.
describe the difference between anatomy and physiology.
describe the anatomy and physiology of the major body systems.
chapter 5: lifting and moving patients
explain why knowledge of body mechanics protects the emt.
describe the safety precautions and guidelines as applied to lifting and moving techniques.
explain when an emergency move of a patient may be necessary.
explain the uses of various patient-carrying devices.
chapter 6: airway management
describe the general anatomy of the respiratory system.
describe the patient with the signs of respiratory distress.
explain why aggressive airway management affects the survivability of the patient.
explain why a mechanism of injury may affect the opening of an airway.
describe the performance of a head tilt, chin lift.
describe the performance of a jaw thrust.
explain why suction is important in maintaining patency of an airway.
describe the function of artificial ventilation.
explain the various techniques of providing artificial ventilation.
describe the importance and use of airway adjuncts.
define the components of an oxygen delivery system.
explain why increased concentrations of oxygen affect the survivability of the critical patient.
contrast and compare the uses of the nasal cannula and nonrebreather mask.
chapter 7: scene size-up
describe the various hazards an emt might encounter at a scene.
explain how an emt might survey the scene in a consistent manner.
describe common mechanisms of injury.
explain the importance of identifying the number of patients encountered.
explain the reason for identifying the need for additional resources.
chapter 8: the initial assessment
explain the importance of establishing an early general impression of the patients condition.
describe the steps in the initial or primary assessment.
explain how the emt would establish an early impression of the patient, based upon the findings of the initial assessment.
explain how the emt would identify and correct problems encountered in the initial assessment.
explain how an emt would prioritize a patient for transport, based upon findings from the initial assessment.
chapter 9: baseline vital signs and sample history
explain the importance of establishing baseline vital signs.
describe how the various vital signs are ascertained and recorded: pulse, breathing, skin signs, pupillary reaction, and blood pressure.
explain what blood pressure measures, and the meaning of systole and diastole.
explain what sample is, and how it pertains to gathering history.
describe the difference between a sign and a symptom.
explain the importance of reassessing vital signs on a regular basis.
chapter 10: the focused history and physical exam: trauma
chapter 11: the focused history and physical exam: medical
compare and contrast the trauma and medical based focused history and examination approaches.
explain why differences exist between trauma and medical histories.
explain why differences exist between trauma and medical focused exams.
explain why mechanism of injury is important to the assessment of the trauma patient.
describe the steps necessary to complete a rapid trauma exam.
identify the components of the detailed physical exam.
explain the importance of the detailed physical exam in relationship to the focused assessment.
describe the differences between the trauma and medical patient in the context of the detailed physical exam.
describe how a medical history and assessment may be conducted on the unresponsive patient.
explain the sample history pneumonic.
explain why knowledge of past medical history affects the medical assessment and history taking.
chapter 12: ongoing assessment
discuss the reasons why assessments should be repeated during patient contact.
identify and discuss the components of the ongoing assessment.
chapter 13: pediatric, adolescent, and geriatric assessment
identify the developmental considerations for the following age groups: infants, toddlers, preschoolers, school age, and adolescents.
describe differences in anatomy and physiology of the infant, child, and adult patients.
differentiate the response of the ill or injured infant or child (age specific) from that of an adult.
chapter 14: communications
identify the order of patient information during a radio call.
discuss the legal implications during communications.
discuss the communication skills that are used between the emt and patient, family, bystanders, and other health care providers.
chapter 15: documentation
identify the components of the written report.
describe how patient information should be entered into the medical record.
explain the legal aspects of accurate documentation of the patient record.
chapter 16: general pharmacology
identify the medications that emts are able to deliver in the prehospital field.
identify the prescribed medications that the emt may be able to assist the patient in administration.
describe the "four rights" of drug administration.
identify methods of drug administration.
describe the six most common categories of medication.
chapter 17: respiratory emergencies
describe the basic anatomy of the respiratory system.
discuss the physiology of breathing.
identify the signs and symptoms of respiratory distress.
identify signs of inadequate gas exchange.
discuss the difference between ventilation and oxygenation.
describe the patient with copd.
describe the patient with asthma.
describe the management of the patient in respiratory distress.
chapter 18: cardiac emergencies
describe the basic anatomy of the cardiac system.
discuss the physiology of the cardiovascular system.
describe the pathophysiology of cad, angina, ami, and chf.
describe the patient experiencing cardiac compromise.
describe the management of the patient in cardiac distress.
explain the concept of the "chain of survival".
explain the importance of aggressive airway management and oxygenation in the cardiac arrest patient.
explain the importance of early defibrillation in the cardiac arrest patient.
describe the management of the patient in cardiac arrest.
discuss the importance of solid interaction and coordination between ems providers during a cardiac arrest.
chapter 19: diabetic emergencies and altered mental status
describe the basic components of the endocrine system.
describe the pathophysiology of diabetes mellitus.
identify the patient experiencing a diabetic emergency.
describe the differences between diabetic coma and insulin shock.
describe the management of the diabetic patient.
describe the components of aeioutips.
chapter 20: allergies
describe the basic anatomy of the immune system.
describe the pathophysiology of an allergic reaction.
identify the patient with anaphylaxis.
describe the management of an allergic reaction.
chapter 21: poisoning and overdose emergencies
describe how poisons enter the body.
identify the patient experiencing an overdose or poisoning.
describe the management of the poisoned or overdosed patient.
discuss the issues associated with substance and alcohol abuse.
chapter 22: environmental emergencies
explain the physiology of heat generation.
describe the pathophysiology of excessive heat gain and loss.
describe the patient with hyperthermia.
describe the management of the hyperthermic patient.
describe the patient with hypothermia.
describe the management of the hypothermic patient.
describe the management of the patient with a localized cold injury.
discuss the management of the near-drowning patient.
discuss the management of the patient experiencing a scuba emergency.
discuss the management of the patient with bites and stings.
chapter 23: behavioral emergencies
define the behavioral emergency.
explain the physiological factors for behavioral emergencies.
discuss the management of the patient experiencing an emotional or psychiatric emergency.
discuss the special considerations associated with the suicidal patient.
identify the patient displaying aggressive or hostile behavior.
describe the management of the aggressive or hostile patient.
chapter 24: obstetrics and gynecology
identify the basic anatomy of the obstetrical patient.
discuss the differences between the pregnant and non-pregnant patient.
describe the stages of labor.
describe the management of normal childbirth.
describe the assessment and management of the newborn.
describe the assessment and management of the mother.
identify the childbirth complications.
describe the assessment of the complicated childbirth.
identify predelivery emergencies.
describe the management of the predelivery emergency.
discuss the considerations associated with sexual assault.
chapters 25: bleeding and shock
describe the condition of shock.
identify the stages of shock.
identify the types of shock.
identify the differences between venous and arterial bleeding.
identify the differences between internal and external bleeding.
describe the management of the patient in shock.
describe the management of the bleeding patient.
chapter 26: soft tissue injuries
identify the anatomy of the skin and soft tissue.
identify the major functions of the skin.
describe the differences between closed and open wounds.
describe the different types of open wounds.
describe the management of the patient with blunt and penetrating trauma.
identify the steps in the management of an open neck wound.
identify the steps in the management of the open chest wound.
identify the steps in the management of the abdominal injury.
identify the types of burns.
describe the classification of burns.
identify the steps in the management of burns.
describe the management of electrical injuries.
describe the general principles of bandaging and dressing.
describe the patient with pneumothorax, tension pneumothorax, traumatic asphyxia, hemothorax, and cardiac tamponade.
chapter 27: musculoskeletal injuries
identify the anatomy of the muscular and skeletal system.
describe the mechanisms of injury associated with musculoskeletal injuries.
describe the general principles of splinting.
describe the considerations associated with a midshaft femur fracture.
describe the management of the patient with a musculoskeletal injury.
chapter 28: injuries to the spine and head
identify the anatomy of the nervous system.
identify the anatomy of the brain, skull and spine.
describe the mechanisms of injury associated with injuries to the head, neck and spine.
describe the patient with a brain injury.
describe the patient with a spinal injury.
describe the management of a patient with a head or spinal injury.
chapter 29: infants and children
define the pediatric patient.
describe the developmental characteristics of infants and children.
discuss the differences between pediatric and adult patients.
describe the general approach and management principles with pediatric patients.
discuss the broad categories of pediatric emergencies.
describe the considerations of pediatric patients and trauma.
describe the considerations of pediatric patients and abuse.
describe the considerations of sids.
identify the pediatric patient with croup and epiglottitis.
chapter 30: ambulance operations
identify the phases of an ambulance call.
discuss the operations of an emergency vehicle in the context of motor vehicle law.
identify basic equipment that should available in an ambulance.
describe the methods used to clean and disinfect an ambulance and its equipment.
explain the rationale for having an ambulance and its equipment for each response.
chapter 31: gaining access
describe the purpose of extrication.
identify personal safety equipment for emergency personnel during extrication.
identify personal safety equipment for the patient during extrication.
explain the importance of training for extrication.
chapter 32: special operations
describe the general management principles of a hazardous materials event.
describe the general management principles of a multi-casualty incident.
discuss the concept of triage.
describe the incident command system and the role of the emt.
emergency medical technician - basic
training program
section 7: manipulative skills
manipulative skill: airway management
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a patients airway using the appropriate equipment.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 5oxygen administration251. "cracks" full oxygen tank to clear valve outlet22. attaches regulator to oxygen tank.
ensures o-ring is in place
tightens regulator to tank securely with hand only
determines that regulator is in "off" position43. opens main valve at least 1 turn
checks pressure on regulator
checks for leaks34. attaches oxygen adjuncts5nasal cannula - places prongs in nose, tightens tubing around ears nonrebreather mask - fills reservoir with oxygen, securely fits mask seal around mouth and nose 5. administers oxygen to patient5nasal cannula - 4 - 6 liters per minute flownrb mask - 10 - 15 lpm, allowing the reservoir to drain and fill with each respiration 6. reassess ventilatory status37. turns off regulator and drains pressure from system3bag valve mask201. opens airway with head tilt - chin lift or modified jaw thrust52. selects and inserts appropriate airway adjunct23. creates tight seal between mask and face34. ventilates patient by squeezing bag completely and steadily
observes for chest rise and fall
checks for gastric distention
checks for leaks35. hyperventilates patient with room air26. attaches bvm to oxygen tank27. sets regulator flow to at least 15 lpm28. ventilates patient at appropriate rate1oral pharyngeal airway151. opens airway with head tilt - chin lift or modified jaw thrust52. determines correct size of opa
measured from tip of earlobe to corner of mouth43. inserts opa correctly
inserts with tip toward roof of mouth until it passes apex
of tongue, then rotates airway 180 degrees44. reassesses ventilatory status2nasal pharyngeal airway151. opens airway with head tilt - chin lift or modified jaw thrust52. determines correct size of npa
measured from tip of earlobe to tip of nose23. lubricates npa with water soluble lubricant24. inserts npa into right nares first, pushing straight down45. reassesses ventilatory status2flexible (soft) suction catheter101. prepares suctioning equipment
connects catheter and tubing to suction machine22. tests suction for vacuum13. determines depth of catheter insertion
nose - tip of earlobe to tip of ear
mouth - tip of earlobe to corner of mouth14. inserts catheter to measured depth15. creates vacuum26. suctions while withdrawing catheter, maximum 10 seconds27. reassesses ventilatory status1
rigid (hard) suction catheter101. prepares suctioning equipment
connects catheter and tubing to suction machine22. tests suction for vacuum13. determines depth of catheter insertion
mouth - tip of earlobe to corner of mouth14. inserts catheter to measured depth15. creates vacuum26. suctions while withdrawing catheter, maximum 10 seconds27. reassesses ventilatory status1total points100comments:
manipulative skill: controlling profuse bleeding
objective: at the end of this skill, you will have demonstrated that you are able to effectively control profuse bleeding utilizing direct pressure, elevation, and pressure points. you will also be able to verbalize that the use of the tourniquet is a last resort measure to control a severe bleed.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. applies direct pressure to site of bleeding
a) uses sterile dressings
b) bandages securely with roller gauze or tape153. if bleeding continues, applies more dressings without removing original bandaging 154. if bleeding continues, elevates affected extremity while maintaining direct pressure. 155. if bleeding still continues, applies enough pressure to pressure points to stop bleeding
a) femoral or brachial artery sites
b) use of the heel of hand or fingers 156. as a last resort, applies tourniquet to stop bleeding
a) placed just above wound site
b) wide band
c) tighten band with lever until bleeding stops
d) note time when tourniquet applied107. applies high flow oxygen to the patient108. places patient in modified trendelenburg position, if possible10total100
comments:
manipulative skill: cardiac arrest
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a cardiac arrest with two other assistants. you will be able to competently demonstrate the operation of a department semiautomatic defibrillator.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. performs initial assessment of patients airway and breathing153. instructs assistant #1 to ventilate patient 2 times with bvm 154. assesses patients circulation. 155. begins chest compressions, with 5:1 ratio
a) assistant #1 inserts opa
b) supplies bvm to 100% oxygen 156. instructs assistant #2 to apply defib pads to patients chest
a) assistant #2 places pads "to sandwich the heart" - posterior chest wall below left scapula, anterior chest wall below left nipple
b) attaches cables to pads
c) turns defib on
d) advises other crew members to stop bvm and compressions
e) depresses "analyze" function107. crew waits for "analyze" function to complete
a) if "no shock indicated", emt assesses for carotid pulse
(-) pulse, (-) breathing: crew continues cpr for one minute, proceed to
step 8
(+) pulse, (-) breathing: assistant #1 continues bvm, assistant #2
attempts blood pressure, emt attempts sample history, proceed to
step 8
(+) pulse, (+) breathing: assistant #1 assesses adequacy of
breathing, assistant #2 attempts blood pressure, emt attempts
sample, proceed to step 8
b) if "shock indicated"
assistant #2 assesses for crew safety
depresses "shock" function
if condition 7(b) exists, delivers 2nd shock when prompted
if condition 7(b) exists, delivers 3rd shock when prompted
emt assesses for carotid pulse, crew proceeds to 7(a)108. assistant #2 depresses "analyze" function
a) if "no shock indicated", repeat step 7(a)
b) if "shock indicated", assistant #2 repeats 7(b)109. no further shocks are delivered, unless stacked shocks are interruptedtotal100comments:
manipulative skill: application of ekg leads
objective: at the end of this skill, you will have demonstrated that you are able to assist the emt-paramedic in attaching the patient to ekg leads.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. attaches cable end to monitor103. attaches electrodes to cable leads154. bears chest appropriately.105. attaches the white negative electrode to patients right pectoris156. attaches the black ground electrode to patients left pectoris157. attaches the red positive electrode to patients left lateral chest wall at the level of t10 158. turns monitor on10total points100
comments:
manipulative skill: emergency childbirth
objective: at the end of this skill, you will have demonstrated that you are able to safely and effectively deliver a newborn infant in the prehospital setting.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 52. determines if delivery is imminent
a) due date of baby (edc) - premature, term, late
b) gravida/para condition
c) prenatal care/ expected complications
d) waters break/ bloody show
e) timing of contractions
f) urge to bear down or move bowels
g) checks for crowning103. prepares equipment for delivery
a) drape area if possible
b) bulb suction
c) clamps
d) towels, blankets, cap54. as head appears, applies gentle pressure to head to reduce tearing of perineum 55. suctions mouth, then nose of newborn w/ bulb syringe106. checks for cord around newborns neck
if present, attempts to loosen cord with one finger, if too tight, rapidly clamps cord in two places and cut 57. assists in delivery of shoulders and torso58. rapidly stimulates, dries and warms the newborn109. assesses newborn:
a) if baby does not begin crying or turning pink within 30 seconds, begin blow by oxygen
b) if baby does not begin breathing or has respiratory rate < 30, begin bvm respirations
c) if pulse rate is < 60, begin chest compressions
a) if baby cries, turning pink, and has spontaneous movement, assess apgar at 1 minute 1010. clamp cord
a) first clamp 6 - 8 inches from baby
b) second clamp 2 - 3 inches away from first clamp511. cut cord with scalpel or scissors512. wrap baby in dry blanket, give to mother, attempt nursing513. deliver placenta, place into plastic bag for evaluation514. massage fundus to encourage bleeding control515. assess baby 5 minute apgar score516. assesses mothers vital signs5total points100comments:
manipulative skill: bvm use with an endotracheal tube
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a patients airway using a bag valve mask with an et tube previously inserted by the emt-p.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 202. attaches bvm to et tube203. visually note depth of tube by markings on et tube204. ventilates patient at appropriate rate205. observes adequacy of ventilation
a) observes chest rise and fall
b) feels for compliance of bvm
c) observes color changes of end tidal co2 cap
d) has assistant auscultate lung sounds and gastric sounds20total points100
comments:
manipulative skill: long bone extremity injury
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a suspected extremity injury with the appropriate technique and equipment.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. directs assistant to support affected extremity103. exposes injury site104. assesses patients csm function in extremity
circulation - presence of pulse, equal to unaffected side
may also check nail blanching
if pulse or blanching is absent, and extremity is cold to touch, attempt to straighten extremity once to restore circulation.
sensory - patient feels physical stimulus applied to fingers or toes
motor - patient able to move fingers or toes205. if open injury is noted, applies sterile dressing to site56. if closed injury is noted, applies ice to site57. applies appropriate sized splint to extremity58. pads voids59. immobilizes extremity above and below injury1010. immobilizes joints above and below injury
a) utilize sling and swath for upper extremity injuries, including shoulder
b) elevate lower extremity after splinting1011. reassesses patients csm function10total points100
comments:
manipulative skill: helmet removal
objective: at the end of this skill, you will have demonstrated that you are able to effectively remove a helmet from a patients head while maintaining manual cervical spine stabilization.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. directs assistant to maintain cervical spine stabilization by reaching under the helmet and grasping mandible and occipital head 203. releases helmet strap104. begins to remove helmet by expanding sides of helmet155. tilts helmet backward to clear tip of nose156. slowly rocks helmet from behind head107. exchanges manual stabilization with assistant108. maintains manual stabilization until spinal immobilization is complete. 10total points100
comments:
manipulative skill: impaled object
objective: at the end of this skill, you will have demonstrated that you are able to effectively stabilize an impaled object, with emphasis on a penetrating eye injury.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. if possible, places patient in supine position on backboard103. controls profuse bleeding if present104. stabilizes impaled object
a) cuts a stack of 4 x 4 gauze pads
b) places pads around object
c) tapes pads into place105. treats patient for shock with positioning and high flow oxygen10if the additional conditions are encountered:penetrating eye injury251. covers patients uninjured eye
-explains to patient62. stabilizes penetrating injury, or damaged globe73. covers injured eye
-uses paper cup or cone if possible64. secures covering6impaled object compromising oral airway251. inspects oropharynx for depth of penetration62. if both ends of object are seen, removes the object by pulling it out in the direction that it entered the cheek. 73. if the tip of the object is impaled, or cannot be seen, object is stabilized in place 64. suctions airway a necessary to maintain patent airway6total points100
comments:
manipulative skill: intravenous setup
objective: at the end of this skill, you will have demonstrated that you are able to assist the emt-p in setting up an intravenous (iv) infusion.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. receives iv solution from emt-paramedic53. confirms that the solution is appropriate, clear, non-expired104. attaches an extension set to an appropriate administration set105. closes roller clamp56. pulls protective caps off the iv solution bag and iv tubing107. inserts iv tubing into bag using aseptic technique108. squeezes drip chamber until half full with solution109. opens roller clamp510. allows fluid to run through tubing, expelling all air1011. closes roller clamp512. maintains aseptic technique throughout procedure10total points100
comments:
manipulative skill: auscultation of breath sounds
objective: at the end of this skill, you will have demonstrated that you are able to auscultate and describe breath sounds using appropriate technique and equipment.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. exposes chest appropriately103. medical: places bell of stethoscope against area of right lung apex, posterior chest wall 54. asks patient to take a deep breath 55. notes lung sound
full or diminished
clear or crackling, wheezing 56. repeats steps 3 - 5 in the following locations
left lung apex
left lung base
right lung base207. compares equality of lung sounds58. repeats steps 3 - 7 on the anterior chest wall259. trauma: places bell of stethoscope against left lateral aspect of lung field, asks patient to take a deep breath, notes lung sound; repeats over right lateral aspect of lung field15total points100
comments:
manipulative skill: oral glucose administration
objective: at the end of this skill, you will have demonstrated that you are able to effectively administer oral glucose to a conscious patient with altered mental status.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. determines patients past medical history
a) patient states diabetic history
b) medic alert tag
c) oral hypoglycemics
d) insulin in refrigerator, syringes203. determines that patient is awake and cooperative sufficiently to self administer oral glucose paste 204. opens glucose tube, or mixes sugar into a liquid105. directs patient to take tube or glass from hand106. observes patient self administer glucose or liquid107. encourages patient to continue self administration108. assesses patient mental status over next several minutes10total points100comments:
manipulative skill: patient assessment
objective: upon completion of this skill, you will have demonstrated a logical, concise and complete assessment on any patient.
manipulative steps:
scene size-up151. puts on appropriate body substance precautions52. checks for scene safety33. determines nature of illness/mechanism of injury34. determines number of patients15. determines need for additional resources16. takes c/spine precautions as necessary2initial assessment301. determines level of consciousness (loc)5avpu: is the patient alert, or responds to verbal/painful stimulus, or is unresponsive2. determines chief complaint/life threats/mechanism of injury43. assesses abcdes and takes appropriate steps to correct life threatsairway: patent (speaking) or compromised5breathing: non-labored, labored, shallow, absent5circulation: strength, rate, location of pulse5life threatening bleedingskin signsdisability: avpu3expose: removes clothing as necessary3conducts appropriate focused history and physical exam50performs ongoing assessment5total score
focused history and physical exam - responsive medical501. assesses history of present illness/injury (hpi)10onset of signs/symptoms
provocation
quality
region/radiation
severity
time
2. assesses medical condition10signs/symptoms
allergies to medicine
medications currently taking
past medical history
last oral intake
event leading to present illness/injury3. performs focused physical exam
assesses affected body system104. assesses vital signs
respiratory rate and quality
pulse rate and quality
blood pressure
skin signs
pupil status (perrl)105. initiates appropriate interventions56. determines transport mechanism5ongoing assessment51. repeats initial assessment22. repeats vital signs23. repeats focused assessment1total points
focused history and physical exam - unresponsive medical501. performs rapid physical exam15head
deformities burns
contusions tenderness
abrasions lacerations
penetrations swelling4neck
dcap-btls, stoma, medic alert, jvd
accessory muscle use1chest
dcap-btls, chest rise, paradoxical movement, retractions, lung sounds, scars 3abdomen
dcap-btls, distention, masses, scars2pelvis
dcap-btls, incontinence, pregnancy2legs
dcap-btls, csm, medic alert, track marks1arms
dcap-btls, csm, medic alert, track marks1back
dcap-btls, scars12. assesses history of present illness/injury (family/bystanders)10onset of signs/symptoms
provocation
quality
region/radiation
severity
time3. assesses medical condition (family/bystanders)10signs/symptoms
allergies to medicine
medications currently taking
past medical history
last oral intake
event leading to present illness/injury24. assesses vital signs
respiratory rate and quality
pulse rate and quality
blood pressure
skin signs
pupil status55. initiates appropriate interventions56. determines transport mechanism5ongoing assessment51. repeats initial assessment22. repeats vital signs23. repeats focused assessment1total points100
focused history and physical exam - significant trauma501. performs rapid physical exam15head
deformities burns
contusions tenderness
abrasions lacerations
penetrations swelling4neck
dcap-btls, stoma, medic alert, jvd
accessory muscle use1chest
dcap-btls, chest rise, paradoxical movement, retractions, lung sounds, scars 3abdomen
dcap-btls, distention, masses, scars2pelvis
dcap-btls, incontinence, pregnancy2legs
dcap-btls, csm, medic alert, track marks1arms
dcap-btls, csm, medic alert, track marks1back
dcap-btls, scars12. assesses vital signs
respiratory rate and quality
pulse rate and quality
blood pressure
skin signs
pupil status153. assesses patient history10signs/symptoms
allergies to medicine
medications currently taking
past medical history
last oral intake
event leading to present illness/injury4. initiates appropriate interventions55. determines transport mechanism, initiates transport56. performs detailed physical exam if possible7. determines need for detailed physical examhead
deformities burns
contusions tenderness
abrasions lacerations
penetrations swellingface
dcap btlseyes
perrl, conjunctiva, conjugate gazenose
nasal flaring, drainagemouth
teeth, drainage, tongueneck
dcap-btls, stoma, medic alert, jvd
accessory muscle usechest
dcap-btls, chest rise, paradoxical movement, retractions, lung sounds, scars abdomen
dcap-btls, distention, masses, scarspelvis
dcap-btls, incontinence, pregnancylegs
dcap-btls, csm, medic alert, track marksarms
dcap-btls, csm, medic alert, track marksback
dcap-btls, scarsongoing assessment51. repeats initial assessment22. repeats vital signs23. repeats focused assessment1total points100
focused history and physical exam - no significant trauma501. performs focused physical exam
assesses affected body system (dcap-btls)
reassesses mechanism of injury152. assesses vital signs
respiratory rate and quality
pulse rate and quality
blood pressure
skin signs
pupil status103. assesses patient history10signs/symptoms
allergies to medicine
medications currently taking
past medical history
last oral intake
event leading to present illness/injury4. initiates appropriate interventions54. determines transport mechanism, initiates transport5ongoing assessment51. repeats initial assessment22. repeats vital signs23. repeats focused assessment1total points100
comments:
manipulative skill: sitting immobilization
objective: at the end of this skill, you will have demonstrated that you are able to effectively immobilize a sitting patient whom you suspect may have a potential cervical spine injury.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 52. directs assistant to maintain manual cervical spine immobilization103. assesses patients csm function
circulation - presence of pulses
sensory - patient feels physical stimulus applied to fingers and toes
motor - patient able to grip hands and move feet104. applies appropriately sized cervical collar
a) measures first
b) applies from the front of patients neck105. places vest type device between patient and assistant, with "wings" of vest placed directly under patients axillae 106. applies torso straps first
in order: middle - bottom - top107. applies leg straps58. immobilizes head and neck to vest
fills void between head and vest109. reassesses patients csm function810. moves patient to supine position on backboard
supports legs while positioning patient511. releases leg straps512. secures patient to backboard513. reassesses patients csm function214. directs assistant to release manual stabilization5total points100
comments:
manipulative skill: spinal immobilization
objective: at the end of this skill, you will have demonstrated that you are able to effectively immobilize a patient whom you suspect has a potential cervical spine injury.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 52. directs assistant to maintain manual cervical spine immobilization103. assesses patients csm function
circulation - presence of pulses
sensory - patient feels physical stimulus applied to fingers and toes
motor - patient able to grip hands and move feet104. applies appropriately sized cervical collar
a) measures first
b) applies from the front of patients neck105. if necessary places patient arms besides body 56. places backboard besides patient, with top of board located approximately 3 inches above top of head 57. log rolls patient onto side toward rescuers10a) directs second assistant to support hips and legsb) directs first assistant to coordinate log rollc) controls patients torso and hips8. sweeps the patients back for injury or bleeding59. has first assistant direct log roll onto backboard510. secures body to backboard using appropriate straps
a) pads all voids
b) secures hips and shoulders1011. immobilizes head and neck to backboard1012. asks first assistant to release manual stabilization513. evaluates patients csm function10total points100
comments:
manipulative skill: sucking chest wound
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a sucking chest wound utilizing appropriate technique and equipment.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 2. checks patients ventilatory status3. inspects chest wound for sounds and bubbling4. applies a nonporous dressing to site
a) if possible, ask patient to exhale completely
b) applies dressing with palm of hand
c) tapes securely on three sides5. applies high flow oxygen using nonrebreather mask6. reassess patients ventilatory status
auscultate lung sounds for equality and depth7. assesses for developing signs of tension pneumothorax
releases dressing if signs develop8. places patient in high fowlers position if possible
or onto affected side if patient is in shock9. reassess patients ventilatory status continuouslytotal points100
comments:
manipulative skill: traction splinting
objective: at the end of this skill, you will have demonstrated that you are able to effectively manage a mid-shaft femur fracture using appropriate technique and equipment.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 102. exposes injury site on femur103. determines this injury to be located mid-shaft104. assesses patients csm function in extremity
circulation - presence of pulse, equal to unaffected side
may also check nail blanching
if pulse or blanching is absent, and extremity is cold to touch, attempt to straighten extremity once to restore circulation
sensory - patient feels physical stimulus applied to fingers or toes
motor - patient able to move fingers or toes105. directs assistant to apply manual traction
may apply ankle hitch prior to applying traction106. measures traction splint against good leg, extending splint 6 to 8 inches beyond foot 107. applies appropriate sized splint to affected extremity58. applies groin strap59. applies ankle strap
tighten ankle hitch until patient feels relief
direct assistant to release manual traction1010. immobilizes extremity above and below injury
distribute straps above and below joints511. reassesses patients csm function1012. position patient onto backboard5total points100
comments:
manipulative skill: vital signs
objective: at the end of this skill, you will have demonstrated that you are able to correctly ascertain a patients vital signs using the appropriate equipment and techniques.
manipulative steps:
1. takes or verbalizes appropriate body substance isolation precautions 5pulse251. selects pulse site
adult - radial, then brachial, carotid, femoral
pedi - brachial, then carotid, femoral, apical62. palpates pulse63. determines pulse rate
counts number of beats in 15 seconds and multiplies by 474. determines quality of pulse
a) regularity - regular or irregular
b) strength - full or weak, thready6respirations251. observes or feels rise and fall of chest82. determines rate of respirations
counts number or breaths in 15 seconds and multiplies by 493. determines quality of respirations
a) regularity - regular or irregular
b) effort - non-labored, labored8blood pressure251. applies cuff to proximal arm
a) just above elbow bend
b) snug fitting
c) center of bladder over artery
d) bare skin42. locates brachial arterial pulse43. places diaphragm of stethoscope over site44. inflates cuff until sphygmomanometer reads 170 mm hg45. positions ear pieces46. deflates cuff slowly
a) notes when heartbeat is first heard (systolic)
b) notes when heartbeat is no longer heard (diastolic)5c) accuracy to within 10 mm hgpupillary assessment201. examines eyes for pupil size
equal/unequal52. examines pupils for shape
round/misshapen53. examines pupils for reactivity
a) brisk, sluggish, fixed
b) equal, unequal reaction54. examines pupils for light accommodation55. checks eyes for symmetry
conjugate, disconjugate, dolls eyes5total points100
comments:
emergency medical technician - basic
training program
section 8: appendix
ems academy
emt student clinical report form
student name: date / time:
evaluator name: rescue #:
this form is required for each patient contact. the form must be typed or neatly printed.
patient: age: sex: wt (kg): cmed #
chief complaint: include all pertinent information about chief complaint, pqrst, signs & symptoms, etc.
vitals signs: resp: pulse: b/p:
pertinent medical history:
physical assessment findings:
treatment / response:
suspected diagnosis:
explain diagnosis:
ems academy
emt student verification form
on student performed
date print students name
his/her field observation on ambulance
unit #
from ___________ hrs to _____________ hrs. starting time ending time
student:
print name signature
preceptor:
print name signature
training officer:
name signature
ems academy
emt student field performance evaluation
students name: __________________ evaluator:_________________date:_____________________
skills evaluation:
4 = superior 3 = satisfactory 2 = marginal / inconsistent 1 = unsatisfactory n/o = not observed
1. assessment / vitals 4 3 2 1 n/o 6. child birth 4 3 2 1 n/o
2. airway management 4 3 2 1 n/o 7. back boarding 4 3 2 1 n/o
3. cpr 4 3 2 1 n/o 8. mast 4 3 2 1 n/o
4. bleeding control 4 3 2 1 n/o 9. als interaction 4 3 2 1 n/o
5. splinting 4 3 2 1 n/o 10. ked 4 3 2 1 n/o
overall evaluation:
4 = superior 3 = satisfactory 2 = marginal / inconsistent 1 = unsatisfactory n/o = not observed
1. student / patient interaction 4 3 2 1 n/o
2. identification of patient care priorities 4 3 2 1 n/o
3. leadership skills / professional demeanor 4 3 2 1 n/o
4. relates to ambulance personnel 4 3 2 1 n/o
5. remains calm 4 3 2 1 n/o
6. accept advice and constructive criticisms 4 3 2 1 n/o
7. overall impression of students performance 4 3 2 1 n/o
comments:
evaluation discussed with student? [ ] yes [ ] no
student signature: ________________________________ date:__________________________________
paramedic evaluator signature: ____________________________________date:______________________________________
appendix xvii: emergency medical health services program
student handbook
(o.d.p.s. #1-002-004)
the acme ems education program
the college of 911
jane doe
program director
content outline:
i. program purpose page 2
ii. program description page 2
iii. program goals page 2
iv. instructional materials page3
v. program fees page 3
vi. class location page 4
vii. class time page 4
viii. clinical experience page 5
ix. attendance policies page 10
x. participant attire page 10
xi. participant progress conference page 10
xii. program examinations and grading page 11
xiii. state examinations requirements page 13
xiv. continuing education page 13
xv. participant safety page 14
xvi. statement of understanding page 15
i. program purpose
this program is designed for individuals interested in providing care to patients in the prehospital setting. it will provide the participant with opportunities to gain information, skills, and attitudes necessary for certification as an emergency medical technician-paramedic in the state of ohio.
ii. program description
the department of public safety approves this program. it addresses information and techniques currently considered to be the responsibilities of the emt-paramedic, according to the most current version of united states department of transportations emergency medical technician-paramedic (emt-p), national standard curriculum. the program consists of didactic (lecture) instruction, practical skills training, and clinical observation and training.
iii. program goals
the program will contain information and skill practice opportunities, which will enable a properly motivated and capable participant to:
a. demonstrate an understanding of human anatomy and physiology and the rationale and fundamentals of prehospital care and treatment of the sick and injured.
b. perform a primary and secondary patient survey.
c. understand, recognize, and provide appropriate als care for life threatening and non life-threatening emergencies.
d. learn and demonstrate correct application and utilization of advanced life-support equipment in the prehospital setting.
e. file a run report of occurrences for the use of the receiving hospital as well as a permanent record for local use.
f. transmit necessary information from the emergency vehicle to on line medical control in an orderly manner using mobile communication equipment.
understand and discuss the rationale of patient/rescuer safety and care at the scene and through transport to a receiving medical facility.
iv. instructional materials
a. several textbooks, workbooks and review manuals are available in the acme ems education program bookstore. the required and recommended books are listed by course number in the bookstore at the beginning of each semester. the costs for books varies each year but average cost is $200-$250 for the entire course.
b. the laboratory skill manual must be purchased as a course pack from the bookstore.
c. additional supplies and materials required (lab coat, shoulder patch, stethoscope and ekg calipers) at approximately $50.00
d. although the textbook selected for the course will be the primary textbook for the entire curriculum, the student will be responsible for obtaining the following supplemental textbooks:
advanced cardiac life support, american heart association
pediatric advanced life support, american heart association
basic trauma life support, american college of emergency physicians
basic pediatric life support, american college of emergency physicians
v. program fees
there will be a tuition and general fee for all students. students must obtain a student id card to participate in activities and have access to the computer labs, libraries, and events.
lab fee/liability insurance $75 per year
additionally, in accordance with the clinical experience policy, each participant in an emt education program must submit the original test results from all required laboratory tests and a physician's statement of fitness to perform the required clinical activities prior to the third week of the fall semester.
upon successful completion of the emt program verified by the medical director and the program director an examination fee of $35 will be due to the national registry of emts. the acme ems education program will arrange for and provide space for the national registry of emts examination at the completion of the program. there is a $150.00 examination site fee payable by the participant to the acme ems education program. this is non-refundable and payable at each examination attempt.
students who wish to purchase certificate of completion cards for acls, pals, pbtls and btls may do so by paying the appropriate fee at the end of each specialty course. generally these cards cost between $8.00 and $15.00 each.
vi. class location
classes and laboratory sessions are conducted in the clinical laboratory building, unless otherwise noted in the class syllabus. please refer to the schedules for room locations. laboratory sessions are held in the clinical laboratory building room 123.
vii. class time
classes meet from 6:00 p.m. to 9:00 p.m. on monday and wednesdays. laboratory sessions meet on tuesday evenings from 6:00 p.m. to 9:30 p.m. periodically during the course of instruction, class times and meeting sites will change to accommodate specialized education and testing programs. students will be informed of such changes at the beginning of each semester.
viii. clinical experience
the clinical coordinator, in cooperation with a medical facility, medic unit, ambulance service, life squad, and/or dispatch center will provide the opportunity for the program participants to observe and train in a clinical setting.
a. clinical instruction and experiences are offered each semester.
1. the clinical experience is designed to meet and enhance the specific learning needs of the student. each area of clinical experience has been selected to correspond with a specific area of didactic classroom instruction and to meet the clinical skill objectives outlined in the usnstc.
2. the number of successful skill completions is designated for each specific area of clinical experience (see appendix 1) and must be met by each student in order to successfully complete the program.
areas used for clinical experience include the following:
a) coronary care unit
b) emergency department
c) life squad
d) obstetrics
e) intubation experience
f) burn unit
g) pediatric ed
f) dispatch center
b. clinical attendance
1. clinical assignments are made for each student. the student is expected to report 15 minutes before the start of the shift. the student is expected to stay in the area for the entire designated shift. if the student is unable to meet the schedule, they must notify the clinical coordinator at the phone numbers supplied to the students at the beginning of each semester. the coordinator will then notify the specific clinical area that the student will not be in attendance.
2. due to the complexity of scheduling students into limited clinical affiliates, there will be no change in the assigned clinical training. students must be in the specific area that they are assigned. make-up time is available only at the end of the semester and only on a limited basis.
3. if a student is ill, they must make-up the time based upon availability. absence from clinical areas is permitted only for true emergencies. a written excuse from a physician must be presented for an accepted excuse for failure to meet assigned clinical rotations.
4. unexcused (no call, no show) absences from two clinical assignments in any one semester will result in the students grade being lowered by one full letter grade.
5. more than two unexcused absences in any one semester will be grounds for dismissal from the program and the assignment of letter grade f for the clinical course.
6. the stated hours for each clinical area are based on the student successfully completing the objectives. this is a minimum requirement and at the discretion of the director of the program, the student may be asked to participate in further clinical learning experiences.
7. the students must have their hours of attendance verified by the preceptor on the acme ems education program form. the completed form must be submitted to the director to be recorded. falsification of these forms will be grounds for dismissal from the program.
8. in order to document the quantity and quality of clinical experiences in each clinical field, the student will keep a clinical log to be reviewed by the clinical coordinator on a weekly basis. failure to have the forms completed and reviewed by the director will result in the student being asked to repeat the specific clinical experience.
9. clinical logs are due one week prior to the end of the semester. clinical logs submitted for review after that time will be subject to a drop of one full letter grade.
falsification of these forms will be grounds for dismissal from the program.
c. dress code for clinical experience
1. students should wear a white, collared shirt, dark blue pants, black shoes, and a short white lab coat, which the student provides. students must wear the acme ems education program patch on the left shoulder of the shirt and on the front pocket of the laboratory coat. students must clearly display their picture student id card while in the clinical setting. the laboratory coat will not be worn during life squad, ambulance or communication center experiences.
2. official student id nametags should be visible at all times during in-hospital clinical experience. id tags will not be worn during life squad and ambulance experience, however the student must present the picture id to the preceptor when reporting for duty. students without picture id will be asked to leave the clinical site.
3. no jeans, sandals, t-shirts, cowboy boots or other inappropriate attire during clinical experience. students should have hair up and off the collar and be free of heavy jewelry, perfume, and inappropriate make-up. no body pierced jewelry is allowed to be visible during clinical experience
d. performance on duty
1. each student must utilize self-initiative in the clinical area in which they are assigned.
2. the clinical coordinator/director reviews and coordinates the clinical experience, but they are not responsible for providing specific activity. hospitals may vary somewhat in their approach to the students.
3. the student must tell preceptors which areas they would like more experience in. the request must conform to the guidelines of paramedic responsibilities. (see specific clinical objectives for each area.) students should utilize the check-off list provided to ensure completion of objectives.
4. the student is expected to be tactful and courteous at all times. if a problem arises during clinical activities, the student is required to contact the clinical coordinator of the program to intervene.
5. students may perform activities only under the direct guidance and observation of the registered nurse, physician, ems dispatcher, or certified paramedic. if the student is unfamiliar with the duty or has never performed the function outside the classroom, they must relay this information to the preceptor and observe. subsequent availability of these specific experiences warrants a request by the student to actively participate.
6. students must conform to all rules and regulations of the clinical affiliate during clinical experience. students who display unprofessional appearance, substandard hygiene, unprofessional or inappropriate attitude, or misconduct as defined by the clinical affiliates employees handbook and the programs clinical guidelines will be subject to dismissal from the program.
in view of the limited time for clinical experience, there should be no area too menial or repetitious for the students to participate. the student should be aware of, and make use of, the vast learning opportunities available in every clinical situation and respect the clinical expertise of the preceptors working in those areas.
ix. attendance policies
due to the volume of the material to be covered and the speed at which it will be presented, attendance will be expected at all classes. the maximum allowable number of absences and make-up arrangements is two per semester. unexcused (no call, no show) absences from two classes in any one semester will result in the students grade being lowered by one full letter grade. more than two unexcused absences in any one semester will be grounds for dismissal from the program and the assignment of letter grade f for the semester coursework. exceptions to these regulations will be made on a case-by-case basis as determined by the program director and medical director.
participants are expected to take responsibility for getting class notes, handouts, and make-up assignments when necessary. the instructor is not responsible for supplying the student with these items. it is suggested that students designate another student to make sure that all classroom material is obtained.
when a student misses a scheduled quiz, the quiz will be made available to the student for study purposes; however, the student will not be allowed to make up the quiz for a recorded score.
x. participant attire
participants will be required to adhere to clinical guidelines when in an assigned clinical setting.
xi. participant progress conference
the program director may request program participants to attend progress conference(s) during the course of the program.
xii. examinations/grading
each student is expected to complete the reading assignment and workbook assignment prior to attending the class sessions. the lectures are based on the us dot national standard curriculum. the lectures vary in sequence from the textbook. the material presented in lectures, textbooks, and assigned readings will be utilized in preparing the mid-term and final examinations.
all assignments must be completed before a grade will be assigned to the student. quizzes and workbook assignments offer guidelines for individual study and for faculty appraisal of the student's progress. late assignments will be not be reviewed or evaluated.
a mid-term examination will be given each semester. a final examination, which is comprehensive in design, is given at the end of each semester. students must obtain at least a 75% on the final examination to successfully complete the course.
academic dishonesty is grounds for immediate dismissal from the program. please refer to the acme ems education program catalogue for statement on academic dishonesty. no hats, ball caps, or sunglasses should be worn during examinations. in addition, no pagers, cell phones, pda or other forms of electronic transmission of information are allowed during examinations.
grading scale:
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