In response to Part I (How Should EMS Courses Be Taught) there are some valid questions about how to teach the interpretation of research to paramedics.
I would not start with paramedic school. Paramedic school is too late.
How much dogma, blind faith, and indoctrination in the EMS old wives’ tales club has already taken place by the time that we reach paramedic school?
Dewayne wrote –
While maybe not along the same line as your intended meaning, I would love to see a mandatory associates degree for the paramedic level. To reach that goal of an AS degree, I would like to see more classes such as A&P, pathophysiology, medical terminology, and the like as opposed to large credit hour classes labeled Paramedic I, Paramedic II, etc. From looking over my local community college’s course catalog, the classes I feel are important are already being taught, they just need to be filled with future paramedics.
We could have the same prerequisites as nursing students, but include a basic medical research course, too.
However, I would rather see paramedics taking a medical research course, than Anatomy & Physiology. Too much of A&P is used to justify assumptions about the necessity of ventilations in cardiac arrest, because the theory has not yet caught up with the research.
Can you go to an A&P textbook and find explanations of the necessity of ventilation and oxygenation for human life?
Absolutely!
Can you find resuscitation research on real people that demonstrates the necessity of ventilation and oxygenation for human life?
Absolutely NOT!
Our theorists have gotten too far ahead of the research on which we base our theories.
We took a good idea. We ran with it, but we ran the wrong way. Now we find ourselves trying to defend a lie. We find ourselves pleading with people to ignore the evidence. We find that we have to cheat in our presentations of the evidence and give an unfair advantage to the intervention.
In medicine, the ethical approach is to give the advantage to benign neglect – not to unproven intervention.
We are giving the advantage to wishful thinking.
This is indoctrination – not education.
-
-
We need to educate people in EMS to see the fraud of this indoctrination.
As long as we are a dogma-based industry, we do NOT deserve to be treated as professionals.
-
It rubs the lotion on its skin. It does this whenever it’s told.
Too much of EMS is rubbing the lotion on its skin whenever it can to avoid getting the hose.
Skinner’s pigeons would have excelled in EMS..
We need to stop applying lotion and start applying real medicine.
We need to get rid of the people with the hoses.
.
“I would rather see paramedics taking a medical research course, than Anatomy & Physiology.”
Can’t we have both? Or is that too earth shattering? I’d stay and chat about it, but I need to pick up more lotion
What kind of “medical research” class would you recommend? I’m assuming one that isn’t truly “medical” research; but instead goes into scientific method and how to understand research in general. Combine that with a “seminar”-type class where everyone is required to read and present (writing or verbally) a legit research paper and that would be a very useful class.
I’ve been shocked at the number of paramedic programs that do not require Anatomy and Physiology as a prerequisite. My program did, but it was a single semester combined A&P, as opposed to the separate Anatomy and Physiology classes that is prerequisite for the RN program.
I agree with revamping the education system; but I think it has to start at the paramedic level. Once out in the field, EMTs are subordinate to paramedics, much more so than one medic would be subordinate to another medic. Well-taught and critically thinking EMTs will graduate, go out into the field…and run into a bunch of old-school paramedics who will be resentful of these EMTs thinking for themselves; and EMT will truly stand for Empty My Trash for those new graduates. The end result will be a lot of EMTs that become great candidates for RN, PA, and medical school; and the EMS field remains full of the indoctrinated type of EMT.
At least at paramedic school, you can explain that as the “higher level of care”, they need to do critical thinking, understand evidence-based processes, and so on that wasn’t included in EMT school. There will still be resistance between “old-school” and “new-school” in the field; but it won’t have the added dynamic of EMT vs. paramedic involved. Once the evidence-based and critical thinking based education is established at the paramedic level, then it can be extended to the EMT level.
Ideally, both levels would be changed at the same time. But as my paramedic instructor told me, “Paramedic school is like eating an elephant, you’ve got to take it a piece at a time rather than all at once.” Trying to reform all EMS education at once will result in the establishment “elephant” stomping all over you.
How far into this new and improved EMT class will majority bother to stay? There are tons of EMTs and Medics who are here for the adrenaline rush that you get when at a gruesome trauma call. Many on the outside when considering becoming an EMT see the fast driving, flashing lights, and wailing siren.
That was me when I was a newly minted EMT. That is a lot of recruits that I see are the same way. Personally, if my class spend any significant amount of time on the research of medicine and constantly improving the medical care we provide as opposed to how to stop bleeding, how to put O2 into a dead person’s lungs, I would have quit in the middle of class.
Time and experience showed me that there is more to it. It takes time to let someone get over the desire for the adrenaline rush and care about the quality of medical care you provide to your patient.
Adding about the research of medicine needs to be added. I agree with you, but it needs to be done slowly and delicately. The marketing for new EMTs needs to change.
How about you? Where you that adrenaline junkie? When did it change?