First Arriving Network
First Arriving Network

The myth that longer classes are better: EMT Boot camp backlash

Neither Barber nor Physician

Every couple of months there is an outraged post on a message board or FaceBook in response to an organization's announcement of a "boot camp" emergency medical technician certification course.

Chris Kaiser is a blogger (LifeUnderTheLights) and co-creator of the EMS 2.0 concept. Chris posted on Facebook last month:

Have you seen this? Go to school for one month, Monday through Friday 8am to 5pm and you can be an EMT-B. Really, go look at this. Any thoughts about this? It's absolutely legal and absolutely a shame.

The more we lower the barrier to entry, the less our profession is worth. While the services we offer will continue to be vital, we will be less…  (link)

Many who agreed with Chris spent three or four months learning EMT, probably in a two weeknight plus Saturday schedule. The time between classes were spent in reading, reflecting and repeating skills. reposted a Boston Herald June 20, 2012 article by Donna Goodison and Matt Stout: Study Finds EMT Certification Easy to Obtain in Massachusetts: EMTs have significantly less days of training than barbers. (link)

No longer empty vessels

The foundation of vocational training came with the Industrial Age as farmers flocked to the factories. The assumption was that industrial processes were alien to the new workers, they had to be taught EVERYTHING.

The empty vessel or banking model expects the teacher to fill the student with knowledge, skills and attitude.

Liz Garnett describes the challenge when describing "The Blue Paint Problem":

If the teacher intended to pour, say, a pint of yellow paint into their pint-sized learner, and the learner was indeed empty, it would be a straight-forward matter.

But if the learner’s head is already three-quarters full of blue paint, the teacher has two problems. First, there is only room for a quarter of what the teacher wanted to put in there, and second, that quarter-pint of yellow paint doesn’t stay yellow for long on contact with the blue.

The teacher may succeed in making a difference to what goes on inside the learner, but the result may not look very like the one they had intended.

It follows from this that the major skill in helping people learn is not the acquisition of information to share, but in figuring out what they already know (or perhaps, think they know).

Actually, even that isn’t the tricky bit – the really key part is in persuading people to let go of the stuff that’s currently in their heads to make room for the new.

Teaching is mostly about helping people dispose of blue paint safely. (link to 2008 article)

Military and paid public safety employees have attended EMT boot camps for three decades, eight hours of class every day until they are done. After Cadillacs and before diesel ambulances, I spent two years running an emt program at a large county fire academy. Four recruit and five incumbent EMT boot camps a year.

They lacked time to read, reflect and repeat skills. My experience is that boot camp graduates have a higher success rate with the state exam than students taking a semester long two night/one day per week program.

Course structure, student readiness-to-learn and instructor skill are success factors

The American Heart Association minimized the role of CPR instructors when they rolled out the 2000 version of the curriculum. Research showed that many students were getting miniscule time practicing skills and hearing too many war stories. At the end of the course they could not perform the scenarios or recall heart attack risk factors.

An initial EMT certification course that complies with the 2009 Educational Standard can be delivered in a boot camp format. You need to require out-of-class readings/preparation, strong DAILY student feedback, use a course management system, provide problem solving scenarios, administer on-line exams, engage in active learning and focus on skills.

The instructor functions as a facilitator of learning and not as a one-way information sprinkler. This requires a tremendous amount of preparation and increased participation by the skill/assistant instructors.

Community access courses will be a challenge due to the wide range of student capabilities. Maybe require a HOBET assessment.

What do you think?

Mike "FossilMedic" Ward

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