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July 31, 2012 / jeffmedic

Guest Lecturers

Guest lecturers can be a great asset in the EMS classroom. My program has been very fortunate over the years in having a string of excellent guest lecturers come through and share their knowledge and experience. There have been a few problems though. Along the way I have made a few mistakes and learned a few things.

The first thing I have learned is that you should not use guest lecturers to teach the material by themselves. Subject matter experts provide real world coverage of a topic but they don’t always cover everything. Also, they often assume a level of background knowledge that your students may not have. By covering the material first and using the guest lecturer to reinforce what has been taught, you get better coverage of the material and the session with the guest lecturer is a better experience for everyone.

Second, guest lecturers tend to be busy people because people with the kind of knowledge and experience that you want are have a lot going on. You want to make coming to your class as easy as possible for them. Before contacting a potential speaker, have a plan for what you would like them to cover and two or three possible dates and times for them to come to your class. It is much easier for them to say yes or no to specific requests than it is to scan their entire schedule and try to figure out what time is best for everyone.

Lastly, stay in the room during the lecture and participate. You need to show your students that the speaker and the information are important. This is not the time to get caught up on other work. You may need to guide the discussion if things get derailed.

Guest lecturers bring real world experience to your classroom. When used properly, they will enhance your program and the experience of your students.

April 25, 2012 / jeffmedic

Wrapping Up

The end of April is usually a very busy time for me. My paramedic students are finishing up their field internships and are in the middle of the final testing process. Then there is the insane amount of paperwork that goes with closing out an academic year. I really had no idea what was involved in teaching full time before I started this job. If it weren’t for my Dean and Clinical Coordinator I would have drowned in office work many months ago. EMS education is just as much of a team sport and street EMS is.

March 2, 2012 / jeffmedic

Gathering of Eagles 2012

I was fortunate, this year, to be able to attend the 2012 EMS State of the Sciences Conference in Dallas, Texas. The presenters are a group of medical directors from the largest EMS systems in the United Stated who have taken to calling themselves the Eagle. The conference is commonly known as the Gathering of Eagles. Prior to the conference, the Eagles meet and discuss issues related to EMS in their areas. Then the Eagles, plus a few other guests, host the conference for EMS medical directors and providers. The presentations are 10-15 minutes long and cover a wide range of current EMS topics. Here are a few things I learned from this year’s conference.

The first presentation was by Dr. Corey Slovis of the Nashville Fire Department. Dr. Slovis lives by the rule of 5. He can reduce or expand any idea into 5 things. Every year he gives a talk about the 5 journal articles that have come out in the past year that EMS providers should know about. The article I was most interested was about a study that compared IM midazolam to IV lorazepam in patients with status epilepticus. The study showed that IM midazolam is at least as effective as IV lorazepam. This is important for EMS providers because our patients don’t usually have vascular access when we get them and it does take a few minutes to start an IV or an IO and give medicine through it. Being able to start with an IM injection is fast and safer in a moving patient. Additionally midazolam does not have the same storage requirements as lorazepam.

Dr. Slovis also gave a presentation on using IV epinephrine in severe anaphylaxis. He proposed mixing 1 mg of epinephrine into a 1 L bag of normal saline making a concentration of 1 mcg/mL. Infuse at rate of 1 mcg/min and titrate to effect. This method is much simpler than the way I was taught. I had heard him give a talk about this previously and was hoping he would discuss it at Eagles. I had intended to propose this to the service I work for but my medical director was sitting in front of me during the presentation and liked the idea.

Dr. George Ralls spoke about the pit crew approach to treating MI patients. This idea has been around for awhile with cardiac arrest patients. All of the major 911 providers from my area were represented at the conference. Hopefully we can agree on a way this should go and then I can teach that method in my program.

Dr. John Freese from FDNY talked to us about intra-arrest hypothermia. The idea is to induce therapeutic hypothermia during cardiac arrest instead of after ROSC. I look forward to hearing about more research on this. It sounds promising.

I learned from Dr. Chirstopher Colwell of Denver that you can’t kill a patient with benzodiazepines alone. He spoke of giving patients with alcohol withdrawal doses that were several times what I carry on the ambulance.

There were many other excellent presentations. The slides from each of them can be found here.

I had a great time learning about my profession and spending time with friends. It was great to see so many EMS medical directors there including the medical directors from my program and the service I work for.

I am definitely looking forward to next year.





February 18, 2012 / jeffmedic

Rethinking the Lecture

I have a confession, I love preparing and giving lectures. I enjoy researching a topic and then distilling all of the information that I have gathered into one main idea and a few memorable points. That is why it has taken me so long to realize that it is time to rethink the lecture.

The discussion about how best to present information to todays students has been going on for awhile in higher education circles. We are transitioning from a “sage on the stage” model of content delivery to a more active, student centered approach. Bloom’s taxonomy has even been revised to reflect this.

Here are a couple of places where I have learned more about how to make my classes more active and engaging. The first link to to a screencast by Dr. Danielle Hart titled “The Millennial Generation and the Lecture.” Dr. Hart is an emergency physician at Hennepin County Medical Center in Minnesota. The second link is to the website of Dr. Mark Taylor. Dr. Taylor came to speak at my school last month and he gave us a lot to think about. He describes the current group of students as Generation NeXt and he has a variety of suggestions about how to meet the needs of these students.

I have spent entirely too much time over the past few years being frustrated with my students because thy just don’t “get it.” Looking back, I see myself giving a lot of lectures with little student involvement and I wondered why my students got bored. My fear has always been that if I don’t cover all of the material in lectures, the students wouldn’t learn it. This left little time for other activities.

Transitioning to a more student centered, active approach means that my students will have to be prepared to participate when they come to class. I have been telling them for years that they should plan on spending 2-3 hours outside of class studying for every hour they spend in class. I am hoping that by using more case discussions and other active learning strategies, it will give purpose and focus to my students preparation efforts.

December 6, 2011 / jeffmedic

Kicking It Up A Notch

There has been a lot of discussion about EMS education in the past year. The release of the EMS Education Standards, recent continuing education scandals and the upcoming accreditation deadline for paramedic programs have all brought EMS education to the forefront of the discussion about the future of EMS. One thing is clear. It is time for EMS Educators to kick it up a notch. Teaching the bare minimum number of didactic hours using the unmodified publisher provided materials just isn’t going to cut it any more. It’s time that we learned how to develop our own curriculum and teach more information than is absolutely required to pass the test.

This is going to require a lot more work on the front end but it will pay dividends in the long run. If we as educators do our part, our students will either rise to the challenge or self select out of our profession. Better teaching will lead to less remediation, which will make our jobs much easier in he long run. Most importantly, our students will graduate well prepared for the challenges they will face in their EMS careers.

I started this blog because I am trying to kick things up a notch in my program. I hope to organize my thoughts and get some feedback.

One thing I know for certain, this is a great time to be an EMS educator!

August 9, 2011 / jeffmedic

Preparing a Combitube for Class

I have a guest post on Everyday EMS Tips about preparing Combitubes for use in the classroom. Check it out.

June 22, 2011 / jeffmedic

LANREMT 2011 Day 3

This morning began with a great talk by Mr. Joe Cook of the Cook Law Firm. He spoke about Louisiana laws that relate to EMS providers. He also gave us a look into the minds of plaintiffs attorneys. One of the things that will sink a healthcare provider in a lawsuit is if the records have been altered in any way after the lawsuit has been filed especially if it was done on the sly. Apparently it is common practice for the plaintiff’s attorney to instruct the family to obtain a copy of the patient’s medical records prior to the suit being filed. The records will then be sealed until afterward. Then the attorney will obtain another copy of the records and compare both sets for changes. Very sneaky.

Spent the rest of the day going to other classes and meeting people from around the state. Later in the evening I went to the Riverwalk for dinner with a couple of new friends. All in all it was a good day.