My Field Training Mindset

I don’t remember specifically when I began to formally field train newly hired paramedics, but I’ve been doing it off and on for about ten years.  My trainees have become trainers, which is a pretty good way to be made to feel old.  

New grads on days when my knees hurt and I feel old.
(By Gideon Tsang via Wikimedia Commons)

I wasn’t as skilled an instructor when I began as I am now, and I don’t think that I am as good now as I will be in a few more years.  I try hard to pay attention to what works and what doesn’t, as well as think about how I teach in the field. 

There are two main points to think about when you are field training. 

The first is that a field trainer is like a test pilot in that they know how to recover from spins in a bunch of different airframes under different circumstances.  When I am training, I will allow the trainee get him/herself into a spin.  Not only that, but I will let that spin continue until the last recoverable moment.  My hope is that they learn to get their call out of the spin on their own.  I won’t intentionally put the call into a spin.

Mistakes are where people learn.  Mistakes are the best lessons.  There is a difference between a mistake and a safety issue, however.  I won’t let a trainee’s mistake affect the patient.  There is a line there – I will let the call get out of the trainee’s control, but not out of my control.  I try to not step in too soon or too late.

This came about because I hate it when I tell a trainee to start an IV and receive the reply that they were “just about to.”  If the patient gets all the way into the ED without an IV, then there is no “just about to.”  We can have then a frank discussion about the need for an IV on that kind of call.  On a call, I have to think about whether I would start that IV and whether that decision is a style issue, protocol issue, or life-altering issue.  I make sure life-altering issues are fixed before they affect the patient.  Protocol issues result in teaching after the call.  Style issues get discussed in a collegial manner after the call. 

I let a trainee draw up the wrong medication, but I stop them before they push it.  I let trainees immobilize patients that I wouldn’t.  I make sure CPR is done when it is needed. 

The point is to let a trainee run their own call however they like - all the way until it would harm the patient.  I allow the trainee to struggle.

The second training thought is that it is my job to change my teaching style, not the trainee’s job to change his/her learning style.  Some trainees respond to preschool teachers and some respond to drill instructors.  Some are visual learners, some prefer to read, and some prefer to listen.  It is up to the trainer to make the adjustment.

Name twenty non-traumatic causes of chest pain or drop and give me thirty!
(By Scott A. Thornbloom [Public domain], via Wikimedia Commons)

The trainee’s success is important, not the method of getting there.

So, do you think you are ready to field train?  It depends.  Are you a good enough medic to let the call spin out of control, grab the yoke, and restabilize everything at the last moment?  Are you insecure in your ability to quickly correct what is going wrong, resulting in you stepping in to the call too soon?  Can you push someone that needs to be pushed, support someone who needs supported, and explain concepts in different ways?