Home > Uncategorized > Translating EMT Concepts Between Cultures

Translating EMT Concepts Between Cultures

By: Grant Campbell

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Inaugural ambulance at hospital in Punjab, India.

Situated in the Himalayas of North India, we at Lady Willingdon Hospital are uniquely positioned at the forefront of emergency medical education in the region.  Due to this fact, we have found ourselves struggling to balance the dual needs of tackling the lack of adequate first responder services in the area while meeting our own requirements for highly skilled critical care Paramedics. 

So, do the tried and true methods of emergency medical education work in the Indian context?  Can we simply translate curriculum developed in the States into the local language?  Well, yes and no.

The typical use of oral boards and skills stations as a means of assessing skills competency, breadth and depth of knowledge is a much-needed enhancement to the way training is done.  But, on the other hand most of the people here have a great ability to make things work with whatever resources they have.  This is a key attribute of a good EMT anywhere and is not an easy thing to teach.

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Campbell’s students learn about ventilation.

Teaching in India, I have found that I don’t have to teach my students to work together.  It is a natural part of the culture.  But I do have to figure out ways to teach them to make the most efficient use of team members. 

I don’t have to tell them to think about remembering to document the medications used because they want to make sure the patient is billed.  But, I do have to encourage them to communicate more openly with the patients about what is happening to them and to get informed consent.

These are just a few examples of differences between teaching in the States and India.  We have certainly had to find new ways to ensure that critical concepts are learned but the information and skills necessary to assess and treat patients remains constant. 

The human body works the same in the United States as it does anywhere else. No matter where you find yourself, at the end of the day, no matter where you go, patients are patients and they all require and deserve the best care that can be afforded to them.

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  1. Anne
    August 19, 2012 at 7:31 am

    “Can we simply translate curriculum developed in the States into the local language?” Question: Did you modify the curriculum based upon illnesses unique to the area? Were there any?

    • Grant
      August 19, 2012 at 5:17 pm

      Anne,

      Thanks for your question! Actually, the modifications that we have made are primarily related to how we communicate the material. There are certainly illnesses that are significantly more common here than what I have seen in the United States such as hyatid cysts caused by worms, a surprisingly high incidence of organophosphate poisoning, and Typhoid. There are also things that are quite common back at home such as emergencies related to asthma and diabetes that are much less common here.

      We haven’t so much had to pioneer unchartered territory as related to emergency medicine as we have simply had to place more emphasis on some areas while placing less emphasis on others as relevant to our context.

      Honestly, none of our modifications have been truly revolutionary. But, I have begun to think more and more about the whole way that emergency medical education is approached. I think it is somewhat universally understood that we have to have a systematic approach to patient assessment and treatment. However, is there a way to do it more holistically? By that I mean, disease processes are not always so linear so maybe we need to re-look at our whole paradigm of step-by-step protocols and algorithms. Obviously I am not the only one thinking about this considering the latest AHA recommendations, but maybe we can apply these new ways of thinking more broadly.

      • Anne
        August 20, 2012 at 1:33 am

        Thank you for your insights. My office is planning to send me along with two other colleagues to deliver an EMT Course and AHA programs to medical professionals in Bhutan.

  2. Grant
    August 20, 2012 at 10:58 am

    Anne, That sounds incredible! Butan is a place that I dream to go one day. All the best! Please post to let us know about your own experiences related to curriculum development.

    I would recommend that you attempt to find out if their are cultural issues that you should take into account when teaching. For instance, for many Buddhist monks, it is not acceptable to touch their head. This may present unique challenges when performing a head-to-toe exam.

    Looking forward to hearing about your training in Bhutan. Truly a chance of a lifetime!

    • acastioni
      August 22, 2012 at 4:42 am

      Buddism is the predominant religion in Bhutan. Buddist nuns were given an opportunity, through the Ministry of Health, to receive First Responder training last year. I will find out how the cultural and religious aspects were covered. I will post my experiences.

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