How All of My Students Passed Board Exams on the First Try

January 26, 2012 Leave a comment

For the last several years I have been learning right along with my students. I’ve never been satisfied with just being an average instructor. As Albert Einstein once said, “Insanity: Doing the same thing over and over again and expecting different results.”

I choose not to be an insane instructor of EMT students.

A personal goal of mine has always been to have all my students pass their practical and written board examinations on the first try. Last semester, I was fortunate enough to reach that goal.

I would like to share some of the things I have learned along the way about student success in the classroom:

  • I have found that students learn best and retain more when they teach themselves. My classes are all required to participate in my online discussion board. I use the critical thinking scenarios and follow up questions from our text (Mistovich; Pre-hospital Emergency Care 9th edition). After the student’s initial response, all of their classmates are encouraged to give constructive feedback. I monitor the discussions and occasionally give my own input. These discussions take place online and outside of class. In class, I encourage small group collaboration to stimulate critical thinking skills.


  • Chapter open book quizzes are to be completed prior to attending lecture. This form of self-study helps prepare the student for the information they will receive during lecture. It stimulates discussion and often times the student will come to class with questions about the material. Once again, this puts the student in a situation where they are teaching themselves.


  • Finally, I am a rigorous not ruthless instructor. My students know from the first day that they can expect frankness and honesty from me. To let students languish for weeks on end, stealing precious time in their lives that they could use to move on to something else, when in the end they aren’t going to make it anyway—that would be ruthless. To deal with it right up front and let students get on with their lives—that is rigorous.

Kent Sallee is Logistics Coordinator and EMT-B /I.C/AA at Hutchinson Community College in Hutchinson, KS.  Sallee found that a combination of rigorous instruction and use of a Brady title helped his students succeed on the first try.


Balancing Full-Time Employment and EMT Training

December 16, 2011 Leave a comment

Twice a week I hurriedly change out of my business casual clothing and into my student uniform, scarfing down a granola bar as I battle rush-hour traffic to get to an evening EMT class. When I arrive, I’m always a bit tapped out. It’s a challenge to maintain equilibrium and find the gusto to all I need to.

One lesson I’ve learned in my current career as an educator is that my energy and sense of balance aren’t always the most important things. What’s important is my preparation and how I project myself. This may not be the traditional definition of attitude, but it’s the one that I like best.

As a student, I fall back on this lesson again and again. For example, my instructor is so good at teaching that I could probably get away with just skimming through my assignments. Instead I come to class having read the relevant chapter and taken notes on it. My preparation allows my instructor to go deeply into the concepts, spending time on anecdotes, examples, and demonstrations.

As for how I project myself, I may be on the verge of exhaustion, but what counts is that I slap a smile on my face, consume enough coffee to avoid dozing off during lectures, and participate even if it means wrestling focus in my tired mind.

Like any class, mine has students (a minority of the class) who project a sense of entitlement and fly by the seat of their pants, shocked by developments they’ve already been advised of. They grumble about everything from the fabric of our uniform shirts to the locations of our Emergency Department rotations and ambulance ride-alongs. Here’s my unsolicited advice to them:

Get over it. Or at least pretend you’ve gotten over it.

I drove an hour to my ride along, too. I detest how chunky my uniform makes me look. I too struggle at times to take it all in. I have a life outside this classroom, and sometimes I feel like I’m not paying enough attention to it. But each night I force myself to be pleasant, professional, and to keep my gripes to myself – as do the majority of my classmates.

Remember: that teacher you scowl at has mountains of seniority at the biggest ambulance company in our area. The lab assistants you talk back to are your future partners and supervisors. These people will have a huge impact upon your career, for better or worse.

Remember this, too: an EMT’s day is full of inconvenient weather, long hours, and situations that change midstream. You don’t have to be pleased by any of this (you may be a masochist if you are), but you roll with the punches.

As time passes, you may find that you’ve actually become more professional and more tolerant of the negatives of this fascinating, awesomely fulfilling field.

Bethany Annsa works full-time at Portland Community College as an Employment Specialist. She teaches career planning, sets up internships, and helps students find employment. In her evenings and weekends, she takes full-time classes (EMT-Basic and taking prerequisites for the Paramedic program).

Categories: emt, Uncategorized

Man vs. Barbed Wire

November 29, 2011 Leave a comment

Have you ever had of those days where your EMS day starts off relatively quiet and then BAM—all hell breaks loose?  Well, this wasn’t exactly one of those days, but it did turn out to be a memorable one for my partner and I.

We receive a call from the local Indian Tribal grounds for an unknown incident.

Beads of sweat began to form on my forehead, my palms began to tingle, and the adrenaline began to rush in anticipation of what we might find.  Would evasive measures like intubation, or drugs be needed? How long will transport time be to a trauma facility or cardiac facility if patient is in arrest?  “Remember Time is Muscle!”

After arriving on the scene, we were greeted by several kids who told to us to proceed down a muddy road in the woods on foot for about a ½ mile to a mile. Also, we were advised that it was an ATV vs. barbed wire fence accident.

Upon arrival, the patient, a five-year-old boy, was alive but his neck was completely severed from the left ear to right ear.  One could see both carotid arteries pumping blood.  “We were riding ATV bikes in the woods and didn’t see the barbed wire fence,” said a friend of the patient.  There was a large part of the client’s throat still lodged in the fence where he struck it.

The primary concern was airway. The young boy was desperate and breathing in a fashion he was not a custom to.  I attacked this by sedation, intubating and holding the tube in place with my hand (there was no way to tie the tube off on his neck). With a bag valve mask attached to O2, I provided oxygen to the patient. Two large bore IMs below the tuberosity of the tibia with Normal Saline administered. I secured patient to backboard, put his missing trachea in a plastic bag and put it in our mobile refrigerator unit in the truck and floored it to the hospital.

Medical Control granted us permission to transport ground to a pediatric trauma center because no helicopters were flying that day. Our ground transporting of the patient took a long hour and a half to facility.  Days later we learned that he survived the surgery and was recovering well.

S. David Pomerantz lives with his wife and daughter in Deerfield Beach, Florida. He can be reached on Twitter at @flaparamedic or Gmail at squad51paramedic [at]

Categories: Uncategorized

Critical Thinking: The Only Skill We Always Use

October 11, 2011 2 comments

By: Nick Montelauro, NREMT-P, FP-C, NCE

Because of the variety of hats I get to wear, I get to talk to students at many different points in their EMS careers – many who haven’t even started yet.   The question I get asked the most about our profession and the training and education we give is, “When I’m done with class, what do I get to do?”

My standard response is that the successful student will “get to” be trusted with other people’s emergencies. With the upcoming changes to the National Scope of Practice and new National Educational Standards, everyone seems concerned with who “gets to” poke holes in people or expose them to other potentially harmful procedures and medications.

The question I enjoy is another common one, “What’s the hardest part about becoming an EMT (or paramedic)?”

This question, in many forms, is what students and educators always want a simple answer to.   I’ll submit that there are many things required and different students will have different things that come easily and that will require more of their attention.  But when people ask me to name the one skill required to be a proficient EMS provider, there’s only one answer that stands out – you have to be able to make decisions.  Educators call this critical thinking and it’s a skill that touches literally everything you do from the time you report for your shift to the time you go home.

“But, wait, isn’t airway more important?  If the patient doesn’t have an airway, they die!”

What makes airway so important and why do we spend so much time harping on it?  Because you need to be able to make decisions about how best to manage it.  Is the patient maintaining an adequate airway on his own?  Do I need to intervene?  Which airway is most appropriate?  How invasive do I need to be?  How often do I need to reevaluate?  Each of these decisions could be the most important one you make today.

My students love the fact that skills are currently tested from a published, step-by-step rubric that can simply be memorized to ensure a passing score.  What they don’t love is when I tell them to put the skill sheets down so we can talk about “real life.”  They know I’m going to what-if them to death.  They know I’m going to ask them what to do when the equipment doesn’t work right, when the airway won’t fit, when the transport is prolonged, when the patient’s complaints don’t fit squarely in any one protocol, or when the patient won’t cooperate with what the skill sheet says will always happen.

They know we’re in for some heated discussions, a lot of push and pull, and a lot of agreeing that there’s more than one way to skin a cat and that some bridges can only be crossed when you come to them.  What they may not know is, I’m forcing them to sharpen the axe in a way that some don’t think about – the anguish I’m putting my students through is going to pay off on their first non-traditional call.

The ability to make a decision is a skill that can be studied at great length.  Professionals in many fields -pilots, physicians, quarterbacks, and executives – study decision making and the ones who are the best at their jobs are often the ones who make the best decisions.

And next time you’re in class, or between calls, or doing some self-evaluation to look for ways you can be a better provider, don’t forget the one skill you use on every call: critical thinking.