Ready for an unpopular idea?

[mycrofft]

You, I like.

So, I have a tendency to wind up working for training houses, not really by design, but perhaps by temperament. We hire them out of school, they work for us for 6 months or so, and either go on to better pay or decide that this isn't the field for them and try something new. This perhaps gives me a different perspective on the question than most, or perhaps not.

From my observation, short of the absolute inability to learn the material, there's very little way to tell from how someone does in school whether or not they'll do well in the field.

As far as I'm concerned, these are the traits that make for a credit to the profession (though in all honesty, to varying degrees you don't need to have all of these traits to do okay in this field, just to be the best, which is what I want every last people with a star of life on their shoulder to be):

1) You've got to love it for what it actually is, not for what Johnny and Roy told you it would be. Considered dispassionately, this is a bad job, if you don't love it, you can do better elsewhere.

2) You do have to know your book-larnin', you don't have to absolutely master it, but you have to know it well enough to serve as a foundation for what you're going to learn in the field. As someone said, though, this stuff isn't exactly rocket science, most anyone who wants to can learn it, and if someone meets all the other requirements (notably the next one), I'll hold their hand through it.

2a) You've got to keep learning. I learn all the time, I learn from articles and studies, I learn from other EMTs (And not just 'medics, I've learned from basics, too), I learn from following up with pts I've dropped off, and I've learned from reading the charts of pts I'm doing IFTs on.

3) You've got to care about your pts in just the right amount. While they're in your truck, they've got to be your best friend, and once you walk away from their bed, you've got to walk away from them, too. I've seen otherwise promising EMTs destroyed because they couldn't get over the code they couldn't bring back.

4) You've got to stay calm when the fecal matter hits the rotary impeller. This one there's a little bit of wash on, to an extent, this can change, they freak out the first couple of scenes they're on then settle down, but some people are just constitutionally incapable of it, and you can usually tell the difference. (There is, by the way, a huge difference between panicking on a scene and panicking on a test. Some people just have test anxiety, and that's why I'll encourage someone who I know knows the material when they fail the test, I'll even work with them on the material, not so much to teach them, but rather to give them the confidence to pass the test.)

None of that can really be taught (aside from the basic grasp of the didactic stuff.), and largely it can't be tested for, the only way to see it is to put them in the field.

I can tell, with about a 95% accuracy, whether someone will make it in this field after I ride a single shift with them.

The ones who won't make it, unless they are dangerous, I'll lead to the conclusion that this isn't right for them, rather than actively getting rid of them. If I don't, then I'm just cursing them on a different service and community.

The ones who will make it, I take over where their school left off, and give them the knowledge and tools they need to be great.

It's not an ideal system, I wish there was some way to wash them out before they ever go near a patient, but I've yet to figure it out.

Try the system we used in the military: wash-backs. Sequence your teaching and practicums, do not deviate, and if someone fails a block, make them fall back with the next class and start over at that point. In a system without the mass of teachers to constantly teach blocks one after another, this might mean a six month layover (if the class is offered twice a year). Time to reconsider, restudy.

UnkiEMT your approach is the one I would aspire to if I were in that position.