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Issue link: https://emsworld.epubxp.com/i/131347
IMMEDIATE ACTION DRILLS Throughout your life you've probably encountered many sayings about achieving mastery performance in any given domain. One that immediately comes to mind is, "practice makes perfect." While this phrase speaks to the importance of repetition—and is reasonable for something like learning to play an instrument—it doesn't address contextual challenges. Another saying often used to address performance in high-stakes environments (e.g., tactical operations) is that given a situation, you will not rise to the occasion, but instead default to the level of training you've mastered. This one does a far better job of capturing the essence of mastery performance as a paramedic, but still leaves room for improvement. When it comes to skills training in EMS, students are typically tested or asked to demonstrate these skills in a manner that allows them to anticipate the process. We give students a skill sheet and ask them to remember a sequence—something akin to an actor memorizing lines. Our national certification process even includes this practice. But we all know EMS calls don't follow a script. This is why seemingly intelligent students sometimes choke when faced with a dynamic situation. It's not that sequence training is bad, but we must focus on short sequences that can be taught and tested dynamically. Immediate Action Drills The concept of immediate action drills (IADs) comes to us from our tactical brethren. These drills have been described as the execution of preplanned actions when an unanticipated threat is encountered.5 Such sudden developments do not typically afford time to think about the situation, so successful performance depends on immediate and instinctive actions. IADs have also been described as a programmed sequence of actions intended to accomplish a particular task.6 Classic examples of IADs in the tactical context involve actions intended to respond to an ambush or weapon failure. The concept of IADs is adaptable to EMS because it's not about specific skills or products, but rather the cognitive aspects of responding quickly to a situation based on having previously drilled in preparation for that situation. IADs must be tailored to the specific challenge you're seeking to overcome.5 These short sequences must then be practiced repetitively—and in response to a designated cue—until they become second nature. Incorporating IADs into EMS education can raise our level of training to accommodate challenges representative of our environment, thus overcoming potential performance limitations. Theoretical Support There are several theoretical perspectives that support the concept of IADs, as well as the use of IADs in the context of EMS education. They include the stages of learning a new skill (i.e., stages of Co-located With 25th SEPTEMBER 8-12, 2013 SEPTEMBER 9, 2013 Las Vegas Convention Center | Las Vegas, NV Hosted by NAEMT's PHTLS Committee and EMS World Expo Experience the Latest Global Trends in Prehospital Trauma Care Due to popular demand, World Trauma Symposium returns to co-locate with EMS World Expo for its second year. Register today to gain access to the latest information on the care of prehospital trauma patients and discover global trends through sessions led by internationally recognized experts. Register by August 12 and Save $50! 50 JUNE 2013 | EMSWORLD.com Participants of this one-day event will earn 8 hours of CECBEMSaccredited CE, CME or nursing credits. Visit WorldTraumaSymposium.com for full event information and to register.