EMS World

SEP 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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EMSWORLD.com | SEPTEMBER 2018 37 being introduced for the first time. It cov- ers information, skills, and equipment that have emerged recently or could be used in the future. Topics that could currently fall into this category include prehospital ultrasound, video laryngoscopy, an update of opioid overdoses or emerging infectious diseases, or equipment for moving patients (keep in mind that this side of the triangle will be fluid and continually change). This side of the triangle could be the most challenging. It requires instructors to stay informed and monitor publications and current events to keep up on emerging topics. This side of the triangle is important because effective surveillance of new activi- ties and other changing information in a field helps keep a program on the cutting edge. Next is the review side of the CET. There is a great deal of literature that deals with learning, memory, and forgetting. There are two concepts that demonstrate the importance of the review side. One theory is termed fading, the other decay. The fading theory holds that information is engraved, or inscribed into our brains, much like a path made in the woods as people walk along the same route. If people stop taking that path, it eventually becomes overgrown until it dis- appears. In the same way, facts and skills we learned in EMT or paramedic class can be forgotten if we don't use or review them. Decay theory was conceived by Edward Thorndike in his 1913 book The Psychology of Learning. 3 His premise was that memory fades simply due to the passage of time (this contradicted an earlier hypothesis, known as interference theory, which basi- cally suggested new information and mem- ories inhibit retrieval of old ones). So if a person does not access their memory and use the stored information, the information will wear away, or decay, over time. These two concepts demonstrate the importance of reviewing the knowledge, skills, and abilities used less often. Finally, the you side of the CET refers to topics that are specific to an agency, depart- ment, or individual. Topics on this side of the triangle depend on local data and should be closely tied to quality assurance or improve- ment (QA/QI) efforts. Remember, QA/QI is not meant to be punitive but should focus on maintaining a desired level of quality and be a way of preventing mistakes and avoiding problems. Thus, continuing education specific to an agency's needs is essential. For example, if data shows that driving accidents or mis- takes in PCRs have increased or the success of IVs or IOs has decreased, these areas need addressing in the next recertification program. The NCCP national requirements are fairly detailed, providing broad topics, then sub- topics with specific lessons. Local content requirements are decided by the state, regional, or local agency, and within the individual requirement providers are free to complete any EMS-related coursework. The con-ed triangle thus becomes especial- ly useful at the local and individual levels. It is fair to say that continuing educa- tion is the shared responsibility of both the healthcare provider and the administration. Whether career or volunteer, providers are expected to maintain their competence, but they are also expected to evolve and continually improve their performance and capabilities. Employers have the responsibility to develop their personnel and increase their potential to perform new, different, or more difficult tasks. Thus another use of the CET could be in agencies that conduct other professional development that's not part of a recertification process. If a fire or EMS agency begins using different CPAP equipment, if a police department begins carrying tourniquets, or if a hospital changes bed manufacturers, the CET can be useful to help steer the needed training. Similarly, the CET can be used on a per- sonal level. Providers who want to take a class but are unsure about the area they want to pursue can use the triangle for guidance. For example, a provider could choose a class on pharmacology (review), which could directly enhance his job performance; complete a course on writing (new) to enhance her documentation skills; or attend a class on public speaking or any other area in which they feel weak (you). Making CE Worthwhile The con-ed triangle is a model that can help simplify and organize the educational process for administrators, instructors, and students choosing a program. It promotes a bottom-up approach, focusing on the needs of field providers, and helps guide decision-making at all levels. The triangle will help turn CE days from something one has to complete to days all parties look forward to. REFERENCES 1. National Registry of Emergency Medical Technicians. National Continued Competency Program, https://www.nremt.org/rwd/public/document/nccp. 2. Commission on Accreditation for Pre-Hospital Continuing Education. About CAPCE, http://www.capce.org/About.aspx. 3. Thorndike EL. The Psychology of Learning. New York: Teachers College, 1914, p. 4. ABOUT THE AUTHOR John Alexander, MS, NRP, is a retired fire captain and currently a volunteer in Baltimore County, Md. He has been a paramedic for 30 years and involved in education for approximately 20 years. A three-sided approach provides direction for EMS CE. EDUCATION AND TRAINING MORE ONLINE! Award-winning EMS educator Rommie Duckworth lists the top 5 tips for better hands-on education at www.emsworld.com/article/220787.

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