The "Old Way" is no longer the best way.

It was the final activity in a long journey to become an Educational Standards credentialed EMT Instructor.

My home state Office of EMS (OEMS) is known for being on the front line of ems education, a strong player among the National Association of State EMS Officials and early advocate for the National EMS Education Standards.

OEMS puts on an annual symposium that rivals national conferences, with an impressive roster of nationally recognized speakers. Reflecting the Commonwealth's large cadre of rural and volunteer providers, a judicious selection of symposium courses will meet all of your required continuing education requirements before your next recertification.

Skills Review

EMTs are required to have 3.0 hours of skill review as a Category 1 continuing education requirement. Saturday afternoon at the symposium had a three hour Skill Review as part of their "BLS Academy" program.

New psychomotor assessment sheets were issued in July. This November session was the first state-run skill session using the new evaluations. My hope was to take away some tips and techniques to share with my fellow "EMT/Ancient" instructors.

I was not the only state instructor attending as a student …

"When attending as a student …"

The skill session was over-subscribed, with about 100 attendees. The lead instructor recruited additional Educational Standards credentialed instructors to double-staff eight skill stations.

My cohort included a factory worker who was part of the in-house safety team, a couple of rural providers and a couple of suburban providers. One of the cohort members was a fellow ancient instructor.

I learned this in the second skill station when she wanted to show the instructor "… how WE do this skill." It was clear my sixty-something cohort instructor/partner was not a fan of the new skill sheets and seemed to be on a mission to convince every instructor we encountered we needed to go back to the EMT/Ambulance skill sheets of the 1980s.

"Who the hell taught you to put the straps on THIS way?"

The inevitable collision occured at the sixth skill station. We were doing spinal immobilization using a backboard. My instructor/partner was putting on the straps. The thirty-something Educational Standards credentialed instructor, who has a job that includes delivering EMT instruction every week, disagreed with the procedure used by the more experienced student/instructor.

The estrogen was flying. While the sixty-something and thirty-something were hardening their positions and raising their voices, a willowy twenty-something student/newlywed burst into tears and walked away from the group.

I was still partially secured to the backboard.

All the industrial EMT and I wanted was to finish the two remaining skill stations and get our 3 hours of credit.

The twenty-something was upset because in a prior skill station she was chastised by another female instructor because she was never shown how to apply a tourniquet. Apparently more than one student at this skill station received the "we no longer use tourniquets" information in their initial EMT course.

In my recent ems1.com column, I advocate that EMT Instructors Need to Step Up. They are the key to successful providers in the Educational Standards era.

Dan Limmer, an EMT textbook author, points out that the Educational Standards eliminates the linear procedures that were a dominant feature in NSC curriculum.

Limmer points out that a better student understanding of physiology and pathology creates a foundation of understanding that allows the EMT to make a complaint-based approach to patient assessment.

In order to accomplish this, the EMT instructor needs to develop educational experiences that focus on decision-making and not regurgitation of a memorized standardized checklist.

This is a new instructor skillset that is not familiar to many.

EMT instructors must move beyond teaching a linear approach to patient care. Instructors have to invest in themselves and reconsider their role.

Mike "FossilMedic" Ward