Precepting the EMS Student

1. Precepting the EMS Student

2. THANK YOU • On behalf of the Trinity Valley College EMS Education Program we would like to personally thank you for working with our paramedic students to assure their competence as a graduate paramedic. Without your evaluation of our students we could not have the quality paramedic program that students and employers have come to expect. After completing this quiz, you can fax it to 903-729-2325, scan it and email it to swalker@tvcc.edu, or by regular mail. The mailing address is PO Box 2530 Palestine Texas 75802. • You will receive 1 hour of continuing education. Scott Walker EMS Program Director Heidi Knowles M.D. EMS Medical Director

3. Contacts Heidi Knowles, MD EMS Medical Director Scott Walker BS, NRM, LP EMS Program Director JD Mason AS, NRM, LP Lead Instructor Paramedic John Miles Med, EMT EMT Program Coordinator Chenoa McGee RN, LP EMS Office Coordinator

4. Objectives • Define the role of EMS Preceptor • Define EMS Education expectations • Define Preceptor’s relationship to students • Describe the tools used for adult learning • Discuss education principles / ideas • State what this does for the student

5. Who should review this Paramedic Preceptor Training Program? • Paramedics in TVCC EMS System • Nurses in clinical areas (pre-assigned locations) • Preceptors in off-site areas (pre-assigned locations) • Requirements to function in preceptor role as a paramedic:

6. Success of the Preceptorship • Success of a preceptorship is determined by the relationship between the student and the preceptor. • Students look to preceptors for answers and guidance. • Preceptors are an extension of the classroom.

7. Role of a Preceptor • Support students to make them feel they are safe and valued • Demonstrate by example how competent staff perform their job • Know and appreciate the student’s knowledge level • Remember what it was like to be a student yourself • Facilitate learning rather than controlling it • Preceptor directs the process of learning • Student sets the pace of learning • Direct, coach, support, and delegate • Be willing to provide constructive and regular feedback on student’s performance • Be responsible for the student for the entire shift the student is scheduled

8. Preceptor Bill of Rights All preceptors have the RIGHT to: Be treated with dignity and respect -Be free from intimidation or harassment -Expect their students to discuss and/or demonstrate core knowledge -Expect their student will be eager to learn -Expect their student will initiate questions -Be creative in student instruction -Report student deficiencies they perceive -Be free from the threat or act of retribution

9. Student Bill of Rights • All students have the RIGHT to: -Be treated with dignity and respect -Be free from intimidation or harassment -Make mistakes; have a preceptor who is able to correct and/or intervene -Expect their preceptor wants to teach -Expect fair and impartial evaluations -Expect fair and reasonable answers to questions -Not be subjected to inappropriate situations -Report situations to appropriate supervisor without threat of retribution or retaliation

10. Conflict Resolution In any situation where a conflict arises, the primary concern should be to ensure the safety of the patient and providers. Actions taken difficult situations should, at a minimum, “do no harm”

11. Conflict Resolution • Patient Care Issues • The student should inform the preceptor whenever he/she is asked to perform or withhold an intervention they feel ill-equipped for, or which is inappropriate for the patients. • If the student is directed to perform the intervention after his/her concerns, they should turn control of the patient over to the preceptor and refuse to perform the intervention • The preceptor shall respect the student’s concern and take over patient management with minimum disruption in the continuity of care. • The student should document the above in writing to the Program Director as soon as possible following the incident.

12. Conflict Resolution • Intern – Preceptor conflicts: • If conflicts arise between the student and his/hers preceptor, the Program Director should be notified by phone as soon as possible; this should be followed up in writing within 72 hours • The Director, in consultation with the Program Medical Director, will review the situation and make recommendations for its resolution. • Problems not resolved to the satisfaction of either party will be referred to Harold Jones who handles student issues for the final resolution.

13. Conflict Resolution • Substitute for required staffing • Should the student find that he/she is replacing a required member of the ALS crew during a rotation, they should remove themselves from the unit and notify the Program Director as soon as possible. This should be followed up in writing within 72 hours. • The student is expected to exercise good judgment in doing no harm to patients.

14. Laws of Learning • Individuals accept and repeat responses that are pleasant • First impressions are lasting • Repetition yields habit • Skills not practiced are forgotten • Dramatic experiences leave lasting impressions

15. Characteristics of Interns • Millennials • Positive and confident • Seek structure but without impeding their freedom • Multitasking is a way of life • Expect to always be connected • Learning is like Nintendo, not logic • Intolerant of delays

16. Characteristics of Interns • Adult learners prefer learning situations that are: • Practical and problem-centered • Promote their positive self-esteem • Integrate new ideas with existing knowledge • Capitalize on their experience • Allow choice and self direction

17. Characteristics of Interns • Learning styles • Visual learners: prefer to see your body language and facial expressions; will do better with written instructions; better understand client from the chart • Auditory learners: interpret meaning through tone of voice, pitch and other nuances; will do well with case conferences and meetings, interviewing and instructing patients • Kinesthetic learners: prefer a hands-on approach; will learn by practicing skills; be adept food production, anthropometric measures, demonstrating skills to others

18. Learning Barriers • Poor work habits • Poor attitude • Lack of experience in applying theory to practice • Discomfort working with those with illness • Discomfort working with professional colleagues and/or employees • Feelings of inadequacy • Fear of making mistakes • Unwillingness to venture out of one’s comfort zone

19. Learning Barriers • Too much or too little self-confidence • Stress • Overly strong or weak personalities • Learning disabilities: Attention Deficit Disorder, reading disorders, dyslexia, slow processing issues • Medical problems

20. Students who Receive Regular Feedback about their Performance • Often perform significantly better • Develop better judgment • Learn faster than students who do not receive regular feedback Goal of feedback is for the student to become competent at the level expected at a given point in his/her education and to be ready to move on to the next rotation/experience.

21. Adult Learners • Characteristics • Self-directed • Are motivated by their desires • Want to participate in planning and evaluation • Relate current experience to previous experiences • Want to be heard • Want their efforts acknowledged • Want to be treated with respect and dignity

22. Creating a Conducive Learning Environment • Display mutual respect • Collaborate; don’t compete • Have open, 2 way communication • Feedback is encouraged and enhances growth • Feedback needs to be concurrent, immediate and shared in a manner void of blame or personal attacks • Feedback should never be provided as a put down

23. Student Development • Students are in a process of developing entry level knowledge, skills and behaviors • Student development is a gradual phased progression • Orientation and a plan outlining activities and expectations for the rotation should be reviewed • Students appreciate the opportunities to participate in activities and learn from observing practices of more experienced colleagues

24. From Novice to Expert • 1. Novice • 2. Advanced Beginner • 3. Competent* • 4. Proficient • 5. Expert • * (goal of entry level) Benner, P (1982) From Novice to Expert. AJN 82( 3), 402-407

25. Novice Student • Participate in orientation program(s) • Perform in an observational role • Demonstrate competency of BLS skills • Possess a general knowledge base • Be able to follow directions • Be dependable • Possess an attitude open to learning

26. Advanced Beginner • Begins to focus on ALS Skills • Model behaviors observed • Additional responsibilities added if student can demonstrate they can handle more and are approved through the training program and are functioning within their scope of practice • Overall patient management should be the responsibility of the preceptor

27. Competency (goal of entry level) Proficient Student • Focuses on overall patient management • Demonstrates team leadership skills • Demonstrates evaluation completed thoroughly and with accurate assessment • Delegates tasks to other team members • Capability for accurate treatment, transportation decisions, effective communication • Displays confidence, performs with authority • Demonstrates flexibility and professionalism

28. Field Evaluations

29. Field Evaluations

30. Clinical Evaluation

31. Providing Feedback • Start with positive feedback • Find something to say! • Reinforces behaviors and encourages repetition • Needs to be timely • Needs to be objective • Needs to be constructive • What was done right • What opportunities for improvement are evident • Needs to be documented to provide continuity throughout the learning process

32. Summary • You are Educators, Teachers, Counselors • Our expectations of you are to be our eyes and ears, to teach, and to evaluate • If we use these teaching tools properly we can pass on our knowledge to the students • If we all do our part, we can continue to graduate quality EMT’s and Paramedics. THANK YOU FOR ALL YOU DO FOR OUR STUDENTS!

33. Resources • https://www2.tvcc.edu/Health-Science-Center/healthscience/EMSPreceptorOrientation/index.html