Guest Editorial: Teaching During the Pandemic

Dear EMS educator:

I have been meaning to write this letter for a while. We are currently facing unprecedented challenges with the COVID-19 pandemic. From the instructional closures to the mandated social distancing, we have been thrust into an educational conundrum. As a fellow educator, I share your worry and feel your pain. But I challenge you to turn this time of deviation from normalcy, consistency, and familiarity into a unique opportunity for experimentation and exploration.

We have all heard of new educational delivery models that revolve around the concept of “flipping the classroom.” Many have fought against change from unidirectional PowerPoint delivery and have forced continuation of a traditional classroom. I’ve heard reasons ranging from “We need to all be together as a group to facilitate discussion” to “I need to teach the material to ensure they get all they need to know.” 

While I can’t agree more that social and communication skills are critical for any healthcare provider, when they leave your nest and are running calls at 2 in the morning, do you want them calling you to discuss the best course of treatment? Teach them how to fish as a team. This pandemic is the perfect time to host Zoom sessions and give topics to crews/students to make learning objectives and teach back to other crews in different sessions.    

The idea of students teaching students is easy: Take the topics you were covering with your PowerPoint and assign them to crews. These crews will collaborate (a mechanism for communication, CRM, and time management) and deliver their learning objectives to the class on a set date. This forces them into the material, knowing they may be asked a question to which they are unsure of the answer and did not prepare. If their classmates don’t ask discussion-provoking questions, then you should as the facilitator. This is the check and balance. Set boundaries and guidelines in their development of learning objectives, forcing them to use interactive media like Kahoot, PollAnywhere, etc. 

Case studies are another solid and relatable mechanism of instruction. Have crews build the “back story” of the patient’s case (HPI) and determine SAMPLE, physical findings, expected treatments, outcomes, etc. Then have the students host the Zoom meeting, with one group member assigned to moulage him/herself as the patient, screen-share the vitals, simulated monitor, etc., while another crew member interviews the patient. Now you have turned a case-based learning module into a virtual simulation. In an ideal world (and in future distance-based classes with more time and prep), the students at home would have a kit of demo medication, skill items, etc., so they can demonstrate to the rest of the class how/what they would do/give to the patient. 

Think about the integration of “flipping the lab” into your program. Now you have an extension beyond your physical lab that can open up the opportunity for virtual-based skill checkoffs. You can hold virtual labs where the students videostream the skills live as they do them, and fellow students or program faculty evaluate them in real time. Since the skills are being performed live, you can give live feedback. 

I recently had the unique opportunity to help a friend facilitate a virtual classroom lesson on sepsis. I was amazed at the engagement of the students, the questions they asked, and the in-depth content we covered. We used the Keynote app on the iPad for drawing on like a whiteboard and iSimulate REALITi for the monitor screens. This allowed the students a direct view of the diagnostics consistent with a septic patient before and during shock while emphasizing the end-tidal CO₂ expectations and vital sign changes based on various treatments students offered. I was encouraged by the student response to this new mode of learning and excited about its measurable effectiveness and relative ease of both implementation and application. 

I leave you with a thought: What if there were no more physical EMS classrooms? What if the expectation was that all didactic education be done in collaboration with distance facilitation by instructors, whether it be via live-streaming sessions or student groups sending recorded video sessions back to faculty for review? What if all in-person education was only utilized for interactive engagement of relatable vignettes, scenarios, and summative full-simulation training? 

We are in a whirlwind of change, with no real information on which way the wind will blow next. Take the initiative and run with the online world of creativity and remote education facilitation. 

Chris Kroboth, MS, NRP, CCEMT-P, has been a paramedic/firefighter in the Fairfax County (Va.) Fire and Rescue Department for more than 15 years and in EMS for more than  21. He is currently the EMS training captain in charge of continuing education programs and certification as well as affiliate faculty with the Virginia Commonwealth University/Fairfax County Fire and Rescue Paramedic Program.