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Original Contribution

How to Craft Continuing Education Worth Attending, Part 1: Start with the Student

Let’s face it, most EMS continuing education courses are bad.

Our field is laboring under a criminal burden of mind-numbing refreshers, painful in-service trainings and conference talks that aren’t worth the hotel room. They aim to achieve very little and fall short. Nobody walks away having learned anything new, and nobody shows up expecting otherwise.

Most continuing education courses suck. Let’s talk about how to make con-ed suck less. 

Start with the Student

Most teachers treat their classes like an audio textbook. They’ve put standard learning onto slides, and they’re going to read them aloud with some war stories mixed in. You may sit and listen, if you’d like.

They’re planning to transmit certain facts. If you don’t need some, can’t grasp others and really need help to understand the rest, tough luck.

It’s lazy teaching, and it doesn’t work. The only approach with a chance of engaging learners is one that starts with them, not you.

Make Them Care

The easiest way to ensure that students will listen is by offering content they’ve actually requested. If you receive a phone call asking you to put together a 12-lead interpretation class because all of the medics have been begging for it, it’s a fair bet that they’ll show up and stay awake.

Barring that, the onus is on you to create material that pertains to your audience, which means you need to sit down and think about their needs.

What do your learners actually do? In other words, what activities comprise their job? What tools, protocols, and skills are available to them? Do they transport patients—if so, how far? Are they 911 first responders, or is 99% of their time spent on interfacility transfers?  Are they rigorously trained and broadly experienced, or are they mostly newbies and newbies-at-heart? If they’re EMTs, do they assume primary patient care, assist medics, or just drive the big flashing box?

Unless you’re teaching to a certification, there is no such thing as a standard curriculum. Every point you make, every slide you project, every word that leaves your mouth needs to have some real utility for the actual providers in the room.

If the relevance of some information isn’t immediately apparent, you need to prove to everyone why they should care. But that can be a difficult task.

Try to connect it back to the audience. Demonstrate why your material pertains to them in a real, usable way. Remember: by default your learners are assuming that you pulled this module from the back of a textbook, and that 99% of it is generic filler. It’s up to you to convince them that you’re having a personalized conversation.

One approach when offering hands-on skills is to convince someone to demonstrate a technique (intubating a dummy, for instance), thus revealing some teaching points. Administering pre-tests is another tactic, but they’re tiresome and widely disliked.

A better method is to open with a case. If you can describe a patient scenario that’s familiar to them you’ll make it clear that you understand their world. Then, when you reach the cliffhanger, they’ll realize that they don’t know what to do, they don’t grasp the disease at hand, and they’ll create some space you can fill with knowledge. 

Build Bridges

Now that you’ve proven your students should care about your material, you need to actually cram it into their heads.

But wait! You haven’t forgotten about starting with the student, have you?

Imagine the content you’re teaching as an island your students need to stand upon. To arrive there, they’ll need a bridge that reaches from where they’re standing to wherever you want them to go.

Here’s the key: you can’t build a bridge by starting from the destination. Bridges start from their origin. It goes like this:

  1. Determine the knowledge learners bring to the table (Point A).
  2. Determine what additional building blocks are required for them to reach their destination (Point B).
  3. Gradually build a conceptual chain from Point A to Point B.

Let’s say you want to teach paramedics about shock, which will require some understanding of aerobic metabolism and oxygen transport. However, nobody in the room learned anything in medic school except “shock is low blood pressure,” and they certainly haven’t taken courses in chemistry, biology or physiology.

But they don’t need all of that; they only need some specific concepts. So you start from where they are, and hit upon the key steps: They know that organs are made from cells. (Yup.) Cells require oxygen for normal function. (Check.) Lack of oxygen produces injury and toxic metabolites. (Simple enough.) This process stimulates inflammation and organ damage. (Everyone’s on board with that.) And so on.

Before you know it, they’ve reached their destination. By focusing on what matters, you can create remarkably long chains, connecting limited background knowledge to sophisticated learning objectives. But short or long, those chains do need to be built, without skipping or forgetting any links. If not, nobody will understand what you’re talking about, nor why they should care, and they’ll be left wondering whether they actually need to be present while you talk to yourself.

How to Craft CE Worth Attending, Part 2: Be Smart, Teach Dumb

How to Craft CE Worth Attending, Part 3: The Takeaway

Brandon Oto, PA-C, NREMT-B, is an EMS educator and a critical care PA resident at The Johns Hopkins Hospital. He manages EMSBasics.com and LitWhisperers.com. His interests include BLS fundamentals, evidence-based medicine, physical diagnosis, and ECG interpretation.

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