I did a short piece for the Missouri EMS Association on the making of an EMS conference. It can be viewed here:
The ICE Spring Break Conference wrapped up earlier this week. Day 3 was another big day of awesome presentations, and I thought that I was all set to share it with my friends in the blogosphere. Then my mobile devices (plural) and laptops (yes, also plural) began dying off from three days of only intermittent recharging. The sad fact was that my hotel room had only enough power outlets for the furnished lamps, television, and perhaps two more devices. What was a traveling tech-nerd to do? My idea of unplugging all the lights and television met with considerable ire from my roommate, so I had to compromise and put my devices on a rotating schedule of recharging. This little geeky misadventure led me to one conclusion. I will have to start traveling with a power strip. I’m not sure if this is the correct conclusion, but I’ll give it a try.
Leaders Make Mistakes Too!!
Chris Cebollero is the EMS Chief for Christian Hospital’s EMS Division in the St. Louis metro area. In this class, he outlined the common pitfalls made by leaders on a daily basis. Besides presenting an appealing a topic, Chris piqued my interest by simultaneously recording his presentation for the EMS Leadership Podcast. Podcasting is like catnip for tech-nerds, so I was downright giddy within the first few minutes of his talk.
Chris outlined a laundry list of mistakes most common to EMS leaders. Some of the most notable are…
- Failing to communicate well
- Failing to delegate
- Failing to develop a vision
- Not setting goals with employees
- Not listening
- Failing to learn
- Not managing change
- Not making time for employees
- Not recognizing employee achievements (even if it’s something as simple as picking up a shift on a holiday)
- Going for quick fix over lasting solutions
- Taking it all too seriously
- Say/Do Conflict (leadership is what you do – not what you say)
- Punishing the many for the sins of the few
- Confusing sameness with fairness (one size does not fit all – acknowledge the individual)
- Not forgetting the paperwork in the desk (if they were written-up last month, fine – leave it in the file and get back to setting them up for success)
I think procrastination was on the list, too. But we can talk about that some other time. Even with the several items I left out, his list is quite long. I could recall times when I had made many of those same mistakes, back in the days of… wait, I think I did most of those last month. Some twice.
His challenge to recognize and correct our mistakes was compelling to say the least. I decided I needed to stay put for his next breakout session.
Getting Things Done Without Getting Done In
In a little over an hour, Chris had managed to help me feel better about my piteous history as a leader. He presented the audience with copies of the workbooks he uses to develop leaders in his organization. The focus of the material is to equip new leaders with the four primary skills of a leader: planning, organizing, motivating, and controlling. Without being able to offer the PDF to you, all I can say is they definitely have their act together at Christian Hospital’s EMS Division. Well done, Chris!
Inspiration and Perspiration
Rommie opened the conference with a rousing keynote lecture, and he also did a great job of sending us on our merry way as the last speaker. Though he is the consummate professional and wouldn’t complain about a job he loves, I couldn’t help thinking that the opening and closing speaker really gets a raw deal. Rommie was either having to wake people up on the morning of the first day or keep them awake on the afternoon of the last day. He was certainly up to the task, though.
He described his role on 9/11/01 at Ground Zero, and the events that later gave him a unique opportunity to comfort a firefighter’s widow and her son. Events such as these often fuel our fires as educators. They inspire us to teach the ones who will be in the field on the next “big one.” The sweat from the brows of the field providers is really where it’s at, but they need inspiration, too. As educators, that’s part of our role in EMS. That’s what it’s all about – Inspiration and Perspiration.
I had a great time at the 2012 ICE Spring Break Conference, and I encourage EMS educators in the midwest to join us there for next year’s event!
Yesterday was day two of the ICE Spring Break Conference for me, and I’m continuing to learn all kinds of new information. For instance, I learned that after the lectures have wrapped up on a particular conference day, many participants attempt to drink the Anheuser-Busch Company out of business. This was all reported to me after the fact, though. Like any good clinical educator, I was back in my room memorizing protocols and asleep by 9:00 pm. Yep, that’s my story and I’m stickin’ to it.
The Nature of Emergency Services: A Beekeeper’s Perspective
Perhaps not everyone left the pre-con to study protocols the night before Rommie’s early morning opening lecture. Easily half of those present were sleepwalkers, but had somehow managed to get dressed. Rommie definitely woke them up. His presentation style is 70% solid info & tactics, 30% humor, and 10% atomic-level energy. Don’t question the math, just go with it.
He has been an emergency services lecturer since 1992, so he knows how to work a crowd. Rommie shared with the crowd all the parallels between EMS and his favorite hobby: beekeeping. He claims, “The parallels between the work of a beehive and the work of emergency services are astounding. Bees have an organization with an overall goal that is achieved by selfless individuals each with a specific job to do. As in emergency services, every beehive has rank and structure, discipline and seniority, leadership and field work, all pulling together for the community.”
I was more than a little skeptical when I read the conference brochure, but he made a lot of great points. Among them were…
- Bees can make honey out of all kinds of stuff. We have to do that to make EMS work in our local areas, too. Whether we are municipal, private, fire-based, or flight; we have to learn to deliver the same product given a variety of environments.
- Beehives may look the same, but they aren’t created equal. Although identical (like many ambulances and stations), some hives are high-performers and others are nearly dormant. EMS agencies can’t be judged solely on seeing ambulances/employees roll in and out of the station.
- Honey bees are the perfect employees. They wake up ready to work, always meet the dress code, clean up after themselves, bring the right tools, etc. They don’t get upset about bees in another hive or policies in their own hive. They have a singular job and they do it well.
Cleverly woven into the energy and humor, Rommie made many other points about serving and leading in EMS. His unique off-topic approach drew the audience’s attention, too. He probably did not set out to learn beekeeping in order to prepare this lecture. At least I hope he didn’t, because that would be possibly the lowest imaginable return on investment. Rommie simply found a novel way to blend profession and pastime. I would love to do the same, but I’m drawing a blank on analogies between EMS and my new pastime… going bald.
The Art of Being Preceptor
Linda was a science teacher before coming into EMS, so I was really looking forward to hearing her views on EMS education and precepting. She immediately caught my attention by encouraging us to drop the term “preceptor” and turn to the term “mentor.” She believes that the latter helps convey the relationship that should be cultivated between the student and the training officer. I couldn’t agree more!
She also stressed that the core qualities of a preceptor are integrity, patience, and BEEEEP, BEEEEP, BEEEEP!!! No, Linda didn’t launch into a list of expletives. The fire alarm went off and the building was evacuated! Seriously, I can’t make this stuff up, people!
Blogger’s Note: For my FTO peeps, I highly recommend the book Field Training Officer: Tips and Techniques by Nepon & Eberly.¹
Cultivating Your Agency’s Medical Director
Dr. David Tan, MD, FAAEM
Dr. Tan was recently elected to the Board of Directors of the National Association of EMS Physicians, so when he speaks people listen. His topic was perfect for those services with part-time Medical Directors who are only able to make it into the office occasionally. Obviously my math and guesstimation abilities suck eggs, but I’m pretty sure 99% of our Medical Directors fit that bill.
He advised, “Many agencies see the value in having a dedicated individual in charge of overseeing medical operations. Most progressive agencies will appoint an EMS Lieutenant, EMS Captain, Chief Medical Officer (CMO), or similar designation to oversee Quality Assurance and to work directly with their Medical Director. However, the process in selecting these individuals is highly variable, and the individuals themselves often have no formal training or qualification other than ‘senior paramedic’ on a crew.” Dr. Tan shared a list of best practices to consider when promoting your next CMO.
Additionally, he gave a list of issues of which CMO’s must be well aware…
- Controlled Substances Act. Do you know all the forms required for tracking your narcotics and how your regional DEA agent wants them filled out?
- Nationwide Drug Shortages. Understand the Active Pharmaceutical Ingredient (API) quality concerns and manufacturing profitability issues that drive the shortage. Have a plan for your agency.
- Continuing Education. Many agencies require NO direct laryngoscopies of their paramedics before saying, “Here’s your bag of drugs and sharp instruments!” How about yours?
- Annual Skills Testing / Crew Competency. Make no assumptions regarding provider competencies.
- QA and CQI. Know the difference between Quality Assurance and Continuous Quality Improvement. Know the importance of feedback to the providers. You need to PDCA; plan, do, check, act (also known as the Deming Cycle).
For those veteran CMO’s he advised getting professional credentialing endorsed by the National EMS Management Association and the International Association of Fire Chiefs EMS Section.
Dennis is currently the paramedic education coordinator at HealthONE EMS and a bi-monthly columnist for JEMS online. His delivery style if very engaging and the presentation was primarily focused on initial EMS education. He encouraged the use of computers and mobile devices in the classroom for their quick-search abilities, but acknowledged that students are probably using them to talk to each other. This made me feel far less guilty for sitting on the front row and using three different mobile devices!
Though I don’t provide initial education, I still gleaned some nuggets of wisdom from Dennis. Make sure that all your handouts are updated. It’s funny how often people will remember the wrong/outdated information you forgot to take out. Likewise for skill demonstrations. Take the time to produce an accurate skills video that can be used for consistent instruction. Experiment with your classroom setup. Don’t be afraid to deviate from the traditional lecture hall arrangement of tables and chairs.
My favorite part of his presentation was an exploration of a quote from Chris Le Baudour. He shares this on the first day of class and though it’s not an exact quotation, the gist is, “Questions are not allowed in class… (long pause for effect)… until you’ve asked two classmates and consulted one reference source on your own.” I would bet half of my readers just fell out of their chairs. Most simply fell asleep from reading this drivel, but a few were violently shaken by the idea of students not coming to the instructor for information (commonly known as “Shaken Reader Syndrome”). The concept of encouraging our students to look elsewhere for information may initially give us heartburn, but think about it in the context of field work. Once students get their boots on the streets, they’ll be encountering far more issues that require team learning. Let’s get them used to doing it now.
Pimp My Classroom
Tim Bobbitt is a fresh new face on the conference circuit in our area. He started his EMS career in 2003 and is currently working for St. Charles County Ambulance District as an Assistant Supervisor, Primary EMT Instructor and Paramedic Adjunct. In his free time (not a term with which I’m familiar), he is also an independent item writer, editor, and contributor for Elsevier.
This interactive class was all about sharing “outside of the box” ideas used for the classroom. Tim’s presentation was over an hour of nonstop genius, and I wish I would have had the presence of mind to record it. Here are just a few of his “pimp my classroom” tactics:
- The manikins you see in the mall can often be found on the cheap if you’re willing to do some hunting store-to-store or search on Craigslist.
- If you don’t have $2-3K in your budget to drop on a Smart Board, you can use simple technology to do the same thing with any projector and screen. Check out this great TED Talk on the subject.
- Idea Paint at Lowe’s. This will turn any surface into a dry erase board.
- Your local butcher probably throws away a lot of stuff that could be used for comparative anatomy or airway labs. Pig lungs (or any other organ, for that matter) are often free for those who simply ask nicely.
- Harness your students’ skills at beer pong for something educational. “EMS Pong” can be played in the classroom with similar rules and test review questions in each cup.
- Think your PowerPoint tricks are amazing? Chances are good that many have already seen them done. Prezi is a more affordable presentation format that offers an immersion feel for your audience.
- Tired of the same old topic posters or flashcards? Add some contemporary design to your teaching using Wordle.
- Zygote Body is an amazing website for teaching human anatomy.
- Trainer’s Warehouse is a great place for purchasing instructional aids.
- Here are a ton of ECG teaching resources.
Tim also has his own website where you can see the other cool stuff he does. He’s definitely a guy to watch over the next few years, and I hope I can get him to start blogging or podcasting to share more of these ideas (hint, hint, Tim).
1. Nepon, Bruce, and Barry Eberly. Field Training Officer: Tips and Techniques for FTOs, Preceptors, and Mentors. Sudbury, MA: Jones and Bartlett, 2008.
|Organizers painstakingly burnt
the edges of 2,000 brochures
Earlier this month, I had the pleasure of attending the 31st Annual University of Missouri Fire Rescue Training Institute’s (MUFRTI) Winter Fire School. As in years past, the conference planners were successful in arranging for the coldest Missouri weather possible for the weekend of their conference. As is also their tradition, they held it in Columbia, MO. For those of you unfamiliar with Columbia, it is the quintessential college town and commonly known as the “Athens of Missouri.” For those of you unfamiliar with Athens, it was where Aristotle invented the light bulb.
|Modern fire apparatus that are capable
of simultaneously putting wet stuff on the
red stuff, waking up the neighbors,
doing your taxes, and making the
perfect caramel macchiato
Each MUFRTI Winter Fire School begins with an equipment exposition on Friday night at the Holiday Inn Select. This year, the organizers wisely chose to move the larger apparatus to the exposition hall after a 17-engine pileup in the hotel restaurant last year. Apparently someone had falsely announced a free pizza buffet.
There were dozens of vendors selling everything from key chains to ladder trucks. FireMaster had a great booth, where I picked up a wiggy-waggy switchy-thingy for my truck. I even ran into several old acquaintances who were surprisingly willing to speak to me in public. To Shelly from Cox Air Care, Joe from 1st Due, Jonathan from Alex Air, and Dennis from LDCFM; it was great to see you!
|Mizzou’s Columns are the embodiment
of super-smart-stuff and my top choice for
the next obstacle in ABC’s Wipeout
Once upon a time, on a campus far, far away…
Stepping onto the campus of the University of Missouri was invigorating. Partially because the wind chill was approximately -10 F, but also because of the collegial atmosphere. Many of the people scurrying to and fro were clearly of the academic sort. Others were stumbling to and fro, and clearly of the inebriated sort. The whole scene brought back fond memories of my college days and my postdoctoral studies in fictional literature under the tutelage of Dr. Samwise Gamgee. Were it not for the imminent danger of hypothermia, I would have strolled the campus all day. But alas, it was time to stumble off to my first course.
“Modern Training Techniques”
Douglas Cline, Assistant Chief of Operations, Horry County Fire Rescue, Conway, SC
|Between his use of chalkboard, handouts,
video, Powerpoint, and iPad; Cline’s teaching
style appealed to more generations than AC/DC.
Cline was a very engaging presenter, which was good since I hadn’t yet had my fourth Mountain Dew of the morning. He focused on two important things rarely done in training: gap analysis and flipping the classroom. Gap analysis (at least as I understood it in the past) is the study of the massive gap between two numbers; 1) a training officer’s salary divided by the number of hours he/she spends at work, versus 2) the hourly wage of a Walmart greeter. Gap analysis studies have been blamed for training officers nationwide considering a mass transition to careers with Walmart.
So imagine my surprise when Cline proposed that a gap analysis is actually a technique for determining the steps to be taken in moving from a current state to a desired future state. The process consists of listing the characteristic factors of the present situation, cross-listing factors required to achieve the future objectives, and then highlighting the gaps that exist and need to be filled. Fascinating, huh?
But wait, there was more! Before I could wipe the slack-jawed amazement from my face, he hit us with another whopper: flipping the classroom. Imagine a training division where the cognitive domain learning is accomplished ahead of time in asynchronous fashion, then the students show up prepped to achieve psychomotor and affective domain learning with the instructor in real time. Cline described several ways in which this could be achieved in any fire department.
Sound crazy to you? If so, buckle up and prepare for turbulence. Training is about to get very rough for those who think that modernized education is just a fad. Don’t take my word for it, either. Among other things, Cline happens to be the President of the International Society of Fire Service Instructors and sports a 15-page curricula vitae. So run, don’t walk, to his next speaking engagement and thank me later.
“Escaping Violent Encounters for EMS/Fire”
Kip Teitsort, EMT-P, Founder of DT4EMS, LLC, Norwood, MO
Mike Novak, Battalion Chief, Branson Fire Rescue, Branson, MO
|Kip gave my photojournalism
two Ninja thumbs up
I went into this course with a little trepidation and tension. You see, I met Teitsort for the first time back in 2005 and knew he wasn’t a run of the mill paramedic. Standing next to him is kind of like standing next to an electrical substation. Curiosity makes you wonder where all that energy comes from, but self preservation tells you that messing with it could be fatal. He has experience in EMS, law enforcement, and martial arts the way Donald Trump has experience with handling money. Moreover, Chief Novak was his co-instructor. Novak is another acquaintance of mine, and despite being soft-spoken with an average build, I happen to know he can deadlift about 900 lbs. There were visions in my head of them using their old friend yours truly as a rag doll. I may or may not have vomited in the hallway outside the room.
Much to my relief, they started off the class with several rules to safeguard against anyone getting hurt (even skinny, weak, and arrogant EMS bloggers). Over the next four hours, we learned what no one else is teaching about violence against EMS & Fire personnel. It is more common than bloodborne pathogens, but we don’t require our people to learn about it. It is also as costly as any lifting injury, but most agencies don’t spend a dime to prevent it. Violence against field providers is on the rise yet few agencies are doing anything about it.
|When I visited Kip’s class,
we used high-speed cameras to confirm
an urban legend. The “Lightning DTP &
Primal Scream Uppercut,” a secret move
only taught within the ancient Shaolin Temple,
can in fact be performed by white guys.
We spent a fair amount of time learning basic movements to protect ourselves from attackers (not “patients,” as some would still call them; though the “patient” is trying to strangle an EMT). There was also a large portion of the class devoted to discussion of legal precedence and local policy. Here is where I began to ponder something. As I surveyed my classmates, I saw mostly young first responders. While I applauded them for learning skills to escape violent encounters in the field, I was still frustrated. The entry-level providers are not the only audience that needs this information. Chiefs and Administrators need to have their policy-writing butts in this class. Why? Because they are usually the harbingers of procedural change for an organization, not the providers. And believe it or not, many of our own departmental policies are making these attacks worse, both before and after the fact. But again, don’t take my word for it (actually, I would never advise taking anyone’s word for it). Teitsort’s message has been gaining momentum over the last several years and demands for greater scene safety are also coming from some of the leading voices in EMS.
This topic has either personal or third-party relevance to every field provider. It certainly does for me. Back in two-thousand-something-or-other, I may or may not have had a psychiatric patient go ape-sh@#-nuclear in my ambulance before trying to steal the apparatus. I won’t bore you with the details, but suffice to say that I don’t leave the keys in the ignition anymore. But perhaps your story is more noteworthy. If so, then Teitsort is offering something too good to pass up. By sharing your harrowing tale, you could win Teitsort’s full 16 hr course for up to 24 people in your agency. Regardless of whether you win the contest or have to register for his next course the old fashion way, it is well worth your time. Head over to his site and check it out before your next shift.
“Bringing Today’s Technology into the Fire Training Classroom and Beyond”
Frank Lipski, BS, FF/EMT-P, Assistant Training Officer, Florissant Valley FD, Florissant, MO
|That awkward moment when
a terrible photographer makes
an innovative instructor appear dwarf-like.
Being a card-carrying tech/gadget nerd, this was one course I absolutely had to take. Lipski definitely filled the bill, too. By the time he was done, my iCup literally ranneth over with new tech ideas.
This wasn’t a tired old class on how to use PowerPoint. He kept us interested by demonstrating ways to integrate many of today’s popular media devices into fire service course design and departmental training programs. Moreover, he covered topics such as podcasting, cloud computing, web based calendars, paperless training records, copyright laws, and mobile computing beyond the classroom.
There were several things about Lipski’s presentation that I enjoyed. First, he had a very dynamic and flexible presentation style. It had a basic substructure, but he had built in enough space to tailor certain sections to the needs voiced by participants. Lipski freely admitted that his presentation changed every time, and saw this as a positive thing. It told me he was willing to meet his students where they were, instead of forcing them to hop on a one-way lecture on rails. Second, he encouraged use of laptops and mobile devices during his lecture. This is something many instructors are not comfortable doing. I have an axe to grind with those technophobic teachers, but I’ll save that for another post. Lipski even went to the trouble of finding MU’s wi-fi passcode for the building and making sure all of his students had it for his lecture. Bravo, sir, bravo! Many of these instructional strengths are also on display at Engine House Training LLC, a fire training collaborative in which Lipski plays a large role. Go check it out!
My Final Thoughts
|Alan Brunacini – Legendary Fire Chief,
author, and Hawaiian shirt connoisseur.
The MUFRTI Winter Fire School was a great experience for me, and I highly recommend it for anyone in Fire & EMS. The purveyors of knowledge mentioned above were but a few of the Fire & EMS Greats who graced this gathering. A lot of you might be on the fence about attending conferences on a shoestring training budget, and I get that. This conference is a lock for consistently solid training. The folks at MUFRTI know that it takes more than a PowerPoint and a different zip code to be considered an “expert.” The speakers coming to this conference are some of the best you’ll see, so here’s to seeing you there next year!