- Email: [email protected]
A model for prehospital personnel continuing education
P
roviding thought-provoking continuing education programs for prehospital providers is a challenge for many nurses who have this task explicitly in their job descriptions or in the “other duties as assigned” category. EMTs who are intrigued and fascinated by their basic introductory courses quickly become jaded as they try to meet their continuing education requirements. “EMT was great, but con ed is deadly,” is a comment this author has heard. EMTs’ main complaint is that many required classes are presented by “talking heads” who present boring lectures or, worse, read to them from a book. What follows is a model for continuing education that draws from several people who actively and creatively teach continuing education classes. One educator builds interest by having the students make case presentations. He calls these “prehospital ground rounds,” and they are presented in the hospital auditorium in much the same format as medical grand rounds. The formality of the setting lends an air of importance to the presentations, and posters announcing the monthly topic invite interested hospital personnel to attend. Audiovisual support is provided for photographs, radiographs, and scans taken at the scene or in the operating room and for slides or graphs that depict critical concepts. An EMT who worked with the patient is the logical presenter for the case. The EMT actually saw the patient and thus is able to relate many of the fine details that are not apparent simply from reading the chart or the prehospital record. Presenters are encouraged to recall how they reasoned through the problem they encountered when they reached the patient.
E. Marie Wilson, Connecticut ENA, is Manager, Department of Clinical Research, Connecticut Asthma and Allergy Center, West Hartford, Corm. For reprints, write: E. Marie Wilson, RN, MPA. 35 Chapman Mill Pond Rd, Westbrook. CT 06498. J Emerg Nurs 2000;26:48-50. Copyright Q 2000 by the Emergency Nurses Association. 0099-1767/2000$12.00+0
18/9/104072
48 Volume 26. Number 1
They are asked to talk about the “rule outs” and alternatives that they considered before deciding which of many treatment options they would use. What were the sounds, smells, or colors that the EMT noticed in doing the survey that prompted a question about other confounding factors to consider in the treatment? What types of chronic or pre-existing conditions would cause a modification of the usual treatment? What treatment options for each condition did they consider before settling on the best, and what was it that made that the best course to take? Such a presentation of alternatives and rationales teaches the skill we call critical thinking.
Trauma cases that posed difficult extrication problems may be co-presented by the public safety official in charge of rescue.
The presenter will need help in formulating the presentation. Using dispatch logs, the prehospital patient care record, the hospital chart, and other documentation, the presenter is lead to consider the patient along the continuum of care. Securing permission for the presenter to use the hospital record may be necessary, and the nurse educator may need to provide a work space in the hospital for the chart review and analysis or access to the medical reference library. Presenters should be encouraged to use a variety of prehospital, nursing, and medical books and journals to enrich their information. The continuing education coordinator may need to intercede with various authorities for permission for the presenter to review their records. On occasion, obtaining permission from
Wilson/lOURNAL.
the patient or family to view the records has been necessary. This task may be best done with one letter that includes permission for all the pertinent records (Figure 1). Confidentiality and the blinding of names and other specific identifiers during the presentation are important to emphasize. Presentations that consider complex cases are the most interesting. Trauma cases that posed difficult extrication problems may be co-presented by the public safety official in charge of rescue. An automobile crash or gunshot wound to the abdomen is more interesting when the patient is pregnant and presents difficult options A patient with a possible stroke presents different concerns if the EMT must consider a history of diabetes or renal disease. Psychosocial case studies that focus on the care of terminally ill patients or recipients of physical or mental abuse give a new dimension to various treatment conventions usually followed in the prehospital setting. In complex cases, the presenter will want to consult with experts in a number of specialty fields. In some cases, the expert may be invited to comment or be available for questions at the time of the presentation.
Arrange with colleagues to trade really good presenters. Hearing from someone outside their usual group will stimulate your group and theirs.
Continuing education presentations may also be used to introduce a new treatment device. When doing so, having enough of the devices so that everyone can have “hands-on” time is crucial. One condition of purchasing a device might be that the salesperson makes additional units available for continuing education classes. An initial presentation should focus on the patient condition(s) that the device is designed to treat and all of the available treatment modalities, including a critical analysis of each of the alternatives. Follow this analysis with an introduction of the device and its particular application, being sure to include the instances when use of the new device would be inappropriate or not the best option. Several assistant instructors can help with the “hands-on” portion of the session. These assistants must be ori-
bF
EMERGENCY
NURSING
1
To Whom It May Concern: (Name) has my permission to view all records created in the provision of prehospital, hospital, and rehabilitation care related to my medical emergency on (date) and following. This permission includes, but is not limited to, public safety dispatch records, ambulance care reports, hospital records, and rehabilitation records. I appreciate your making such records as are in your possession available to (name). Sincerely yours, (4 Patient’s Name) (Address) (Date) Figure 1 Written permission to use medical record for teaching.
ented before the class so they will all be demonstrating and teaching the same information in the same way. Orienting them and then supervising them while the teaching progresses in small groups is the lead presenter’s responsibility. A ratio of 5 or 6 trainees to 1 instructor ensures that everyone can see and have time to become familiar with the feel and manipulation of the device. A general rule is that the more complicated the device, the fewer the trainees who should make up each group, if they are to have maximum benefit for the time they spend in this portion of the class. A good way to conclude a continuing education presentation is an open forum for questions and discussion after the presentation and skills training. Most presenters will feel more at ease if some of the experts they consulted in preparing the session are available to lead the discussion with them. Whereas presentations should be kept closely focused, this is a good time to follow the interests of the class, especially if it leads to new knowledge and understanding of issues they have not previously considered. A time limit should be set for the entire program so attendees know when they can expect to leave; however, do not be surprised if the discussion goes overtime because it is so interesting. Simply take note of the closing hour and invite those who want to leave to do so. The remainder of the participants can continue the discussion until everyone’s curiosity is satisfied. The nurse educator or continuing education coordinator can help make presentations interesting by doing the following:
February 2000 49
IOURNAL
OF EMERGENCY
NURSING/Wilson
1. Make assignments early. A good presentation takes time to research and organize: 2. Provide leads, contacts, and introductions to people who are experts on the topic to be discussed. 3. Provide a setting and amenities commensurate with the time the presenter has spent in preparation and the level of interest you want from the audience. 4. Arrange with colleagues to trade really good presenters. Hearing from someone outside their usual group will stimulate your group and theirs. 5. Try to identify people with a knack for explaining and an aptitude for speaking. This is an excellent training ground for those who might enjoy teaching.
6. Encourage innovative thinking backed by sound reasoning. 7. Enjoy a well-deserved reputation for the excellence of your continuing education program. New people with fresh ideas will seek out your sessions.
Contributions for this column should be sent to Connie J. Mattera, MS, RN, EMT-P, 6801 N Olcott, Chicago, IL 60631;pbone (847) 618-4485; E-mail: [email protected]; or E. Marie Wilson, RN, MPA, 35 Chapman Mill Pond Road, Westbrook, CT 06498; phone (860) 232-9111; E-mail: [email protected].
QUERY FORM Journal of Emergency Nursing 915 Lee St, Des Plaines, IL 60016
(800) 900-9659 Do you have an idea for an article? E-mail the Section Editor directly to discuss your idea, format, and focus.
CdUmn
E-mail address
Section Editor Gail Lenehan Patty Campbell Anne Marie Lewis Gail Lenehan Deborah Blazys Gail Lenehan Connie Mattera E. Marie Wilson Julia Fultz Gail Lenehan Susan Moore Vicky Bradley Marsha Zimmerman Polly Gerber Zimmermann Anne Phelan Bowen Deborah Parkman Henderson Donna Ojanen Thomas Marlene Jezierski Jane Koziol-McLain Linda Ledray Maureen Harrahill Lisa Molitor Gail Lenehan
Guest Editorial Case Review Clinical Notebook Clinical Nurses Forum Drug Update EMS Flight Nursing Forensic Nursing Impressions Informatics Managers Forum Nurse Educator Pediatric Update Profiles The Research Column Sexual Assault: Clinical Issues Trauma Notebook Triage Decisions Feature (“regular” articles) You may request the following additional to [email protected]: l Case Review Guidelines
guidelines l
Informal
from the Journal Guidelines
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] jhfultz%[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] Jamerican4@aolcom [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] of Emwgmcy
for Writing Research
Be sure to see pp. 15A-17A for Information
50
Volume 26, Number
1
Nursing office by sending a message
for Authors.
l
Reference Style Sheet
roviding thought-provoking continuing education programs for prehospital providers is a challenge for many nurses who have this task explicitly in their job descriptions or in the “other duties as assigned” category. EMTs who are intrigued and fascinated by their basic introductory courses quickly become jaded as they try to meet their continuing education requirements. “EMT was great, but con ed is deadly,” is a comment this author has heard. EMTs’ main complaint is that many required classes are presented by “talking heads” who present boring lectures or, worse, read to them from a book. What follows is a model for continuing education that draws from several people who actively and creatively teach continuing education classes. One educator builds interest by having the students make case presentations. He calls these “prehospital ground rounds,” and they are presented in the hospital auditorium in much the same format as medical grand rounds. The formality of the setting lends an air of importance to the presentations, and posters announcing the monthly topic invite interested hospital personnel to attend. Audiovisual support is provided for photographs, radiographs, and scans taken at the scene or in the operating room and for slides or graphs that depict critical concepts. An EMT who worked with the patient is the logical presenter for the case. The EMT actually saw the patient and thus is able to relate many of the fine details that are not apparent simply from reading the chart or the prehospital record. Presenters are encouraged to recall how they reasoned through the problem they encountered when they reached the patient.
E. Marie Wilson, Connecticut ENA, is Manager, Department of Clinical Research, Connecticut Asthma and Allergy Center, West Hartford, Corm. For reprints, write: E. Marie Wilson, RN, MPA. 35 Chapman Mill Pond Rd, Westbrook. CT 06498. J Emerg Nurs 2000;26:48-50. Copyright Q 2000 by the Emergency Nurses Association. 0099-1767/2000$12.00+0
18/9/104072
48 Volume 26. Number 1
They are asked to talk about the “rule outs” and alternatives that they considered before deciding which of many treatment options they would use. What were the sounds, smells, or colors that the EMT noticed in doing the survey that prompted a question about other confounding factors to consider in the treatment? What types of chronic or pre-existing conditions would cause a modification of the usual treatment? What treatment options for each condition did they consider before settling on the best, and what was it that made that the best course to take? Such a presentation of alternatives and rationales teaches the skill we call critical thinking.
Trauma cases that posed difficult extrication problems may be co-presented by the public safety official in charge of rescue.
The presenter will need help in formulating the presentation. Using dispatch logs, the prehospital patient care record, the hospital chart, and other documentation, the presenter is lead to consider the patient along the continuum of care. Securing permission for the presenter to use the hospital record may be necessary, and the nurse educator may need to provide a work space in the hospital for the chart review and analysis or access to the medical reference library. Presenters should be encouraged to use a variety of prehospital, nursing, and medical books and journals to enrich their information. The continuing education coordinator may need to intercede with various authorities for permission for the presenter to review their records. On occasion, obtaining permission from
Wilson/lOURNAL.
the patient or family to view the records has been necessary. This task may be best done with one letter that includes permission for all the pertinent records (Figure 1). Confidentiality and the blinding of names and other specific identifiers during the presentation are important to emphasize. Presentations that consider complex cases are the most interesting. Trauma cases that posed difficult extrication problems may be co-presented by the public safety official in charge of rescue. An automobile crash or gunshot wound to the abdomen is more interesting when the patient is pregnant and presents difficult options A patient with a possible stroke presents different concerns if the EMT must consider a history of diabetes or renal disease. Psychosocial case studies that focus on the care of terminally ill patients or recipients of physical or mental abuse give a new dimension to various treatment conventions usually followed in the prehospital setting. In complex cases, the presenter will want to consult with experts in a number of specialty fields. In some cases, the expert may be invited to comment or be available for questions at the time of the presentation.
Arrange with colleagues to trade really good presenters. Hearing from someone outside their usual group will stimulate your group and theirs.
Continuing education presentations may also be used to introduce a new treatment device. When doing so, having enough of the devices so that everyone can have “hands-on” time is crucial. One condition of purchasing a device might be that the salesperson makes additional units available for continuing education classes. An initial presentation should focus on the patient condition(s) that the device is designed to treat and all of the available treatment modalities, including a critical analysis of each of the alternatives. Follow this analysis with an introduction of the device and its particular application, being sure to include the instances when use of the new device would be inappropriate or not the best option. Several assistant instructors can help with the “hands-on” portion of the session. These assistants must be ori-
bF
EMERGENCY
NURSING
1
To Whom It May Concern: (Name) has my permission to view all records created in the provision of prehospital, hospital, and rehabilitation care related to my medical emergency on (date) and following. This permission includes, but is not limited to, public safety dispatch records, ambulance care reports, hospital records, and rehabilitation records. I appreciate your making such records as are in your possession available to (name). Sincerely yours, (4 Patient’s Name) (Address) (Date) Figure 1 Written permission to use medical record for teaching.
ented before the class so they will all be demonstrating and teaching the same information in the same way. Orienting them and then supervising them while the teaching progresses in small groups is the lead presenter’s responsibility. A ratio of 5 or 6 trainees to 1 instructor ensures that everyone can see and have time to become familiar with the feel and manipulation of the device. A general rule is that the more complicated the device, the fewer the trainees who should make up each group, if they are to have maximum benefit for the time they spend in this portion of the class. A good way to conclude a continuing education presentation is an open forum for questions and discussion after the presentation and skills training. Most presenters will feel more at ease if some of the experts they consulted in preparing the session are available to lead the discussion with them. Whereas presentations should be kept closely focused, this is a good time to follow the interests of the class, especially if it leads to new knowledge and understanding of issues they have not previously considered. A time limit should be set for the entire program so attendees know when they can expect to leave; however, do not be surprised if the discussion goes overtime because it is so interesting. Simply take note of the closing hour and invite those who want to leave to do so. The remainder of the participants can continue the discussion until everyone’s curiosity is satisfied. The nurse educator or continuing education coordinator can help make presentations interesting by doing the following:
February 2000 49
IOURNAL
OF EMERGENCY
NURSING/Wilson
1. Make assignments early. A good presentation takes time to research and organize: 2. Provide leads, contacts, and introductions to people who are experts on the topic to be discussed. 3. Provide a setting and amenities commensurate with the time the presenter has spent in preparation and the level of interest you want from the audience. 4. Arrange with colleagues to trade really good presenters. Hearing from someone outside their usual group will stimulate your group and theirs. 5. Try to identify people with a knack for explaining and an aptitude for speaking. This is an excellent training ground for those who might enjoy teaching.
6. Encourage innovative thinking backed by sound reasoning. 7. Enjoy a well-deserved reputation for the excellence of your continuing education program. New people with fresh ideas will seek out your sessions.
Contributions for this column should be sent to Connie J. Mattera, MS, RN, EMT-P, 6801 N Olcott, Chicago, IL 60631;pbone (847) 618-4485; E-mail: [email protected]; or E. Marie Wilson, RN, MPA, 35 Chapman Mill Pond Road, Westbrook, CT 06498; phone (860) 232-9111; E-mail: [email protected].
QUERY FORM Journal of Emergency Nursing 915 Lee St, Des Plaines, IL 60016
(800) 900-9659 Do you have an idea for an article? E-mail the Section Editor directly to discuss your idea, format, and focus.
CdUmn
E-mail address
Section Editor Gail Lenehan Patty Campbell Anne Marie Lewis Gail Lenehan Deborah Blazys Gail Lenehan Connie Mattera E. Marie Wilson Julia Fultz Gail Lenehan Susan Moore Vicky Bradley Marsha Zimmerman Polly Gerber Zimmermann Anne Phelan Bowen Deborah Parkman Henderson Donna Ojanen Thomas Marlene Jezierski Jane Koziol-McLain Linda Ledray Maureen Harrahill Lisa Molitor Gail Lenehan
Guest Editorial Case Review Clinical Notebook Clinical Nurses Forum Drug Update EMS Flight Nursing Forensic Nursing Impressions Informatics Managers Forum Nurse Educator Pediatric Update Profiles The Research Column Sexual Assault: Clinical Issues Trauma Notebook Triage Decisions Feature (“regular” articles) You may request the following additional to [email protected]: l Case Review Guidelines
guidelines l
Informal
from the Journal Guidelines
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] jhfultz%[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] Jamerican4@aolcom [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected] of Emwgmcy
for Writing Research
Be sure to see pp. 15A-17A for Information
50
Volume 26, Number
1
Nursing office by sending a message
for Authors.
l
Reference Style Sheet