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Training Day: Train, educate and develop – or lose

If you want to keep people around, invest in them in these three ways

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Retaining people requires an ‘all or nothing’ approach. This doesn’t mean everyone has to aspire to become a leader, but it does mean everyone needs to be open to learning more stuff, new stuff and how to grow.

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Retaining personnel isn’t just about increased wages. How you inform and help grow your people also helps them want to stay.

Medical practices change, clinical protocols update, best practices emerge. Your crews need to – want to – learn about them. If your response as an administrator or training officer is just to tell them, “Read the protocol,” “Look it up” or simply “Watch the video” for everything that comes up, then you’re simply failing your people (and agency).

New hires of all experience levels and tenured employees alike require three elements within their learning: training, education and development.

Follow these three steps to satisfaction

1. Training. Look at training as your in-service refreshers and renewals on information, skills or equipment – it’s knowledge being applied. A large portion of the content you review in training should not be new; rather, it should be reinforced (but not regurgitated). This is a common failure point for many EMS agencies, especially if you utilize the same training, year-in and year-out, by the same people. This training method, while it fulfills the required hours you might need, only promotes stagnancy and complacency.

Training is where your EMS agency has the most opportunity to be flexible and creative. Yes, the same people might be able to deliver this information every year, but the important part here is that it’s not simply not the same content repeated. Agencies that employ this method often have a personnel problem on their hands – meaning they have the wrong personnel either delivering or coordinating (or both) their continued training content.

If COVID-19 has brought any benefit to our industry (besides finally promoting the disinfecting practices many agencies long ignored), it’s the benefit of virtual/distant training and education. Now something like STEMI recognition training can be completed on duty, in the ambulance, at the kitchen table or even in the comfort of a recliner, delivered by an in-house instructor or another instructor from across the country. Learning platforms can be utilized that contain recorded or live topics presented by instructors from all areas with different presenting styles and approaches to the same topic. Bound Tree University, as an example, offers free training on numerous topics utilizing a recorded video presentation method.

Reflecting back on my instructor career, I was recently working as an EMS educator within a hospital system that had medical direction oversight with more than a dozen local EMS agencies. One of my primary roles was to deliver continuing education to EMS crews from five different EMS agencies. While a lot of my delivered training was conducted in person and generalized to meet a mixed audience of both EMTs and paramedics, each quarter I would break away from the in-person method to deliver live broadcast webinars to all the agencies for three days (rather than the nearly dozen days I was completing in person). With this virtual format, I was able to provide EMT-specific content during one session and paramedic-level content during the other (and record the sessions too!). This allowed for cost savings in many ways, along with more in-service time by not having crews travel across town to meet at a central location. Training overall was flexible and tailored to meet multiple learning styles, specific to meet each scope of practice individually and generalized to meet the combined needs of all provider levels on any given scene – and it was time-efficient, too!

People typically don’t want the “same old thing” when it comes to their renewal or refresher information – and I bet your patients wouldn’t appreciate knowing this was your agency’s practice.

2. Education. When new content or protocols hit the street, there’s a need to supply knowledge to everyone on what’s about to be happening – that’s education.

In hands-on (skills) situations, providing in-person education is typically the best practice for this. But when the new information is didactic-focused, delivery can be provided by a variety of means – including virtually.

Look at new employees. Little training should be needed to remind EMTs how to apply splints or paramedics how to interpret 12-lead ECGs. Orientation academies, therefore, should be much more focused on education specific to the agency – how to be an EMT for your particular service – rather than reiterating knowledge and skills the candidate should already know (although you must of course verify that knowledge and skills). New-hire education is knowledge that likely can’t be obtained by working elsewhere, or even in one’s initial EMS education. Providing new hires with the necessary education to become an agency EMT can set them up for more success than a one-day ride-along ever will.

For both new and tenured employees, education provides new information. With new information comes interest. With continued interest comes retention. This is how EMS agencies need to structure their time, not just determining whether you can check all the refresher boxes by repeating the same information year-in and year-out. Educate, inspire and retain!

3. Development. Both training and education keep your agency operating, but they don’t necessarily move it forward. Without that added push – development – even the best-educated and most-trained providers can’t keep a positive culture alive within your agency.

It’s not the responsibility of the National Registry or your state to assign development hours for your agency – it’s yours! You therefore have the responsibility and flexibility to design a development program that works best for you specifically. That may mean bringing in an outside career coaching expert to help aspiring employees focus on their growth. It may mean having a consultant come in to help your agency develop a strategic plan. It may also mean assigning different development topics to each member of your agency’s management team, those with leadership positions or those enrolled in your own development program.

Stay open to learning

This isn’t an “almost” kind of approach we need to take – retaining people requires an “all or nothing” approach. This doesn’t mean everyone has to aspire to become a supervisor, field training officer or chief, but it does mean everyone needs to be open to learning more stuff, new stuff and how to grow. Without all these elements – training, education and development – your agency will continue to be on the losing end of the recruitment and retention battle.

For more information, visit Bound Tree University.


Not every ingestion is an overdose, and not every drug is taken in isolation

This article, originally published in December 2022, had been updated.

Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at tnowak@emergencymedicalsolutionsllc.com.