LAS VEGAS — Many EMS field training programs are designed to be regimented and hours-based, a systematic process, that can drag out unnecessarily.
In a presentation at EMS World Expo, Louis Imperatrice, NRP, national manager of clinical excellence, DocGo, discussed how to develop an adaptable, competency-based field training program that takes into consideration the experience level of the new employee.
Memorable quotes
Following are memorable quotes from Imperatrice.
- “Time does not equal competency.”
- “We (FTOs) should be learning from them (trainees) as much as they’re learning from us.”
- “The first impression is the biggest impression you make on your employees.”
Top takeaways
Imperatrice learned the challenges of a time-based training program first-hand when he took a 1-year break from a previous organization. Upon his return, he was expected to ride along as a third/trainee for 3 months, even as a 13-year medic.
Here are the top takeaways from his presentation on concierge – flexible – training programs catered to each trainee’s needs.
1. Competency vs. time-based training
One of the biggest problems with a time-based training program is, well, the time it takes to complete.
What’s the most important thing to all of us except for our family, Imperatrice asked? It’s our time.
He made a case for basing training on competency, rather than time, evaluating can trainees:
- Solve a problem
- Perform a valid assessment on every single patient every single time
- Effectively use their assessment skills to come up with differential diagnosis and treatment plan
If they can do that, they’re competent, get them out there, he said. If it takes two shifts, clear them. If it takes a month, clear them.
He shared the operational benefits of competency-based field training:
- Fill the shifts
- Employees with experience can be cleared quicker
- Returning employees can be cleared quicker
- Those who excel and catch on to the organization’s mission, vision, values and expectations can be cleared quicker
This doesn’t mean there’s no place for hours-based training, Imperatrice cautioned. If someone is really struggling, if they can’t identify an obvious problem, pull them in and come up with an hours-based remediation program. If they become competent, great; if not, you have documentation to move them to a different position.
2. Diversify FTO-trainee matches
Imperatrice noted it’s easy these days to access assessments to understand trainees’ different learning styles, and to pair them appropriately with an FTO.
One of the biggest mistakes EMS agencies makes is assigning one FTO for the duration of an incoming employee’s training, he shared.
Instead, he advises having a mix of training styles, and then ensuring each trainee gets to learn from a diverse mix of instructors to get the best education.
3. Make a good first impression
With the current demand for EMTs, if a trainee’s first impression of your organization is being bored by a lengthy training program or worse, put down by an aggressive field training officer (FTO), they will move on to the next option.
Imperatrice encouraged attendees to build up trainees and to focus on the 5 Cs of orientation to set the right tone:
- Compliance. Ensure trainees are taught everything in black and white on company policies and procedures (if too extensive, pick out the most important policies and provide easy access to all others).
- Clarification. Clarifying the company’s mission and vision – and what the expectations are.
- Culture. Double down on reinforcing the mission and vision and how your organization achieves them.
- Connection. Names and faces are important. Have chiefs stop in to connect with new employees. “You should know every player in the game when you finish orientation,” Imperatrice said.
- Check back. Trainees should not be left with more questions than answers. Check in regularly with new employees to ask how their training is going. While regularly scheduled formal check-ins are important, go above and beyond, Imperatrice advised. Show up at the ED when they’re dropping off a patient. Stop when you see them on a call, give them a hand and check in. “Make it informal, it’s more meaningful.”
Two other things to include in your orientation classroom setting? Teach them what they need to do to maintain their certification, Imperatrice stressed. You’d be surprised how many have no idea. Imperatrice also recommends including documentation training in the classroom. Teaching documentation in the field is a waste of everyone’s time, he noted.
Additional resources
- Year one: Creating a career path for EMTs
- 10 things your EMT onboarding process is missing
- Whatever will we do without the skill sheets?
- What skills should we test? A simple framework for an EMT skills competency portfolio
- Upgrading EMS education: Goodbye skill sheets, psychomotor exam
