Welcome!

EMS Internship PreceptingGoals & Guidelines Amy Gutman MD ~ EMS Medical Directorprehospitalmd@gmail.com

ObjectivesDefine preceptor roles & responsibilities

Define student roles & responsibilities

Define rotation expectations

Review adult learning principles

Welcome To Tobey Hospital & TEA! TEAs motto Decus, bonitas et lustum fac translates to Pride, Integrity & Professionalism, literally Do The Right Thing

Learning is an ongoing process, not a singular event that ends after initial certification

This presentation is an adjunct to the Prehospital Education Outreach (PEO) Handbook given to each student which you are expected to be familiar with prior to starting your rotation

When You Have A QuestionLate to shift or Ill?ED HUC: 508-273-4680During business hours Donna Costa (TEA Office Manager): 508-273-4198

General Questions?Your preceptor

Complaints / Concerns / Issues?Sue Valdez RN (Prehospital Care Coordinator / PCC): 508-274-6690; valdez_986@msn.comSusan Robbins RN (ED Manager): 508-273-4186Amy Gutman MD (EMS Medical Director): 513-255-1353 (text me); prehospitalmd@gmail.comPaperwork Issues?www.TEAEMS.com has extra forms, handbooks & presentations in your in Rotation sectionAsk your preceptor for assistanceAll completed forms turned in to Donna Costa for filing in the ED

General Information:Address: 43 High St, Wareham MAParking: Across from front entrance, or in ED parking lotTobey ED Phone: 508-273-4680Tobey ED Fax: 508-273-4185Human Resources: 508-273-4005Tobey Main: 508-295-0880TEA Website: www.TEAEMS.comEMS Wall: back hallway leading to ED office constantly updated

Tobey Hospital is a Non-Smoking Campus!

Preceptor = MentorThere is no EMS For Dummies every student, interaction & environment requires attention to detail & modification of educational principles

Your attitudes & actions have a significant impact on the kind of EMT the student will become

The mentoring a student receives is as, if not more important than their initial or recertification classroom training

Students pattern their style by observing management strategies of their mentors

Learning DomainsKnowledge:Facts, procedures & affective phenomena

Cognitive:Comprehension of facts, procedures & affective phenomenon by analysis of information, synthesis of information & evaluation of the information

Affective: Receive & respond to knowledge & perceptions in an organized format

Psychomotor: Articulation, imitation, manipulation & naturalization

Problem Solving:Analysis of information or situations to develop course of action & judge impact of actions

Adult LearnersLearning is an active change in behavior due to interactions with environments & experiences with acquisition of habits & knowledge

Adult learners different than new learners, as they have already developed methods to cope with weaknesses & accentuate strengthsAuditory LearnersLearn by lectures only; may have learning disability diagnosis i.e. dyslexiaVisual LearnersNeed to see things & conceptsKinesthetic LearnersLearn by doing

Adult learners often have combination styles of learning that combine auditory, visual and kinesthetic components

Prehospital Care CoordinatorRoles & ResponsibilitiesSue Valdez RN, EMT-P is TEA Prehospital Care Coordinator (PCC). Her decades of clinical, didactic & teaching experience in the educational, prehospital & hospital realms are a perfect background for her job

In addition to her responsibilities with TEA & EMS / Fire, Sue provides supervision for student-related activities within the ED & Tobey HospitalAddresses issues arising during internship Remediates students identified by preceptor(s) as having difficultiesBrings out the strengths & weaknesses of our students & our preceptors

Sue Valdez and Susan Robbins RN (ED Manager) help coordinate the rotations & act as point of contact for concerns or complaints

The PCC is NOT responsible for making sure your forms are filled out, you show up on time, you are dressed appropriately (etc) this is a function of fulfilling your professionalism requirements

Tobey ED Rotation GoalsPhase OneStudent focuses on skills performance & patient assessmentTask oriented, i.e. assigned to start the IV or perform & interpret the EKG

Phase TwoStudent begins to assimilate assessment, diagnostic & treatment skills & information to make global decisions as a team leaderLead team on straight-forward patients such as single system trauma, abdominal pain, etc.

Phase ThreeStudent functions as leader on complex patients under the direct supervision of the preceptorFocus on decision making, delegation, communication with EMS & ancillary personnel

Preceptor ResponsibilitiesProvide model for student to emulate & provide climate conducive to learning

Supervise & guide performance

Provide positive & correctional feedback encouraging student development

Be passionate about EMS Education & helping students succeed

Be the eyes & ears of EMS Education

Update educational program to meet students, preceptors & hospital needs

Good communication skills including listening to student

Share practical & didactic knowledge

Completely & honestly fill out evaluation forms

Maintain high degree of professionalism

Keep an open mind

Prevent student from doing harm to patient(s) or themselves

Preceptor 10 Commandments1. People can surmount their environment, therefore there is rarely a hopeless student

2. Try to help everyone become sensitive & compassionate while at the same time be tough-minded & steadfast

3. Students must own responsibility for their own conduct & consequences thereof

4. You can learn from your students as they learn from you

5. Professionalism, professionalism, professionalism

6. Remember the sacredness & dignity of your calling as a clinician & a preceptor

7. Your primary responsibility is to the patient to do no harm

8. Honor those engaged in the pursuit of learning no matter their background or perceived potential to contribute to the field

9. The students who put more effort in, get more out the same goes for the preceptor

10. Cherish & maintain an appropriate sense of humor

Adult Learning Teaching PrinciplesKnow student & adapt around any special needs

Use experiences (yours & theirs)

Tie theory to field practice

Provide positive learning climate

Offer a variety of teaching formats

Motivate & inspire with your actions by modeling expected behavior

Assist students in finding resources & answers

Be success oriented

Have a positive attitude

Develop feeling of support, acceptance & teamwork

Relate to students past experiences, both positive & negative

Provide positive & constructive feedback

Student GoalsGain experience in provider role

Integrate as a member of the medical team & begin taking role of team leader

Take a more global view of provider role by learning about:Assignment delegationTransportation choicesStockingDaily vehicle & supply checks

Integrate professionalism into every action & interaction

Be humble: no matter your experiences you can always learn from those around you

Student ResponsibilitiesYou are responsible to confirm your clinical timeshow up prepared to work & learn

Arrive at least 10 minutes before the start of the shift

Be properly dressed with proper ID

Review paperwork with preceptor when questions arise

Inform preceptor of your level of training / prior rotations & your expectations for the rotation & / or shift

Accept criticism with an open mind

Act in a professional manner at all times

Review end-of-shift paperwork with preceptor each shift

Do homework as assigned

Prior to Each ShiftPreceptor reviews prior field time / ED time student has completed

Preceptor determines students perceptions of strengths & weakness

Preceptor determines other preceptors / peers perceptions of students strengths & weaknesses

Preceptor relays their expectations of the directly to the student, i.e. Today were going to focus on ACLS medications

Student should relay expectations of the preceptor, i.e. I really need to work on EKGs today

Both will review daily routine/responsibilities

Both will review equipment & department / ambulance layout

Student PreparednessMedicationsproceduresGeneric / Trade Name

Mechanism of Action

Pharmacology Class

Indications

Contraindications

Dosage (adult / pediatric)

Reversal AgentWho gets procedure (i.e. clinical indications)?

What equipment required?

Where do you correctly perform procedure (i.e. IO in medial proximal vs mid-shaft tibia)

When /Why is procedure indicated & when is it contraindicated?

How is procedure performed & how do you fix potential problems?

Good StudentsCommunicate clearly with patients, peers & preceptors

Efficiently manage scene / case

Rapidly complete a thorough patient assessment

Identify chief complaint & develop differential diagnosis based upon that complaint

Formulate & provide appropriate management strategies

Provide clear direction & leadership for team members & EMS personnel

Abide by the 100% / 100% principle give 100% effort, 100% of the time!

Patient Assessment EvaluationAllow student to complete their assessment before intervening to ask additional questionsHowever, if there is a need for a prompt or the student asks for help, gently guide the assessment conversation

Intervene immediately if student at risk of doing harm

Take mental notes about what student did well, & how they could improve

Skills Performance EvaluationPositive but honest

Remember that patients & their families are an audience to the educational process

Mentally note weaknesses, then in a timely manner, document on evaluation form as well as speak to student directly

Never let student do harm!

Documentation Evaluation Ensure chief complaint, history, assessment, management & outcomes are properly documented

Noting pertinent positives & negatives key to developing critical thinking skills

Documentation of variances or unusual aspects enforces critical thinkingi.e. NTG not given as patients SBP