Educator Update Winter 19-20

EUPDATE

DUCATOR WINTER ISSUE 2019 - 2020

WINTER 2019-20 UPDATE

WINTER 2019-20 UPDATE

NAEMSE Celebrates 25 Years! Looking Back & Moving Forward Seeing Now What I Could Not See Then: Reflection William Leggio

Look Ahead to the 2020 NAEMSE Educators Symposium & Trade Show in Pittsburgh, PA! D.O.C.U.M.E.N.T. Mneumonic & Rubric Substantially Improved Documentation Performance Douglas Randell

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CONTENTS

1

2019 NAEMSE Symposium Recap

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NAEMSE Throughout the Years

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2020 NAEMSE Symposium Announcement

9

What Is There To Do In Pittsburgh, PA?

By Stephen Perdziola

25th Anniversary

By Stephen Perdziola

Symposium 2020

11 NAEMSE Give Back Day

By Stephen Perdziola

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Documentation Mnemonic & Rubric Substantially Improved Documentation Performance

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Seeing Now What I Couldn’t See Then: Reflection

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Foundations of Education: An EMS Approach

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Becoming a Member & Core Values

By Douglas Randell, et. al.

By William J. Leggio

2019

SYMPOSIUM RECAP

INTRODUCTION

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In August 2019 NAEMSE held our 24th Annual EMS Educators Symposium & Trade Show at the Omni Hotel in Fort Worth, Texas. The event was a great success and was a phenomenally educational experience for all who attended.

We would like to extend a heartfelt thank you to all who contributed to a wonderful week of conversation and education!

The 24th annual NAEMSE Educators Symposium & Trade Show wrapped up on August 5th in Fort Worth, Texas! Thanks to all those who attended and helped make this symposium a great success. Over 420 attendees, faculty and exhibitor representatives gathered in Fort Worth over 6 days to experience NAEMSE’s mission statement of “Inspiring Educational Excellence!”

We are excited to announce that this year’s attendance increased 13% over last year and we had a 25% increase in exhibitor participation.

At this year’s board meeting we acknowledged two board members that are leaving after serving six years as a NAEMSE board member: Dr. Nerina Stepanovsky and Becky Valentine. We also welcomed new board members that were seated at the annual membership meeting: Dr. Paul Rosenberger and Ron Lawler.

The exhibit hall had over 40 companies interacting over three days with the hundreds of attendees.

David Bump of International Board of Certification said, Please share our thanks for a job well done. The meeting was well planned, organized, and stayed on time. We attend many meetings and this one was fantastic. Thanks for the hard work in making things look flawless!

Kory Lane, one of the many presenters at this year’s symposium states, “I was impressed with how well and organized the entire conference was done.”

We thank all of you who chose to advance your skills as an educator by attending this year’s symposium. If you participated in an Instructor Course, should have received an email explaining how you can obtain your CEU certificate. If you did not receive this email, please contact laurie.davin@naemse.org.

Check out naemse.org for updates and other exciting opportunities we have in store for next year’s 25th Anniversary Symposium in Pittsburgh, PA! The 2020 Symposium will be held at the Wyndham Grand Hotel in Downtown Pittsburgh on August 3-8, 2020! We are very excited to show off all of the hard work we have been putting in to improve and inspire educational excellence.

We’ll save a seat for you!

Check out some sights and scenes from this years’ symposium! We were very fortunate to have an amazing exhibit hall showcasing new products and companies at the forefront of EMS education. NAEMSE is all about engagement, and one of the ways we encourage this is by highlighting the advancements in EMS simulation, the ways this technology can benefit educators and improve the overall classroom experience. Promoting engagement is one of the most effective ways to inspire educational excellence.

NAEMSE

25th ANNIVERSARY

We are very proud to announce that 2020 is NAEMSE’s 25th Anniversary year! Over the years we have had the opportunity to interact with thousands of members, teach courses in most states, even several different countries.

NAEMSE has come a long way, but we are not done yet. As we begin this new chapter, we would like to take a moment to thank all of our members for motivating us to continue to raise the bar for EMS Education and inspire educational excellence.

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Every year, NAEMSE organizes the premier event for EMS educators. This event attracts attendees from all over the country and every year we move to a new city. We are very happy to announce that we will be celebrating our 25th year at home in Pittsburgh, PA.

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NAEMSE Inspiring Educational Excellence

ANNIVERSARY

2020 7

25th ANNIVERSARY EMS EDUCATOR SYMPOSIUM & TRADE SHOW

AUGUST 3-8, 2020 WYNDHAM GRAND HOTEL PITTSBURGH, PA

VISIT NAEMSE.ORG TO FIND DETAILS & UPDATES, REGISTER OR CONTACT US!

AUG 3-8, 2020

WHAT IS THERE TO DO IN PITTSBURGH, PA?

SYMPOSIUM 2020

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Pittsburgh is a fantastic city with enormous opportunities for visitors to engage in! NAEMSE’s 25th Anniversary EMS Educators Symposium & Trade Show will be hosted at the Wyndham Grand Hotel in Downtown Pittsburgh. While you are in town enjoying our Symposium, check out these fun activities and events as well!

PITTSBURGH ICONS & EVENTS

PERFORMING ARTS

Phipps Conservatory

A Chorus Line in Pittsburgh

Three Rivers Regatta

Zabrecky in A LITTLE SOMETHING DIFFERENT

August 1, 2020 @ Point State Park

August 4, 6 & 8, 2020 @ Benedum Center

Pittsburgh Zoo & PPG Aquarium

Liberty Magic

Gateway Clipper Tours

Runs thru August 9, 2020

Original Primanti Bros. Restaurant

The Black Crowes

Strip District

August 1, 2020 @ KeyBank Pavilion

Beach Party Boys - Tribute to The Beach Boys

SPORTS

August 8, 2020 @ Allison Park

Pittsburgh Pirates vs. Milwaukee Brewers

August 3 & 4, 2020 @ 7:05pm

SPECIALTY MUSEUMS & NOVELTIES

Pittsburgh Pirates vs. Arizona Diamondbacks

Allegheny Observatory

Randyland

August 6 & 8, 2020 @ 7:05pm

Pittsburgh Steelers vs. Miami Dolphins

Duquesne Incline

Frick Art & Historical Center

August 5, 2020

The Clemente Museum

MUSEUMS

Pinball Perfection

Carnegie Museum of Art

Bicycle Heaven

Carnegie Museum of Natural History

Pennsylvania Trolley Museum

Carnegie Science Center The Andy Warhol Museum

EXTRAS

Senator John Heinz History Center

West End Overlook

Mattress Factory Art Museum

Pittsburgh Public Art Tours

Fort Pitt Museum

Rivers Casino

Photo Antiquities Museum of Photo History

Meadows Casino

Soldiers & Sailors Memorial Hall & Museum

City Brew Tours

NAEMSE

GIVE BACK DAY

On Friday, August 2, 2019, NAEMSE hosted the first NAEMSE Give Back Day as a component of the 2019 Educator Symposium & Trade Show! We had the privilege of training 25 kids from the Boys and Girls Club of Tarant County, Texas about proper techniques and practices for taking action in emergency situations and administering potentially lifesaving care to buy time for professional help to arrive. The day began with kids learning the Until Help Arrives and Stop the Bleed programs, then they got to

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take that newfound knowledge and apply it to some simulated situations!

This proved to be a remarkably rewarding experience, as exemplified by Nerina Stepanovsky, one of our National Faculty members, who said: To me, being an EMS educator is about helping others make a difference. At first, the students were shy, but once they started to interact with us, they taught us how to be better people and educators by their pride in learning something new, something that could save someone they love. It was one of the highlights of Symposium for me, and I hope to help out again next year. A very rewarding experience!

Joe Grafft, another National Faculty and an active member of our Board of Directors, had this to say about his experience at the NAEMSE Give Back Day: We sponsored the “Stop the Bleed” program and as one of the instructors I felt we made a connection with the kids in a very positive manner! I believe we instructors got as much fun and feedback from the kids as we experienced putting this program on! It was terrific!

NAEMSE’s Give Back Day continued in the afternoon with our NAEMSE Faculty conducting a CPR training course for 25 of the Omni Fort Worth staff members. This course was intended to provide the Omni staff with the necessary tools to assess and temporarily treat patients in situations they may potentially encounter on any given day at work. The Omni was a fantastic host for the 2019 NAEMSE Educator Symposium & Trade Show and this CPR training course was a rewarding way to give back and show our appreciation for the work the Omni staff put in to ensure the success of the Symposium.

Laurie Davin organized this event and worked closely with the Omni Fort Worth as well as the Boys and Girls Club to ensure the success of our first Give Back Day. We would like to thank our NAEMSE Faculty members Joe Grafft, Casey Quake, Laurie Sheldon, Steven Mountfort, Nerina Stepanovsky for their efforts in teaching this course, as well as Shawn, Caleb and Jacob Treloar for their help setting up.

We’d also like to thank CAPCE, EMS Ed by Pocket Nurse, Laerdal, Platinum Educational Group, Simulator Solutions, and Simulab for providing merchandise for all of the participants and MedStar Mobile Health Care in Fort Worth, TX for donating CPR mannequins!

This event was a great success and NAEMSE is looking forward to forming this event into an annual part of the NAEMSE Educators Symposium & Trade Show. If you have expertise or resources and would like to donate to NAEMSE Give Back Day, please reach out to laurie.davin@ naemse.org or call (412) 343-4775.

DOUGLAS RANDELL

DOCUMENTATION MNEMONIC & RUBRIC SUBSTANTIALLY IMPROVED DOCUMENTATION PERFOMANCE

AUTHORED BY WITH HELP FROM AWARDS

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Douglas Randell, BS, NRP (Division Chief of EMS, Plainfield (IN) Fire Territory) Michelle Mayer, BA, NRP (Administrator, Union (MO) Ambulance District) This evidence-based research won the award for Best Poster Presentation at EMS World Expo in 2019 in New Orleans, LA competing against 30 other posters from around the globe.

INTRODUCTION EMS documentation is an essential element in the continuity of patient care. EMS training from EMT to Paramedic school and EMS employers has taught documentation that if it was not documented, it was not done. Hospitals use EMS documentation as a way to continue the care provided in the field

by EMS providers. This state medical record must be accurate, have correct grammar, no misspelled words and clearly describe the patient’s complaint, treatment, and outcomes. For example, to ensure that an organized system of trauma care evolves and improves over time, there must be a mechanism for continued system review to ensure that protocols are being followed, that sources of error are identified and addressed, and recurrences prevented. Current recommendations by the American College of Surgeons Committee on Trauma (ACS-COT) include a performance improvement (PI) process, which describes the continuous evaluation of the center and providers through structured review of the process of care and patient outcome.1–4 Laudermilch noted failure of EMS to document basic measures of scene physiology is associated with increased mortality.5 The development of criteria to standardize EMS documentation is essential to retrieving more accurate data and improving patient outcomes. This documentation should be attached to training of a new, systematic process of documentation that is objectively scored through a rubric. There are many benefits of using rubrics in assessment, and realize that rubrics should be well-designed, topic-specific (contextual), analytic, and complemented with exemplars to be effective. The history of writing assessment shows that achieving high reliability in writing assessment is not easy, and we should be careful not to sacrifice validity to achieve higher rates of reliability.6 Continuous Quality Improvement is a process that couples carefully identified, measurable performance indicators with information systems to monitor, analyze, and trend data. Benchmarking outcomes

with other EMS systems allows the identification of “best practices” and the evolution of standards.

Emergency medical services professionals must actively participate with the broader health care community in creating performance measurements to ensure that high-quality care is delivered consistently.7 The objective was to evaluate the performance of a newly-developed mnemonic for documentation, an accompanying evaluation rubric and to improve compliance with documentation of patient care report elements.

METHODS A descriptive method was used based on the development of a mnemonic, as a method for improving the process of recording patient care.

An evaluation rubric was developed in conjunction with the mnemonic to assess documentation performance. Scores greater than 80% were deemed ‘passing’ and scores greater than or equal to 95% were classified as ‘high achievers’ out of 100%. Training was conducted at a fire-based EMS agency in the fall of 2017. Beginning January 1, 2018, the EMS Committee supervised randomly reviewed one run report per employee, per shift.

The analysis was from January 1 to December 31, 2018.

RESULTS In October 2016, a retrospective analysis was conducted using the rubric (instrument). The review was conducted prior to the implementation of the instrument, training or evaluation. Fortythree percent of patient care reports were reviewed in October 2016 (n = 122) using the rubric. Reports above the passing score (greater than or equal to 80% compliance) were 48%. Reports in the ‘high achievers’ category (greater than or equal to 95% compliance) was 0%.

After implementation of the instrument 37% (n = 1,482) of patient care reports were reviewed. The reports with a passing score ranged from 85% in January 2018 to 98% in December 2018. Reports in the ‘high achievers’ category ranged from 16% in January 2018 to 71% in December 2018.

In January 2018, one element (primary impression), had been documented 25/146 times (17%).

This low outcome was partially due to their EMS education instructing them not to ‘diagnose.’

Further training from the medical director was conducted and documentation for this element in February 2018. Primary Impression rose to 64%

by March 2018 and improved to 84% by June 30, 2018! This element has held steady at over 90% through December 2018.

DEFINITION

LIMITATIONS

D.O.C.U.M.E.N.T. TM

This study was conducted at a single fire-based EMS agency. Future work is needed to assess impact at other agencies. Further prospective work is needed to confirm sustainability of observed improvements in this study.

Dispatch/Demographics/Distance On-scene Assessment Chief Complaint U Say What My Eyes, My Eyes Examination N the Verdict is…

Treatment and Transport... Decisions, Decisions

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CONCLUSION

REFERENCES

Substantial improvement in the documentation of key patient care record elements was noted following implementation of the newly-developed mnemonic (instrument) D.O.C.U.M.E.N.T. ™ and associated objective evaluation rubric. Future work is needed to assess the generalizability of these findings at other EMS agencies.

1. American College of Surgeons, Committee on Trauma. Trauma Performance Improvement Reference Manual. Chicago, IL: American College of Surgeons; 2002.

2. West JG, Williams MJ, Trunkey DD, et al. Trauma systems. Current status future challenges. JAMA 1988;259:3597–3600. [PubMed: 3373707] 3. Bazzoli GJ, Madura KJ, Cooper GF, et al. Progress in the development of trauma systems in the United States. Results of a national survey. JAMA 1995;273:395–401. [PubMed: 7823385] 4. American College of Surgeons, Committee on Trauma. Resources for the Optimal Care of the Injured Patient: 1999. Chicago, IL: American College of Surgeons; 1999.

5. Laudermilch DJ, et al. Lack of Emergency Medical Services Documentation Is Associated with Poor Patient Outcomes: A Validation of Audit Filters for Prehospital Trauma Care. Journal of American College of Surgeons 2010; 2:220-7.

6. Rezaei AR, et al. Reliability and Validity of Rubrics for Assessment through Writing. Science Direct. Assessing Writing 15 (2010) 18–39.

7. Dunford J, et al. (2002) Performance Measurements in Emergency Medical Services. Prehospital Emergency Care(2002) 6:1, pages 92-98.

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SEEING NOW WHAT I COULD NOT SEE THEN:

REFLECTION

William J. Leggio EdD, NRP

INTRODUCTION

The value for life-long learning is becoming more important in our profession. Educators certainly have opportunities to cultivate skills for life-long learning in EMS learners. The need for educators to form capable life-long learners exist both in initial and ongoing education.

Reflection is a capability for learners to develop to assist life-long learning. For educators, incorporating the practice of reflection in our approaches to education can positively impact the learner’s experience and outcomes.

REFLECTION Reflective practices in education provide opportunities to plug into a learner’s understanding and thought processes. Reflection has been embraced as a foundation to professional practice as it links theory to practice as an active process for the learner to evaluate their own learning. (8-9,18) Just as we put an emphasis on the importance of critical thinking, critical reflection is a capacity to uncover assumptions about self, others, and the workplace.1-3 In essence, reflection brings knowledge to mind and allows for learning to be strengthened, thus aiding students in learning complex and contextual materials.4 Embracing reflection as an active skill and capacity allows for it to be more than just a post event exercise or practice because reflection can occur in action and on action. It should be appreciated how both forms of reflection contribute to learners developing active regulation, understanding, and self-efficacy.

REFLECTION IN ACTION Reflection in action is most likely the least common form of reflection. Despite the potential benefits it holds in improving patient safety and providing care to an emergent or complicated patient.

Perhaps one way to start thinking about reflection in action is to think of it as understanding the voice of reason or gut feeling in real time. Reflection in action occurs immediately and is a skill of learning and developing by applying current and past experiences.1-3 This form of reflection encourages past experiences to be observed or reflected upon to provide perspective on current actions and behaviors.1-3 Just as previous negative experiences are opportunities for growth, reflection in action is intended to include positive experiences as well.1-3

REFLECTION ON ACTION The form of reflection that is perhaps the most common and familiar is reflection on action. 1-3 Reflection on action is thinking back on what happened, exploring contributing factors, reliving

an event, etc.1-3 For most, this is essentially how we debrief calls, scenarios, and major incidents. Often, the goal of reflection on action is to develop corrective actions or an action plan for similar events in the future.1-3 Just as with reflection in action, reflective practices ought to include a focus on positive experiences as well as negative ones.

IDEAS FOR CULTIVATING REFLECTION Reflection arguably cannot be facilitated, evaluated, or measured using multiple choice questions and tests intended to assess knowledge.4 There are opportunities to design writing assignments, openended forms of assessment, and ongoing portfolio evaluations to embrace reflection as a skill and competency.4 Developing these opportunities into program activities does not require assigning a grade or a significant workload increase. For example, short reflective writing assignments could be reviewed during advising sessions, incorporated into affective domain activities, and revisited as part of a portfolio for program completion.

Another example is providing a disease or brief patient scenario and have learners map connections from pathophysiology,

anatomy and physiology, patient presentation, and treatment for the disease or scenario.

For many, the most likely and comfortable area of EMS education to incorporate reflection is in simulation and clinical learning. Models for reflection exist and they could help guide debriefing of simulated and actual patient encounters.1,5 In summary, the starting point is recalling the experience in moderate detail. From there the dialogue flows into exploring what was being felt during and after the experience.

After an exploration of feelings, analysis of performance occurs including positive and negative actions and behaviors. The analysis segment also allows for exploring relevant theories, knowledge, and past experiences. Following an analysis is a bridge into a conclusion and action plan by identifying gaps in knowledge, skills, or behaviors. Time spent in concluding allows for a final synthesis or summation to form a practical action plan with the intent to transform future practice. Just as this may read like a structured approach to debriefing a call or simulation, it too provides a partial presentation outline for real patient case studies for learners to present.

The preceding ideas are largely for reflection on action. It is a challenge to form ideas for

reflection in action as this is form of reflection is more intrinsic and does not require audible words. A practical idea is to monitor a learner’s performance during a formative scenario. If the learner is not performing well, then a facilitator could intervene and ask the learner broad questions such as, what are you feeling now, how have you experienced this patient before, and what is your intuition telling you? Another idea is to start each course with a review of expected learning outcomes or objectives. Then ask learners to reflect on the items and identify their personal strengths to leverage as part of their action plan to be successful in the course.

CONCLUSION Motivation for writing this article came from personal reflections and an appreciation for embracing critical reflection as a skill and competency required for life-long learning.

A value that is becoming more cherished by educators and clinicians. The examples and ideas shared were intended to serve as practical starting points and to illustrate different approaches to reflection in action and reflection on action. An inherent requirement for these ideas and reflection itself is patience.

Reflection is a skill and competency that takes time to develop and is intended to support life-long learning. It is unlikely to see immediate

or tangible signs of reflection like we are accustomed to with student performance on multiple choice exams and demonstrating routine skills. Anecdotally, indications of successful strategies in graduating learners with reflective skills and competencies show on employer feedback surveys and program culture. Direct indications eventually present when graduates share how reflective skills impacted their decision making, prevented harm, or contributed to their success. Some things in life and education require time in order to become visible when it could not be seen then.

REFERENCES 1. Hillard D, James K, Batt AM. An Introduction to Reflective Practice for Paramedics and Student Paramedics. Canadian Paramedicine. 2017;40(2):17-20.

2. Kaufman DM. ABC of learning and teaching in medicine: Applying educational theory in practice. BMJ. 2003;326(7382):213216.

3. Somerville D, Keeling J. A practical approach to promote reflective practice within nursing. Nurs Times 2004;100(12):42.

4. Agarwal P. Retrieval Practice & Bloom’s Taxonomy: Do Students Need Fact Knowledge Before Higher Order Learning? Journal of Educational Psychology. 2019;111(2):189-209.

5. Smart G. I.F.E.A.R. Reflection: An Easy to Use, Adaptable Template for Paramedics. Journal of Paramedic Practice.

2013;3(5):255-257.

FOUNDATIONS OF EDUCATION: AN EMS APPROACH THIRD EDITION

If you are interested in learning about current educational theories and methodologies that will help you improve in the classroom, we encourage you to check out the 3rd Edition of Foundations of Education: An EMS Approach!

Published by Jones & Bartlett Learning, this textbook offers practical advice, scenarios and tools in compliance with state and national accreditation guidelines.

This book is used in our Instructor Courses, but it is tremendously beneficial for all EMS educators.

You can purchase the book through naemse.org or from Public Safety Group!

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BENEFITS OF MEMBERSHIP Members enjoy several benefits, such as access to a network of high level EMS educators, State Directors, and companies providing equipment for practice and the classroom. In addition to this vast member network, we offer access to our unique, newly redesigned Resource Library and a weekly members-only newsletter that provides the latest news and articles from NAEMSE and the EMS educator community.

3,000+ EDUCATORS

RESOURCE LIBRARY

NAEMSE CORE VALUES Values are the foundation on which we perform work and conduct ourselves. In an ever-changing world, core values are constant. Core values are not descriptions of the work we do or the strategies we employ to accomplish our mission. The values underlie our work, how we interact with each other, and which strategies we employ to fulfill our mission.

The NAEMSE Resource Library is a system that allows members to share video, photo and audio resources they have found to be beneficial in their professional experience. We’ve redesigned our Resource Library to allow users to easily find files and search for content. This system allows members to communicate about how they used resources, provide examples and share plans, all in one place!

Our members also receive a free one-year subscription to EMS Magazine and a discounted subscription to Prehospital Emergency Care Journal. v

MEMBER DISCOUNTS

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NAEMSE UPCOMING INSTRUCTOR COURSES (All courses, dates & locations are subject to change.)

JANUARY 17 Memphis, TN 24 Los Angeles, CA 31 Elmhurst, IL

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FEBRUARY 21 Albuquerque, NM

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MARCH 6 Charleston, WV 13 Indianapolis, IN 20 Fair Haven, NJ 27 Louisville, KY

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APRIL 3 Casper, WY 17 St Peters, MO 24 Rapid City, SD

IC1 IC1 IC2

MAY 1 Denville, NJ 8 Oglesby, IL

15 New Britain, CT 29 Monroe, NC

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JUNE 12 Turner Falls, MA 26 Ventura, CA

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HOW TO REGISTER:

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Please find all of our upcoming courses and exams listed on naemse.org in “Educational Courses” under “Upcoming Courses & Exams.”

Select the course that is most convenient for you to attend and click “Register.” Please follow all instructions prompted subsequently.

NO COURSES NEAR YOU? We do our best to cover as much ground as we can and we organize Instructor Courses in as many places as possible. If there is no course within practical range of your location, let us know where you are! We value your feedback and we work constantly to accommodate our members in different places.

INTERESTED IN HOSTING? Have a location you are interested in using to host a NAEMSE Instructor Course? We would be happy to work with you! Please submit a Location Request Form on naemse.org under the “Educational Courses” tab.

WINTER 2019-20 UPDATE

DUCATOR WINTER 2019-20 UPDATE

EUPDATE