A Matter of Substance, Not Style

When I took the Methods of Instruction course, in 1989, I do not recall any of the participants seeking instructor certification for financial gain. We volunteered, or were more likely railroaded, to "learn to teach." Indeed, most of us were not sure we could even be good instructors, but there was a need in our service or area to have a local instructor. In fact, a major factor in selection for acceptance to the MOI course was demonstration of local need.

Inevitably the instructors, and a lot of other folks, soon discovered there was "gold in them there instructional hills." Since then, I have witnessed a huge surge in for profit businesses that are designed to provide emergency instruction in all areas. Is this a bad thing? Well, of course not. Do I fear the competition? Absolutely not. There is certainly nothing wrong with being paid for all the work associated with providing quality instruction. The public is better educated. Services maintain adequate numbers of responders and offer continuing education without the additional cost of importing an instructor. Responders can participate in locally offered advanced courses, and many of us continue to do some instruction on a volunteer basis. However, this financial awareness has also led, in my opinion, to a host of instructors who could care less about the quality of their instruction, so long as they get the money.

We all know of instructors who seem not to care about the quality of their instruction. No, I'm not referring to those of us who experience a bad instructional day from time to time. Nor am I referring to instructors who simply have a different "style" of teaching than my own. I have witnessed, and had relayed to me, examples of what I felt was very poor instruction. I have done remedial for groups of students who were originally taught by other instructors and the students had not a clue! I have been shocked to find out what has been going on in some classrooms.

Instructors that focus on teaching what students need to know to pass the examination for certification. Instructors who are absent a great deal of the time and provide no continuity. An instructor who hires someone, to substitute or actually co-teach an entire course, that lacks any teaching credentials or certifications. Instructors who greatly exceed the allowable hours for instruction by non-instructors, such as guest speakers. Instructors who cancel class frequently and never make up those hours. Instructors who hand out the skill sheets three-quarters of the way into the course, then focus on driving students to only practice what is necessary for testing. Instructors that inform the students what the random station will be at the test site.

In my inquires as to how to rectify these situations, provide remedial for instructors or just plain weed them out, I was told documentation is needed. Understandably. At that time it was recommended to have the students document the insufficiencies, send in a complaint, or contact the powers that be with their concerns. There are inherent problems with placing the burden on the students shoulders for this documentation. Some students simply do not know what to complain about! Some know the course is not quite what it should be, but have no past experiences to draw upon to formulate a valid and clear complaint. Some simply do not care to rock the boat; they got through the course, so all's well that ends well. Many of our students feel the instructor is a "nice person," feel a certain loyalty and do not want to get them in trouble. Some students have to work with these folks and will not jeopardize their EMS future by taking a stand.

I believe we have a serious lack of oversight once folks are deemed fit to teach. Who really should be responsible for providing oversight? The training facility? The region? The state? If it was clearly demonstrated that an instructor should have their certification pulled, I'm not sure there is a clear channel for de-certification and the legal risk is high. Yet, with our good intentions and effort to balance it all out, maintain services, and keep responders up to snuff, we keep churning out the instructors.

The negative impact of poor instruction begins with the student, who may be falsely led to believe they can provide competent patient care. This impact progresses through to the services that find themselves having to provide remedial instruction. Ultimately, it ends up with the general public, the people we are entrusted to serve. Everyone is put at risk in this situation.

I am aware of some of the efforts that have been made to attempt to insure instructors are of quality caliber. Skills check during the MOI course, which proved they could at least do the skills, or not in some cases. An attempt to seek funding to visit classrooms, which resulted in zero dollars. And I do not know many who want to volunteer to be the "henchmen" that lurk in the back of the classroom to judge our own.

What if a number of students did complain? What if someone could demonstrate or provide evidence that an instructor committed serious breeches? How would the powers that be go about validating these complaints? Providing remediation, if that appears to be viable option? Outright rescinding an instructors certification? There certainly is not funding or staff to tackle much of an investigation in this area. Our regional and state staffs are already over-burdened. No one is willing, able, or financially capable of being tied up in the lawsuits that will arise when we take away persons ability to earn a living.

Some suggestions have been to; greatly reduce the numbers of instructors we are turning out; provide a committee to orchestrate visits to the classroom; formulate a better evaluation tool for the student that would be forwarded to the region/state. It is said that you should not complain unless you also have a solution. Unfortunately, I do not have any solid answers to what I perceive as a problem, but I am more than willing to try something. I would welcome having my class monitored. I would not mind my students evaluating the instruction to those other than the employer or service. I would try almost any methods that would result in us actually being able to identify, remediate and/or eliminate those who need it.

We need to do something to ensure that our instructors are doing an adequate job, as a paid or volunteer instructor, and students are at least minimally competent when they hit the bricks. I'm willing to help in whatever way I am capable of to see that this is done. Are you willing to help?

COMMENTS

Some Replies to "A Matter of Substance, not Style:

Mike Colley

tips: you hit it just right. one way to change things is to have a state ems rep sit in on a class or for students to eval the class and that form goes to the state ems office.

David Udey
Hi Valerie! I am new to this Internet stuff, so I am a little behind times. However, I did just read the article you wrote concerning the quality, or lack thereof of quality in today's EMS Instructors. Very good article. I think part of the fault falls with the State or Agency that certifies them. But those of us who witness these grossly negligent people are equally responsible to report what we see. If the State does not act on our report, then, we have done all we can do and should not feel bad for it.

We DO however have that Duty to Act when we see this happen. Remember we can be charged for negligence for not turning in an incompetent EMT. I think the same should apply for incompetent instructors. Let's not complain about it anymore, lets DO something about it. I have seen it myself, and I will not stand for it. The least we are obligated to do, is to report it to the proper authorities. If nothing happens, go over thier head. It works, trust me.

Thanks for the opportunity to input on your articles. I will try and keep up on what's going on.
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Joseph Arsenault
Valerie here in Rhode Island we have encountered the same problem. During state exams if we notice a pattern of mistakes or short cuts, we ask the student where and when they took their course. We then submit a review to the state expressing our findings. Currently only verbal warnings have been issued . We will see what the future will bring.
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I keep checking back here hoping that some of the Powers will reply to this problem. I know I have had my share of bad instructors. Please, won't some of the people in charge let us know what is going to be done? (I wish to be unknown as I still work with some of these bad teachers) King
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Just like to give my thoughts on the commentary regarding instructor quality. I'll make it short: AMEN Anne

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From Valerie

Unless it can be proven that an instructor has blatantly crossed the line, such as compromising the exam, there is little that can be done. Current regulations lack the necessary teeth for the state to take any action. Further prove that an instructor organization is needed that can push for the accomplishment of said teeth, as well as addressing other issues.