I love Power Point. So much, that my guys would come up with a great class idea and I would tell them to come back to me when they had a Power Point presentation. I would hear the groans when I told them we had a 150 slide EMS presentation on “The Cell and the Cellular Environment.” But I thought my classes were different! I would chisel the class down to only 100 slides, and of course I am much more entertaining than the other instructors! WRONG! It took me a while to get my big head around it, but one day I looked out and only saw zombies. There was no interest; and no engagement. I would sit through other instructor’s presentations and find myself thinking about how many different types of M&Ms were available to buy these days. It dawned on me that if I’m bored out of my mind (and I love learning!) then these other guys were probably ready to beat their head into the wall.
Now, I don’t know what program your department uses, but we use the AAOS EMT program. This program is full of extremely long Power Point presentations, which is great for an initial EMT course, but way too much for a refresher. For example, every presentation has a long section on primary and secondary assessment for that specific emergency. Not much changes in your assessment between different emergencies. Rather than re-teach the procedures of the primary/secondary assessment for each and every type of medical emergency, we started actually performing assessments. A lot. We should all be well versed in the theory of primary and secondary assessment; it has been hammered into us over and over since we became EMTs. Where we need to focus our energy is hands-on training to enhance our skills and reinforce our knowledge. To be clear, we were supposed to be conducting hands-on with every class, but let’s be real: who wants to spend another hour conducting hands-on training after being tortured with 60-90 minutes of classroom lecture?
I started reviewing basic principles of adult learning. This is stuff straight from our Fire Instructor I certification! Who remembers Edgar Dale’s Cone of Learning? This model teaches us that after 24 hours, we only retain 10% of what we read and 20% of what we hear. But if we practice performing a task or teach others how to do a task, we retain 70% and 90% respectively! I began telling instructors that if their class had more than 20 slides or took more than 20 minutes, to come back to me when it was shorter. Firefighter Martin Barnes says that the current EMS presentations we are using have too much information for what is essentially a refresher class. He says that he doesn’t remember much from watching an instructor with a Power Point presentation, but remembers a lot when performing hands-on training. This is exactly what is illustrated in the cone of learning!
In my training section, gone are the days of speed reading 180 slide EMS presentations and worrying more about how fast we could get through them, than whether our people are actually mastering the knowledge. We now spend about 10-20 minutes reviewing our local protocols and the key differences in assessment procedures for the specific medical emergency, before spending the bulk of our training time performing assessments.
When I asked Firefighter Mike Gongora what he thought about our shift to more hands-on training, he stated, “I actually learn more from making mistakes.” In the book Failing Forward, John Maxwell quotes author Jim Zabloski who wrote, “The more you do, the more you fail. The more you fail, the more you learn.” I want my students to make mistakes, because that is the best way to learn! The only way to make mistakes is to do more!
My friend and long-time mentor Lt. Juan Estrada says that he prefers the hands-on training, but that most guys don’t want to put in the effort it takes. This is a great point! It does require effort to put together a quality hands-on training program. I reluctantly admit that for many years I was a lazy training officer! As a training officer you have to ask yourself, do you want a department of mediocre firefighter/EMTs who are zombies during your long classroom presentations, or do you want engaged active firefighter/EMTs who are getting quality hands-on experience; especially those of us who work in low call volume departments.
The goal of our hands-on training before this change was to get as many people through as quickly as possible. This meant groups of five to six guys working on one patient. We no longer have one EMS practical scenario for five to six guys. We now train with two but no more than three EMTs working on a patient. Obviously, this is more work for the instructors, but the benefits are huge. Our firefighters are now getting more hands-on training in EMS, which is our biggest percentage of calls. Also, it forces the firefighters who prefer to stand in the back and chart or do other low risk skills, to step up and challenge their EMS skills.
I would like to point out, this isn’t exclusive to EMS training; EMS was my focus of this article because that subject takes up a large portion of my department’s training time. However, this concept applies equally to all training. As an instructor, do you think your students are going to learn more sitting in a classroom looking at a Power Point presentation about fire streams, or actually going out and doing it? The Cone of Learning gives us the answer to that question! There is a time and place to sit around and talk about hose streams, pump theory, etc., but this should be very brief so you have more time to actually perform the task. Malcom Gladwell states in Outliers that it takes 10,000 hours of practice to master a skill. Even if he’s ½ wrong, 5,000 hours of hands-on training/experience would still take 19 years to reach for a typical firefighter to achieve. This is assuming a firefighter who receives 2 hours of training/experience every workday on a 56 hour rotation. This could go up or down depending on your department’s shift schedule, but regardless, we still have many hours to attain mastery; and mastery won’t be achieved with a Power Point! The time to get started is now!
Don’t get me wrong, I still love Power Point. I believe, when you are going to do classroom work, it is an invaluable tool. It gives your students something to look at and aids your visual learners. But make sure you are using it as a tool, not a crutch. If your presentation takes more than 15-20 minutes, or the slides are saying more than you as the instructor, you need to cut some material from the slides. And whatever you do, don’t stand there and read the slides! They should only be prompts. Spend less time in the classroom and more time on the training ground, and never let your slides have more to say than you do.
I would like to leave you with this quote I see every week on the wall of our training office. “In the absence of experience, all you have to fall back on is your training.” Do you want your firefighters to retain 20% of that training, or 90%percent? The answer to that is up to you.