Medical scenarios

[Pattree]

@TeeDee
Interesting.
Would you do one technique at a time (how to tie a sling, how to support an ankle etc etc.) or different levels of impact/urgency? (Preparing the kit, The importance of reassurance, the difference between alarming and urgent etc each tied in with technique of course)

My 4 day course and 3 day refreshers went way beyond anything that I have thus far needed but the trainer was a very practical field guy.
EG. You have no need to time a pulse, you know whether it is fast, slow or stopped but taking it gives you control over the situation and time to think. You can tell people (not casualty) to shut up while you appear to be taking a pulse but in fact planning and checking. I learned a lot from him about controlling the scene until the “grown-ups” arrived, quite apart from sticking plaster and bandages.

 

[TeeDee]

@TeeDee
Interesting.
Would you do one technique at a time (how to tie a sling, how to support an ankle etc etc.) or different levels of impact/urgency? (Preparing the kit, The importance of reassurance, the difference between alarming and urgent etc each tied in with technique of course)

My 4 day course and 3 day refreshers went way beyond anything that I have thus far needed but the trainer was a very practical field guy.
EG. You have no need to time a pulse, you know whether it is fast, slow or stopped but taking it gives you control over the situation and time to think. You can tell people (not casualty) to shut up while you appear to be taking a pulse but in fact planning and checking. I learned a lot from him about controlling the scene until the “grown-ups” arrived, quite apart from sticking plaster and bandages.

So full context.

I have in my head that there 'maybe' room for a sort of night course of mixed useful skills -things that are normally taught as dedicated single subject courses over a weekend - but that means they are intensive and some what of a turn off if one wants to learn a multitude of useful skills.

So say a night course duration could be 2 hours ( I'm basing this on my experience of my recent Spanish language course ) - would it be possible to take that 2 hour window and split it up to teach a range of subjects? ( with an emphasis on skill retention and maintaining a high level of student interest/education) -so 30 mins of every weekly lesson is a first aid block.

That would need the first aid subject to being able to start at a very low level , over view and then look at particular subjects with a broad 'how to' lesson covering salient points. Eating the elephant one bite at a time requires a structured breakdown of skills and how best to tie them together.

#edit - As First Aid is broad and relevant high impact / high probability skill it would probably pay to make it a solid core of every class taught as part of a core curriculum.

Just an idea at this point.

 

[Wildgoose]

It’s absolutely possible, indeed some people learn better from a short enthusiastic lesson than a whole day multi discipline type course

 

[TeeDee]

It’s absolutely possible, indeed some people learn better from a short enthusiastic lesson than a whole day multi discipline type course

Yes -thats also my observation and thoughts , having experienced death by powerpoint by being flooded with a single topic I've concluded learning is best done by bite sized , well constructed instruction backed up with intervals of hands on - " show me/yourself what you've learnt " - I think this could be well structured to cover a few big ticket items.

First Aid
Map reading
Survival priorities

A bit of a smorgasboard of various subjects underpinned with good teaching tools.

 

[Pattree]

I agree with the concept and recognise the learning style that you are talking about. The only issue I can see with short snippets weekly or monthly is the use of time repeating and going over the last lesson before continuing and then reiterating it again in the coordination sessions whether those are termly or yearly.

Could you teach CPR on that timescale? Would you want to?

There are first aid clubs much as there are bushcrafter clubs. They suffer from the usual egos and kit purchasers as well as the all round useful generalists.

Probably the most important part of planning such training (any training) is the question: What do you want the end product (person) to be?

I hold that you haven’t completed learning a skill until you’ve used it in a real life situation with real life emotions and environment. On fire prevention and control courses; no one asks you to set fire to something that is valuable to you and then to try and find the right fire extinguisher in the dark!

This means that I have never completed most of my first aid training despite the certificates.

 

[Pupers]

We were previously told to apply “training tight” but it became a negative teach as people weren’t applying them tight enough in real life scenarios, hence the change.

It’s a personal thing though.

Just a quick one, were you initially taught to use a Tourniquet in the military?

 

[TeeDee]

I agree with the concept and recognise the learning style that you are talking about. The only issue I can see with short snippets weekly or monthly is the use of time repeating and going over the last lesson before continuing and then reiterating it again in the coordination sessions whether those are termly or yearly.

Could you teach CPR on that timescale? Would you want to?

There are first aid clubs much as there are bushcrafter clubs. They suffer from the usual egos and kit purchasers as well as the all round useful generalists.

Probably the most important part of planning such training (any training) is the question: What do you want the end product (person) to be?

I hold that you haven’t completed learning a skill until you’ve used it in a real life situation with real life emotions and environment. On fire prevention and control courses; no one asks you to set fire to something that is valuable to you and then to try and find the right fire extinguisher in the dark!

This means that I have never completed most of my first aid training despite the certificates.

I've experience of primacy and recency and how it affects learning and yes , You can't really spend too much time covering off last weeks lesson before one is eroding the current path of learning. But that is the trade off - so it would need to be a sort of one-&-done teaching with at some point a review refresher of skills and knowledge instructed. You can lead a horse to water etc.

Ref CPR and do you want to teach it? - Ultimately - yes, I think more people with a base level of first aid knowledge , even if that knowledge is locked away and only comes back in flash back in stress induced muscle memory situations is better than no knowledge. Or willingness to act.

#edit - As opposed to people not acting at all because they feel they have no knowledge , because they have never had any training at all - not sure how the data may show how many people have ZERO training in First aid? ( Another good reason to teach the basics in the last year of school or 6th form before the young adults join the workforce. )

By that I mean I think people are more likely to act/react if they have had some training at some point of their lives. It maybe a distant memory but its surprising what a jolt of adrenaline can do ( if its been initially taught with a stress test at some point ) to rekindle a muscle memory response.

So do I think it would be better to have more people present with some training as opposed to less - Yes.
And I think its more likely that people will attend a mixed skill lesson spread over the year for a few hours a week to opting to volunteer 2/3 days to a single course.


"I hold that you haven’t completed learning a skill until you’ve used it in a real life situation with real life emotions and environment. On fire prevention and control courses; no one asks you to set fire to something that is valuable to you and then to try and find the right fire extinguisher in the dark!"

Not sure what a possible response could be to this statement - Whilst I agree with the gist of what you are saying , not sure how you bypass that - The only thing I can think of is one teaches a skills , then has the skills replicated under no stress to show its learnt , then create a stress test of sorts ( hopefully unknown to the students ) to see how much they can remember and act under possible stressors.

But ultimately elapsed time and tests that are conducted under as near real-life replication as possible is key.. But still , How is that different to any other training method. ?

 

[mrmike]

We were previously told to apply “training tight” but it became a negative teach as people weren’t applying them tight enough in real life scenarios, hence the change.

It’s a personal thing though.

When I did my efaw+f course we were told that you tighten it until tight, then tighten it until the casualty was screaming.
The trainer was an ex firearms copper who had done it for real, and had it done to him.

 

[Wildgoose]

Just a quick one, were you initially taught to use a Tourniquet in the military?

No, in my limited military exposure with the TA Torniquets were seen as a last resort and were improvised, no CATs or SOF T’s then.

 

[Pupers]

No, in my limited military exposure with the TA Torniquets were seen as a last resort and were improvised, no CATs or SOF T’s then.

Yeah, “Pack and wrap”

 

[Wildgoose]

You could teach CPR in 30 minute segments, something like:

Lesson 1. Adult CPR (recap 5 minutes primary survey)
Lesson 2. Defib (recap CPR)
Lesson 3. Child and baby CPR
Lesson 4. Defib child and baby
Lesson 5. Scenario based training on the above

 

[Pattree]

I’m really not at all sure that is possible.

Is this for theory only?
If not how many resussi-Annie’s have you got?
There is 30 minutes just in positioning the casualty for CPR, clothing and respect - well there was for us.

I took more than 30 minutes getting a print out that didn’t break her ribs. (breaking a rib doesn’t matter in real life but for the exam I mustn’t do it!) She had very fragile ribs to test us.

 

[Pupers]

There is 30 minutes just in positioning the casualty for CPR, clothing and respect - well there was for us.

Is it possible to give a quick explanation of the above please.

 

[Pattree]

There is a hell of a difference between writing it on a page and delivering it, reassuring and discussing it and answering questions with a group of ten to twenty learners!

Unless of course, you’ve got it all written down in Key Points in yellow writing on a blue background with animated transitions. In that case wake me up when it’s time to go home.

Adjusting clothing, M2M resus, recovery position and manhandling patients requires respect whether or not they are conscious.

 

[Pupers]

There is a hell of a difference between writing it on a page and delivering it, reassuring and discussing it and answering questions with a group of ten to twenty learners!

Unless of course, you’ve got it all written down in Key Points in yellow writing on a blue background with animated transitions. In that case wake me up when it’s time to go home.

Adjusting clothing, M2M resus, recovery position and manhandling patients requires respect whether or not they are conscious.

Wow, easy tiger, I only asked a reasonable question…..Jees, lighten up.

 

[Chris]

There is 30 minutes just in positioning the casualty for CPR, clothing and respect - well there was for us.

I have never heard of this… as in, to preserve dignity??

I don’t think it’s possible to look dignified as someone bends your ribs into your thoracic cavity, nor should it even be a consideration. Not criticising you there Pattree, but the training if that’s what was taught. This may be where learning first aid in a military context was different, as people who actually have to more regularly deal with casualties who *are going to die* if you don’t help them tends to focus the priorities more than First Aid At Work style courses where people are more sheltered from the realities of traumatic injuries and death, in a world where The Guardian will write an article about how someone had their life saved but it was jolly embarrassing and the NHS should be apologising.

To the thread in general:

When I was teaching we did VAK (visual, audio, kinaesthetic) tests to assess what spread of learners we had and we’d go from there. We’d teach for no more than 45 minutes at a time as people really cannot focus and absorb information very effectively beyond that, so for a 2 hour session I’d assume a 15 minute break in the middle. 2 hours could be two separate subjects, or you could go for 45 mins of theory and guided learning and then 45 minutes of supervised practice.

As old as the EDIP (explain, demonstrate, imitate, practice) model is, it’s still pretty functional. It worked well in a military setting, where you have a spread of learning styles and abilities. It worked well with non-military teenagers as well.

That said, when it comes to assessing people’s learnings by having them demonstrate back to you, as well as having them demonstrate it back to you towards the end of the session itself, I would also make sure you get them to do this a week or more after that session as well. Perhaps a ‘learning consolidation’ session every month (assuming weekly sessions) where people demonstrate all their learnings from the last month. Demonstrating immediately after a lesson is one thing, but retaining and practicing that knowledge at a later date is essential for longer term learning.

You might find it beneficial to write some lesson plans to include intro/summary time and see how much you can break the subjects down without losing context and focus. Once you’ve got a lesson plan that contains the minimum you need for one session, you can then give it a trial run and go from there. If you are doing a ‘dry run’, as in presenting to yourself out loud but at a slow pace to get an idea of timings, you can expect it to probably take 3 or 4 times as long when doing it with students.

If you video yourself doing a dry run, you’ll spot where you made mistakes or started talking too quickly (you will) and adjust timings with that information as well.

Start with the syllabus first and then try to break it down logically, would be my advice. Starting with timings first will mean you miss things.

 

[TeeDee]

I appreciate a lot of the feedback on how to teach / how one learns - an that IS important.

But still asking if one knows a good structured produced syllabus of tiered F.A lessons. That will start the other processes.

Many thanks.

 

[Pattree]

Wow, easy tiger, I only asked a reasonable question…..Jees, lighten up.

You may believe it or not but that was just me being me. Absolutely no animosity what so ever

@Chris
Your military point is well made.
The public are not on average well muscled, resilient folk.

We were learning to work on colleagues and members of the public - all ages with the probability that we would be dealing with pensioners, ladies in frocks, old guys with false teeth. Also we were taught to control the scene - there is a much higher probability of rubber-neckers at the scene.
It is quite possible that we would have had to give M2M to an old guy who stinks of old alcohol and lack of oral hygiene.

 

[Chris]

The Army Cadet Force one is pretty much civilian syllabus, and is broken down quite well; https://www.dataplate.co.uk/hosting/detachment/files/acs-syllabus.pdf - page 100 onwards

The lesson plans are probably floating around somewhere, but it gives a good overview of what a syllabus and individual sessions might look like.

Looks like you can buy the books, for example: https://www.cadetdirect.com/army-cadet-one-star-training-handbook

 

[TeeDee]

The Army Cadet Force one is pretty much civilian syllabus, and is broken down quite well; https://www.dataplate.co.uk/hosting/detachment/files/acs-syllabus.pdf - page 100 onwards

The lesson plans are probably floating around somewhere, but it gives a good overview of what a syllabus and individual sessions might look like.

Thank you Chris - for both the posts. Appreciated.