Creating a Culture of Learning in EMS

This article was written by Sean Graham and previously published in a 2019 issue of The EMS Director magazine. It has been reposted here with permission from the publisher.

You know the type … the punch-in and punch-out paramedic.

The individual that constantly pushes back on any clinical advancement that you bring to your department. They are the first ones to answer “diesel bolus” when you give a scenario around a critically-ill cardiac patient requiring advanced interventions. At the surface they appear toxic to your other employees and a strain on your department.

The reality is that the very industry that had them once excited to provide prehospital care failed them.

They are overworked, underpaid, and left feeling like what they do day-in and day-out lacks purpose. Sure, it is easy to tell them to find another profession if they are truly that unhappy. However, that would be taking the easy way out; and the easy way is not what you are looking for.

Burnout is a constant threat to good clinicians. The problem is it doesn’t stop at the individual.

Eventually, burnout will leak out of the individual and into the quality of your department. While there are a multitude of issues that fit hand-in-glove with burnout, one of the main problems is creating a culture adverse to learning … and one that is averse to quality.

Having an entire department that is disinterested in learning can be a challenging one to manage. So how do you inspire those around you to want to learn more and become better clinicians? What strategies can we employ to get these employees back on track … focusing on quality … focusing on the big picture?

First, make it competitive. While there are a variety of personality types that gravitate to prehospital care, a competitive spirit is something that you can find in almost any department. Creating an opportunity for teams to compare to themselves to one-another is a great way to motivate your employees.

One idea is finding clinical metrics to present at regular staff meetings. By creating a clinical dashboard, you can demonstrate the overall performance of your crews. You can measure things like first pass success rate of intubation, number of 12 lead ECGs performed, or how often intubated patients had an OG/NG tube placed. This will naturally create a desire to improve clinical abilities which is tied to the requirement of learning.

Another strategy is to embrace social media. This is most likely going against all conventional advice … but sometimes we need unconventional solutions in order to create desired results. Social media, like any tool, has a right way and a wrong way to use it.

With such a large and active community of clinicians from around the world sharing ideas, research, pearls of wisdom and cases, it is an incredible resource. In addition, it adds a casual element to the often over-formalized world of academic journals and research.

Encouraging your employees to engage the FOAMed (Free Open Access Medical Education) community on Twitter, for example, will start to influence clinicians to become knowledgeable on new and upcoming trends in prehospital care. There is a high likelihood that many of your employees are already using some form of social media. Your job is to coach them on how to use it for learning.

Lastly, make training a priority and empower your employees to lead it. Everyone has heard the excuses of how training budgets are non-existent, or how there is no time to train. This is absolutely ridiculous.

Training does not need to be on a high-fidelity simulation mannequin. Nor does it need to be held only at staff meetings. Encourage stations and crews to perform their own training. Provide a mechanism for supporting their training needs. Have them gather expired equipment and organize it for training purposes. Give crews ideas on how they can engage in small group simulation exercises. Help those interested in clinical education to develop presentation skills so they can provide small group talks to those on their shift.

The main takeaway is that learning is something that is encouraged and nurtured. It is equally the responsibility of field crews and the leadership staff to find ways to promote learning and make it a fun and engaging process. The strategic and cultural benefits to having a culture of learning are endless. It can stave off burnout, it can improve patient outcomes, and most importantly, it empowers clinicians to grow.