Apparatus

Field Training Officers Improve EMS Delivery

Issue 3 and Volume 12.

Five Braun Type III ambulances were delivered to the Colerain Township Fire Department, Cincinnati, Ohio.
Five Braun Type III ambulances were delivered to the Colerain Township Fire Department, Cincinnati, Ohio, recently. Each of the $134,000 units were built on 2006  Ford E450 cabs and chassis, powered by Ford 6 liter engines and Ford transmissions. The aluminum-bodied units have Whelen LED warning lights in all positions, climate controlled patient areas, OnSpot tire chains and vinyl striping. Other features include EVS child safety seats, double CPR seats and squad benches. The units were sold by Rick Bell, Life Star Rescue, Van Wert, Ohio.
The Anderson Fire Department recently received a remounted Life Star Rescue Type III ambulance.
The Anderson Fire Department, Anderson, Ind., recently received a remounted Life Star Rescue Type III ambulance. The body was remounted on a 2005 Ford cab and chassis powered by a 6 liter Ford engine and a 4-speed torque shift transmission. It has Whelen and Carson warning lights and systems, a Knox box system, custom vinyl letter and a cab extension. At $80,000, it was sold by Tony Crum, Life Star Rescue, Van Wert, Ohio.

Field Training Officer (FTO) programs are designed to mentor people taking on new roles. These programs explain the complexities of the new position as well as help them assimilate into the agency’s social structures.

FTOs can play a role in recruitment and retention, orienting inexperienced personnel and providing continuous quality improvement.

The opportunity to teach professional behaviors and guide new hires to optimal professional competencies is often lost, as new hires fail to receive positive reinforcement and guidance as they begin their careers with our agencies.

Defining Your Mission

FTO programs must be based on your agency’s mission. This starts with defining your mission and the elements necessary. Required competencies should be clearly defined and written in reference manuals. The FTO program should facilitate learning and determine that competencies are attained.

FTO programs should first focus on acclimation to the work environment and job context for new hires. These elements introduce employees to the culture of the occupation and the organization.

Acting As A Role Model

While an orientation can make the introductions, the FTO can guide an employee through interactions with fellow employees and other professionals with whom they must interact. The relationship also allows the FTO to act as the new employee’s role model, particularly for the young and inexperienced.

Bridging from the classroom to the field is always a challenge. Learning is contextual. We need to see the knowledge we have gained applied in the real world for true learning to occur. FTOs can faciliate this by showing context and teaching in real-life situations.

As a role model, the FTO can be the most important figure in molding young recruits. Attitudes and behaviors are hard to teach new hires. Your FTOs should be the best of your best. New and inexperienced personnel will imitate people they emulate or admire.

Your FTOs, by demonstrating professionalism, compassion and confidence, will give the new employee a model upon which to build their own careers.

The FTOs should identify standards and show their charges how the standards are applied. Standards of practice and business practices can move from the abstract to concrete as the FTO works with the trainee in the field.

Ethics and compassion are tough to teach, but once the expectations are described, the example set by the FTO can help employees develop standards.

The FTO can encourage questions and teach the new hire to develop critical thinking skills. On their own, inexperienced employees may have difficulty with critical thinking and problem solving, but with the confidence encouraged by their FTO, they may ask the right questions and puzzle their way through problems knowing help is available. Advice on organization skills and approaches to various situations can be critical in the professional development of your employees.

Teaching responsibility and accountability is difficult. Through modeling, new employees will come to understand what they are accountable for, and learn to accept responsibility for their actions and performance. Complex issues like patients rights can be learned with guidance in real life situations.

As we grow and learn how to think, we go through developmental stages. While we may believe we have fully evolved our thinking processes, new work environments can bring us back to square one concerning our confidence in our thinking processes.

Critical thinking is a complex but necessary skill in our type of work and the FTOs can mentor the development of these thought processes in new hires. Thinking evolves from temporary and uncertain, to finding context or real world applications, as new recruits learn from their FTO mentors. Critical thinking continues to evolve so that we can adapt to any situation through careful questioning and application of learned skills.

Along the same line is moral development, which is described as conventional and post-conventional. Conventional morals involve maintaining relationships and obeying laws. Post-conventional morals involve conscience and personal principles. FTOs acting as professional mentors and as role models help reinforce positive morals.

Motivation is an internal drive to meet unmet needs. While many people invest in motivational experts, motivation is personal. Hunger is a good example. I cannot make you hungry but once hungry, you are motivated to resolve that hunger. FTOs can provide support for personnel who are discovering what motivates them and how to drive that motivation.

Practical Instructions

As a preceptor, or teacher who provides support and learning experiences, the FTO has the opportunity to act as an experienced practitioner providing practical instruction. Most of us can recount the moments when we realized that “we got it” or when things became clear and skills were executed correctly.

Generally, there was a mentor or experienced provider there to help us make the connections necessary to get to that point. FTO programs take this from a chance occurrence to a planned experience with more reliable positive outcomes.

Field Training Officer programs can be rewarding for the individual officers and productive for the agency and the providers under their mentorship.

There are various models ranging from identifying key personnel charged with working with new hires until they reach the minimum standard performance levels, to programs that have FTOs roaming the field monitoring large audience behaviors and incorporating their review into training programs.

FTOs should be involved in quality improvement/quality assurance (QA/QI) programs so their review of practices and performance can be incorporated into training. Continuing evaluation by the QA/QI program should show the FTOs results.

Standard Practices

For the FTO program to succeed, standard practices and behaviors must be documented. Once these are identified, the FTOs should have a process of documenting the new hire’s performance within the policy guidelines and practices. This documentation describes the activity of the FTOs and the new hires and should tell the story of the progress of the new hires development.

While this is just a snapshot of what FTO programs can do for your EMS operations, it’s a start. Consider your current new hire orientation and how they would benefit from planned mentorship.

Consider how your current QA/QI program works and how FTOs can help make adjustments where the rubber meets the road and enhance the care given to your citizens.

Editor’s Note: Will Chapleau has 30 years of EMS experience. He is the Advanced Trauma Life Support (ATLS) program manager for the American College of Surgeons and he is in charge of trauma training programs for doctors all over the U.S. and in 50 countries. He is the former chief of the Chicago Heights (Ill.) Fire Department. He has served as the chairperson for the Prehospital Trauma Life Support (PHTLS) program since 1996, and has been a member of its international faculty since 1984. He is a board member of the National Association of EMS Educators.

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