Jim2cck08’s Weblog

Much can and has been said about the role of the education systems in societies around the world. For instance, one perspective declares this system’s role as a tool for maintaining a compliant and programmed populace while ensuring that the established socioeconomic strata remain effectively unchallenged. Others view the system as an institution needed to efficiently perpetuate knowledge and facilitate a progressive culture. Rather than voicing my opinion on the larger societal impact of the educational system, I will share my thoughts on the impact of systemic change in the educational community within which I work.

My current portfolio involves coordinating and instructing an Advanced Care Paramedic Program to learners that each have a minimum of two years experience as an urban-based paramedic. I think that a connective learning approach has potential for all cognitive learners but it is particularly well-suited to this type of learner since they have real-world experiences to share in a profession that requires effective interpersonal connection-making skill. Such an apparent application has, as is often the case it seems, been completely overlooked. I feel somewhat comforted by the fact that components of the Program developed by the American Heart Association that deal with teamwork during resuscitations also missed this obvious approach for developing connections between resuscitation team members.

I suppose an argument could be offered that to develop connective dialogue would demand a large amount of time, extending the Program timeframe and budget beyond what could be comfortably tolerated. More likely though is the well-documented observation that we prefer to teach like we were taught. However, I don’t think that resistance to a new educational approach can be excused as simply a matter of egocentricity or lack of imagination but also one of pragmatism. The familiarity and confidence in the style of presentation in which we have been taught means less preparation time is required in order to teach. Less time needed for preparation allows the educator to manage larger class sizes. This then leads to a circular ‘which came first?’ argument: larger class sizes requiring more efficient student education or more efficient education allowing for larger class size. Either way, one could argue that it doesn’t make good sense to change an established educational system for a more costly and unproven one.

But efficiency is also measured in quality of output. I share the observation of “mrs durff” when she notes on the CCK08 Moodle forum that by “not attending to connections then my students are failing to learn… students could be getting excellent marks by regurgitating but still failing to learn”.

In my opinion, the only way to challenge the existing educational system is to relate it to the bottom line of providing a quality service as efficiently as possible. Efficiencies are continuously sought in all areas of the medical profession to manage ever increasing demands for service. This includes the field of paramedicine which is in a state of constant change and so requires its practitioners to develop into self-directed lifelong learners in order to cope. Failing to do so has already caused increased worker frustration, increased service-related complaints or ‘incidents’, and noticeable reduction in worker morale and productivity.

These consequences can be seen as proof that the status quo is not sustainable even if operational resources are increased to match the demand for these resources (and this seems unlikely). Efforts must then shift from solely focusing on operational efficiencies to other more creative solutions in workforce education and the development of a sustained capacity for flexibility in the paramedic role. Creation of a connective learning approach in paramedical education provides such a solution by establishing collaborative dialogues and encouraging the lifelong learning needed to adapt to such a dynamically changing workplace. At virtually no additional cost, an interconnected workforce should be the goal for sustained quality prehospital patient care.

In a recent Princeton University podcast involving a panel discussion on the recent American election, Anne Marie Slaughter, Dean of Woodrow Wilson School of Public and International Affairs and Bert G. Kerstetter ‘66 University Professor of Politics and International Affairs, shared her sense of the changes in the world. She stated that fundamentally all human beings (and nations) are connected and therefore we must start any discussion on humanity from that proposition. She further noted that “power in an integrated and interdependent networked world came from being the most connected”. It would seem that the idea of connectivism encapsulates much more than just a learning theory but also of a way of being. As an educator, I think that how we learn is who we are and who we are defines how we interface with our world. In a global community or in my humble workplace community, an educational system based on connective learning and connectivism seems the most efficient, logical, and organic approach to growing a progressive educational environment.

Much like other areas of the medical profession, the field of prehospital care has gone through dramatic changes over the last few decades. Thirty years ago the ambulance driver would “load and go” and rush the victim to hospital. Now the paramedic is trained to “stay and play”, applying advanced medical care to stabilize the patient prior to transport to the most appropriate medical facility based on the assessment of the patient’s illness or injury. This shift in the fundamentals of prehospital care has reduced patient morbidity and mortality as well as achieved efficiencies in patient management, allowing budgets and resources already at the breaking point to be stretched further. It has also had a significant impact on the approach to paramedic education and the role of the paramedic educator. I have worked as a paramedic and a paramedic educator in an urban-based ambulance service over the last twenty years and have experienced many of these changes first-hand.

At the start of my career, training was organized in the traditional formal approach with a behaviourist philosophy. Instructors were considered to be experts above reproach and as students, we dutifully wrote down what the instructor said as we were told how to interact with our patients. In simulated settings, we were examined with checklists on the skills we would soon be applying in the field. Essentially, many of us were intimidated by our trainers and followed orders without question, there was no room for critical thinking or creative thought. Patient care protocols were absolute and the world was black and white. As could be anticipated (Anderson, T., 2008), lifelong learning skills were not developed and we learned to be helplessly dependent .

This system worked well as long as there was enough money in the budget and enough ambulance resources at hand to allow for such a structured approach. However, it wouldn’t be long before the emergency medical community became stressed by an aging population, a growing street drug problem, and a progressively more violent segment of society. At the same time, medical science continued to develop new technologies that have moved advanced levels of patient care into the prehospital environment, easing hospital workloads but further taxing ambulance resources. A more progressive approach as well as a more flexible and autonomous workforce would be needed to meet these challenges as efficiently as needed.

The emergency medical system is therefore undergoing fundamental changes. What once had been a series of isolated and entrenched groups now have become partners sharing a common goal. For instance, I now teach fire fighters alongside paramedics routinely. The municipal-run ambulance service for which I work has also established learning networks with two community colleges and the local provincial health authority. This now allows the sharing of instructors with backgrounds in paramedicine, respiratory therapy, critical care nursing, emergency medicine, and cardiology. This sharing not only creates connections between the organizations but also between the instructors and learners (Downes, S., 2006) who also interact outside the formal classroom in the emergency departments and critical care areas of the hospitals patients are transported to. These connections can not only facilitate a more fluid progression of patient care between specialty areas, it can lead to development of new techniques and build worker confidence as different perspectives are shared and information-sharing solicited – much like networking on the net (Dutton, W., 2007).

In the classroom, we are working create an environment that stimulates the learner to take more responsibility in his or her own learning by incorporating a higher degree of self-discovery through online research and exercises, self-directed computer-based tutorials, increased emphasis on critical thinking and self-reflection, participation in a peer-oriented computer-based prehospital forum (Phelps, R., 2003 ), and a greater focus on real-world, peer-assessed learning opportunities (Downes, S., 2007 and Downes, S., 2008).

In an increasingly complex workplace, support for the learner is needed to manage the information overload he or she will face (Heylighen, F., 2002). Since many of the paramedic learners now have more practical field experience with newer technologies than the educators do, the paramedic educator role is evolving from the experienced expert to a support provider who is expected to model critical thinking, self-reflection, and progressive attitudes. It seems to me then that program construction and evaluation is evolving back to the information sharing networking of past eras rather than the structured funnel of education that is currently commonplace (Illich, I., 1970).

Works Cited

Anderson, T., (2008), in Connectivism and Connective Learning Online Course