How do you know what to do when you are in the field?  You practice in station of course.  That is why we go to school to learn.  That is why we have to take practical exams.  That is why we take continuing education classes.  Without that, we lose the skills we don't practice regularly.  Because of that, I am working on my next invention, the Paper-Sim 2000!

It's lightweight, portable, and able to change patient presentation at the drop of a pen, the Paper-Sim 2000 is the answer to your EMS training simulator prayers!  Not only that, the P-S 2000 is both re-usable and disposable, making this little, paper person cut-out just the thing for your next training event.  Okay, maybe I’m over-hyping it a bit.  The point is, you can have all of the high tech stuff you want, it’s the instructor that counts.  The imagination, expertise, and personality he or she brings to a training class engage students in a way that makes them both think about the matter at hand and take away real skills to use in the field.

Do not misunderstand me, the new computerized, robotic simulators are fantastic tools.  I wish every EMS student, new or old, could use them all.  The question I have to ask is, “do you have regular access to one?”  The number one challenge to getting access to these devices is money.  Many state EMS offices and some regional hospitals are acquiring these devices, housing them in RVs, and traveling around to area EMS and fire stations for training.  It is a great use of limited resources and puts the simulators in the hands of the broadest possible audience.  Unfortunately, this often means the access to them is still infrequent and short lived.

What educators need is another option to actively engage students in the learning process and adult learning styles while meeting the budgetary constraints set by our agencies.  Adult learners are more engaged when multiple teaching styles are used to convey information.  Lectures and computer aided presentations are frequently used to convey written information, but when it comes to engaging the students in psychomotor learning, many classes are severely limited by monetary and time constraints.  And yet, it is the correct use of these psychomotor skills, coupled with cognitive learning in the field, that is the goal of EMS educators.  Skills are first imitated, then practiced.  Ultimately, instructors hope that skills will progress to habit, the highest level of psychomotor learning.

The Paper-Sim 2000 comes from an idea I saw used by an instructor as he conveyed the concepts of rapid pediatric trauma assessment under mass casualty conditions.  Prior to addressing a specific scenario, the class reviewed rapid trauma assessment and applied those principles to the pediatric assessment triangle (PAT).  We discussed mass casualty issues and some of the unique problems faced when dealing with pediatric patients.  Finally, the instructor broke the class into groups of 4 or 5 responders and sent us out for a quick break while he set up the scenario.

We returned from our break to find our instructor standing outside the classroom door.  The door’s glass window had been taped over so we couldn’t see inside.  He read a scenario to us and sent us into the room, one group at a time.  The goal involved correctly prioritizing 25 pediatric patients based on triage and rapid assessment techniques learned earlier.  “You are dispatched to the scene of a gas explosion at a local elementary school.”  The instructor reads.  “Two units arrive nearly simultaneously, and the remaining units will begin to arrive in about 20 minutes.”

Upon entering the room, I immediately notice the flickering of a strobe light ($20.00 at any novelty store), a smoke machine (can be rented or purchased at a party supplies store), and the furniture has been rearranged with some tables and chairs on their sides or flipped over.  We quickly stated we were donning SCBA for entry to the room.  Scene safety is always first, right?  We began a search and noticed small, pink and blue construction paper cut out figures scattered on the floor around the room.

We approached the first pink one and flipped it over to find the following description:

Patient #7 -- 8 y/o female, crying weakly but not answering questions or focusing on rescuers.  Bleeding from nose and ears.

Prioritizing this patient as a level 2 (orange) we proceeded to divide into two groups, traveling in opposite directions around the room.  5 minutes later we had found 24 of the students, compared notes, and created a list to prioritize the patients by need.  We missed the 25th student.  That paper patient was under an overturned table against the wall and required airway management as an immediate intervention.  The following groups entered the room and began their assessments.  Everyone agreed it was one of the best training classes we had ever taken.  The students were engaged in the process and we enjoyed the scenarios and use of the paper manikins.

The paper simulated patients were very effective as a teaching aid, required no special training to use and were dirt cheap.  If one breaks, just make another one.  You can duplicate as many patients as you need, easily move them around to change scenarios, and clean up is a breeze!  With all of the expensive, high-tech equipment out there, it is easy to get off track trying to get the latest training toy.  All for just a few hours of training.  The most valuable (and free) training tool lies between the ears of the instructor and the students.  Imagination, ingenuity, and adaptability are skills that can be applied to any topic to create a challenging and rewarding training class that will leave a lasting impression.

When in doubt you can always try out the Paper-Sim 2000!

Jamie Davis, the Podmedic is the host of the MedicCast Podcast.  The weekly EMS audio podcast for EMTs and paramedics that offers news, commentary, tips and tricks plus a whole lot more!  Check it out at MedicCast.com!