Educator Update / Domain3 (FALL 2017)

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EU

FALL 2017

UPDATE

by Todd Cage, MEd, NRP

EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL by Judson Smith, Paramedic, MHA, Vice President of Continuing Educatiom, Medic-CE

WHAT HAPPENS TO THE BRAIN WHEN WE LEARN? AND MORE!

SAVETHEDATE!


REALITi System Includes REALITi Software

Controller iPad 9.7”

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Mobile WiFi

Monitor iPad Pro 12.9”

Support & Maintenance


IN THIS ISSUE National Association of EMS Educators 250 Mount Lebanon Boulevard Suite 209 Pittsburgh, PA 15234 Phone: 412-343-4775 Fax: 412-343-4770 www.naemse.org

2017

2017-2018 Board of Directors Christopher Nollette, EdD, NRP, LP President Linda Abrahamson, MA, ECRN, EMT-P, NCEE Vice President Lindi Holt, PhD, NRP, NCEE Treasurer

WHAT’S INSIDE

Rebecca Valentine, BS, NRP, NCEE, I/C Secretary Leaugeay Barnes, MS, NRP Dan Carlascio, NRP

PAGE 3 NAEMSE NEWS PAGE 4 Membership Spotlight

James Dinsch, MS, NRP, CCEMTP Bryan Ericson, M. Ed, RN, NRP, LP Joe Grafft, MS, NREMT, EMS Mgr (Rt)

by NAEMSE Staff

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John Karduck, MD Jill Oblak, MA, MBA, NRP

EMS Continuing Education Requirements: The Audit Trail

Dr. Nerina Stepanovsky, PhD, MSN, CTRN, PM John Todaro, BS, NRP, RN, TNS, NCEE

by Judson Smith, Paramedic, MHA, Vice President of Continuing Educatiom, Medic-CE

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DOMAIN3

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The Vicarious Trauma Toolkit (VTT)

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National Office Staff Joann Freel, BS, CMP Executive Director, Editor Stephen Perdziola, BS Business Manager Brandon Ciampaglia, AS Communications Coordinator, Editor, Designer

by Karen Owens, Emergency Operations Manager, Virginia Office of EMS

Erin Mihalsky Membership Coordinator

What Happens to the Brain When We Learn? by Dr. Bill Young, NRP, Director of Paramedice Department, Eastern Kentucky University

Laurie Davin, AS Education Coordinator Jarred Kallmann Education Coordinator Matt Whiting, BS Administrative Assistant

Reprinting Information

Interested in reprinting one of the articles you find in this publication? If so, please contact Brandon Ciampaglia via e-mail at brandon.ciampaglia@naemse.org or by phone at (412)343-4775 ext. 29

Submission Guidelines

Unsolicited submissions are welcomed. Members of the NAEMSE Publications Committee review Domain3 manuscripts. Acceptance of a manuscript for publication is contingent upon completion of the editing process.

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Manuscripts should be e-mailed to brandon.ciampaglia@ naemse.org. Submit a cover letter with each manuscript indicating: Author name, credentials, title, and affiliation. A title letter should also be included disclosing any commercial associations that could post a conflict of interest. If you have an idea brewing that you’d like to submit, please contact us. We would be happy to discuss it. New authors are welcome and encouraged.


NAEMSE NEWS

NAEMSE NEWS NAEMSE MEMBER NAMED REPLICA COMMISSION HONORARY CHAIR Representatives from member states (Alabama, Colorado, Georgia, Idaho, Kansas, Mississippi, Tennessee, Texas, Utah, Virginia and Wyoming) have chosen longtime NAEMSE member, Debra Cason (along with Dia Gainor and Rick Patrick), as honorary chair for the first meeting of the Interstate Commission (Commission) for EMS Personnel Practice. The Recognition of EMS Personnel Licensure Interstate Compact’s (REPLICA’s) model legislation creates a formal pathway for the licensed individual to provide pre-hospital care across state lines under authorized circumstances. REPLICA states continue to prepare for the first meeting of the Commission. Debra Cason is chair of the National Registry of EMT’s (NREMT) Board of Directors; Dia Gainor is executive director for the National Association of State EMS Offices (NASEMSO); and Rick Patrick is senior advisor for the Office of Health Affairs at the Department of Homeland Security. They are being recognized for their contributions to the development and implementation of the nation’s first EMS Compact. “The NREMT applauds the spirit of collaboration the Compact fosters between EMS professionals, their employers and state EMS offices in ensuring that patients and their loved ones always receive timely, safe and competent care,” stated Debra Cason. “I am humbled by this honor and truly value our relationship with the REPLICA team.” Dia Gainor added “NASEMSO is proud of our role in advancing our profession through standing up the nation’s first compact. I am honored that the REPLICA states have chosen to memorialize my efforts on behalf of state EMS officials in the development and implementation of this tool for solving cross border issues while bringing about maximum accountability. After being officially seated, REPLICA state delegates will immediately take up the business of the Commission. Agenda items include the adoption of interim bylaws, nomination and election of officers, and establishing standing committees. A public hearing for Chapter One, Rule on Rulemaking will be held Sunday, Oct. 8, at 9:30a.m. CST. The first meeting will be held at the Oklahoma Museum of Fine Arts, starting Oct. 7, at 1:00 p.m. CST, and continuing on Sunday, Oct. 8, 8:00 a.m.-4:30 p.m. CST. All meetings are open to the public and are available via virtual participation. For more information contact Sue Prentiss, advocate for REPLICA, at (603) 381-9195 or by email at Prentiss@emsreplica.org. Meeting and public hearing notices will be available on http://www.emsreplica.org/commission/.

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NATIONAL EMS COURSES NAEMSE continues to bring its heralded EMS instructor course to all corners of the country. If you have never attended, you can reserve your spot online. If you’re an instructor, spread the good news to your colleagues in the EMS community. The following is a complete listing of some of our upcoming FALL/WINTER courses:

INSTRUCTOR COURSE I Cheyenne, WY: October 13-15, 2017 Held in partnership Wyoming12-14, Office of2014 EMS Louisville, KY: with December Held in partnership with Louisville Metro EMS Rochester, NY: October 25-27, 2017 Held in partnership with Vital Signs 2017 EMS Conference Lancaster, CA: November 10-12, 2017 Held in partnership with the University of Antelope Valley Ft. Worth, TX: November 17-19, 2017 Held in partnership with the 2017 Texas EMS Conference

INSTRUCTOR COURSE II Greenville, SC: October 27-28, 2017

Held in partnership with Greenville Technical College

Beckley, WV: November 17-18, 2017 Held in partnership with Jan Care Ambulance

NREMT REGIONAL SCENARIO DEVELOPMENT WORKSHOPS Jacksonville, FL: November 17, 2017 Held in partnership with FSU @ Jacksonville Albuquerque, NM: December 8, 2017 Held in partnership with UNM School of Medicine

NATIONAL EMS EDUCATOR CERTIFICATION (NEMSEC) EXAM Indianapolis, IN: November 1, 2017

For more information, please visit

NAEMSE.ORG


NAEMSE MEMBER SPOTLIGHT

NAEMSE MEMBER

SPOTLIGHT Hometown Newbury Park, CA – Currently from Keller, TX (Lived in Texas since 1994) Current Employer/s Tarrant County College, EMS Program Job Title/s Associate Professor of EMS

Personal Hobbies Travel with my wife, hunting, and cooking! Who Would Play You In a Movie? John Goodman. What is Your Refrigerator Never Without? Dark Chocolate Almond Milk for my morning coffee.

N AT I O N A L A S S O C I AT I O N O F E M S E D U C AT O R S

foundations of e d u c at i on A N E M S A P P R OAC H

BRYAN F. ERICSON, M. Ed, RN, NRP, LP Job Scope Paramedic Education Hardest Job Aspect?

SECOND

Sometimes the hardest part of the job is just keeping up with all the demands placed on faculty by college administration that really has no direct connection to EMS education or the classroom. (Meetings anyone?)

EDITION

Most Rewarding Job Aspect? Helping students unlock their talents and be successful in their careers in EMS and Fire. Nothing is more rewarding then watching a student grow and succeed! Why Did You Join NAEMSE? NAMESE provides an awesome opportunity to network with EMS educators from all over the county. The relationships I have made thru my time with NAEMSE have been critical to my ongoing success as an educator. NAEMSE Activies/Participation Education Committee, Symposium Presenter, Co-Chair of the Symposium this year and recently elected to serve on the Board of Directors.

Have You Picked ORDER TODAY! Up YOUR Copy Yet? (412) 343.4775

NAEMSE.ORG

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EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL TM

EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL By Judson Smith, Paramedic, MHA, Vice President of Continuing Education

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EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL

Introduction Continuing education is part of any healthcare professional’s ongoing requirements, but over the last decade, fire and EMS departments and personnel have been penalized for inaccurately reporting training record completions during their departments’ recertification process. Avoiding penalties and fines in the event of an audit requires your agency to track your employees’ records properly and understand the CE reporting requirements at the local, state, and national level.

The best way to do this is to have one centralized recordkeeping method or learning management system (LMS) to track your employees’ records for both internal (departmentconducted) and external (outside-department) training events. This gives your department real-time tracking with all the mandated completion documents in one location, making it easy to report to any governmental body or professional organization.

Continuing Education: State vs. National Requirements Keeping up with the frequent changes to continuing education requirements is no easy task for individual fire/ EMS professionals, let alone a department managing these requirements across their entire staff. For example, in the last 5 years the National Registry of Emergency Medical Technicians (NREMT) has transitioned from the I-99 requirement to the National Continued Competency Program (NCCP) requirement. However, several states have decided not to follow the NREMT guidelines or have not yet adopted the new NCCP requirements. States also vary on what they require on an annual or bi-annual basis for continuing education. Depending on an EMS provider’s level of certification, the time required each year to meet the mandatory requirement for compliance could be anywhere from 8 hours to 72 hours. The National Registry and most states require that the majority of providers’ EMS recertification requirements be completed in a live environment. This has traditionally been met through training sessions in brick-and-mortar buildings with distributive learning—or “self-paced” online modules—used as a supplement to fill a few additional hours. But with the introduction of F5 - Virtual Instructor Led Training (VILT) accredited by the Commission on

Accreditation for Pre-Hospital Continuing Education (CAPCE), most EMS providers around the United States can now fulfill all their EMS recertification didactic requirements online. With a blended model of VILT and self-paced courses, the National Registry now allows all nationally registered EMS providers to recertify with this method. Companies like Medic-CE provide curriculum designed for this blended approach, delivering all the required training— both VILT and self-paced—through a single, robust learning management system (LMS).

Transforming EMS and Fire Education Delivery with Innovative Platform Technology 2

Medic-CE.com

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EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL

Noncompliance and Penalties: Individual and Departments Over the last decade, continuing education noncompliance has increased. As a result, the number of audits has also increased, at both the state and national level. Providers found in noncompliance can lose their jobs—subjecting them and their families to financial hardship—and departments are put at risk for financial penalties for failing to ensure proper record keeping and a qualified, certified workforce responsible for responding to 911 calls. In some instances, departments are also seeing an increase in penalty fines—in the state of Texas, there have been fines of up to $50,000 in some cases. Other states around the country are also more frequently imposing fines and penalties for public safety organizations found lacking adequate records. To avoid these fines and penalties, agencies and individual providers must keep accurate and comprehensive training records. This can be challenging with the reporting requirement variations between the National Registry and the different states. In some cases, states require verification of continuing education completion over the entire licensure period. This means you must keep track of the official paper certificates for

years. The alternative is to use a learning management system like Medic-CE. An LMS enables departments and individuals to store all certificates electronically— indefinitely. This makes it much easier when tracking and recording continuing education courses, programs, and certification card requirements, removing the worry and headache from department administration and the individual providers when they need to provide documentation to the state certifying body. The National Registry and several states now allow providers and departments to hold on to the actual certificates. In this case, providers simply attest that they have completed the required training requirements for that recertification period. However, random audits may occur from the state or national regulatory body, requiring documentation to support the providers’ claims. These random audits make it critical to keep records in one location to provide an audit trail. Audits are stressful no matter what, but having recertification records and documentation in one place minimizes that stress by ensuring compliance with all fire and EMS continuing education records in one place.

Tracking, Compliance, and Record Management In addition to tracking completed CE requirements, it is also important to track employees’ progress toward recertification requirements. An LMS like Medic-CE makes it easy for departments, or individual providers, to keep tabs on CE completion with a robust and real-time CE tracker that shows the department administrative staff where each employee is with their state certification. Records are maintained indefinitely even after the employee leaves the department.

entire department—knows that it’s confusing. But CE completion and tracking does not have to be stressful for the individual or the department. Having a robust learning management system provides value by ensuring compliance for your department and peace of mind for your employees. Streamline the record-keeping process and decrease the opportunity for error that could lead to financial loss for your agency with robust, electronic record keeping that provides you a defensible audit trail.

Non-compliance, or even just sloppy record keeping, can cost big bucks. And anyone who has ever had to track recertification—whether for themselves or an

Medic-CE.com

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EMS CONTINUING EDUCATION REQUIREMENTS: THE AUDIT TRAIL TM

About The Author Judson Smith, Paramedic, MHA, Vice President of Continuing Education Judson Smith brings more than 20 years of experience in emergency medical service to his role as Vice President of Continuing Education at Career Step, the parent company of Medic-CE. A licensed critical care paramedic, he also currently serves as an officer in an Air Force Reserves aeromedical evacuation squadron. In 2014 Judson founded Code3 CME, an education company focused on providing live, instructor-led training with online flexibility. His goal in founding Code3 CME was to provide EMT, paramedic, and critical care transport training with a level of educational support he felt was lacking in the industry. Career Step acquired Code3 CME in 2016, and Judson joined Career Step at that time. Judson holds a master’s degree in Healthcare Administration from Lindenwood University.

If you’d like to learn more find us at

Medic-CE.com 4

or call

1-877-458-9498

2901 N Ashton Blvd, Lehi, UT 84043

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DOMAIN FALL ‘17

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Providing a Voice for EMS Educators

Official Publication of the National Association of EMS Educators

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To Open or Not to Open: Testing in the Open Resource Era by: Todd Cage, MEd, NRP

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Relevant Leadership for EMS Education Program Directors by: Gordon A. Kokx, PhD, NRP and Laura B. Holyoke, PhD

MISSION STATEMENT: To inspire and promote excellence in EMS education and lifelong learning within the global community.

Reprinting Information

Interested in reprinting this article? If so, please contact Brandon Ciampaglia via e-mail at brandon.ciampaglia@ naemse.org or by phone at (412) 343-4775 ext. 29

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DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

To Open or Not to Open: Testing in the Open Resource Era By: Todd Cage, MEd, NRP

A

major educational change of the 2015 American Heart Association (AHA) Guidelines is the move to “open resource” exams. As a training provider, it is completely at the discretion of the AHA to allow this type of testing, but the decision may result in educators being challenged by their students to allow more exams to be open resource. How to perform evaluation is up to the instructor or program, however, an understanding of the literature is important in making an informed decision. In reviewing the guideline document, one will find little discussion of exams and no recommendations about how tests should be taken (Bhanji et al., 2015). In light of this shift, EMS educators must carefully evaluate this testing method to determine if it meets their needs, just as their students do with any new clinical field intervention. What is it? Traditionally, OBE involves some combination of the course textbook(s), notes and other information the student may have gathered in preparation for the test. The entire test could be OBE, or a portion could remain closed-book (CBE) (Agarwal, Karpicke, Kang, Roediger III, & McDermott, 2008; Eilertsen & Valdermo; Theophilides & Dionysiou, 1996). What constitutes an openbook exam (OBE) is up to the discretion of the course instructor. The Argument for OBE The study most commonly cited in discussions on the merit of open-book exams was conducted by Theophilides and Dionysiou (1996) and involved undergraduate education students during their sophomore year. After an open book final exam, students were asked to respond to 38 statements on a questionnaire. The statements addressed pretest, test and posttest states. The results were synthesized and five factors emerged. I. Creative use of knowledge gained. This factor deals with critical thinking and problem solving. An emphasis is placed on developing an answer, rather than recall of memorized facts. As a thorough understanding of the material is required, “cramming” for the test of textbook access in the time allowed will be insufficient to obtain a good score (Stalnaker & Stalnaker, 1934).

Additionally, students reported an ability to transfer existing knowledge to new situations, which is a vital skill for EMS providers. II. Course content mastery. This factor is all about study skills and exam preparation. Open book exams shift the student’s focus to obtaining information from multiple sources and developing the ability to evaluate and synthesize information. Specifically mentioned is the practice of such study skills as note taking. This section relates to a common theme in the literature, which is whether the students use active/deep learning in preparation for exams (Heijne-Penninga, Kuks, Hofman, & Cohen-Schotanus, 2011) (Vanderburgh, 2005). Examples of such active/deep learning can include study groups, highlighting, outlining, rewriting notes and office hours (Carrier, 2003). Phillips (2006) found that the use of timed OBE helps students with weak study skills improve over time, because it encourages reading of the text and improvement of study skills. III. Student self-evaluation and feedback. This factor deals with how students process information after the exam. This includes an analysis of learning gaps with associated gap filling and further study. It offers students a chance to focus on study skills and evaluate a need to adjust the process. This is the undertaking of learning from one’s own mistakes and carrying the information into the future. A study of psychology students found that taking a test (either OBE or CBE) produced greater long-term retention than repeated studying. Additionally, providing students with feedback amplified their learning (Agarwal et al., 2008). Although the focus of this element is self-awareness, a correlation can be drawn to the practice of debriefing as a method of performance improvement. IV. Reduction of exam stress. The primary thought here is that open book exams allow students to work out answers in a relaxed way. One topic in this factor reflects positive psychological health; students are optimistic about the potential to perform well and are confident about the outcome of the exam. Interestingly, they also report anticipating that the grade will be accurate. V. Student self-regulation in course studying. The final factor returns to the pretest environment. Students learn the ability to identify gaps as they study and work to fill them. Emphasis is placed on information gathering, and students report an overall satisfaction with the study process.

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DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

Concerns About OBE Open book exams are not without detractors. A common observation among instructors is that students take longer to complete open book exams (Vanderburgh, 2005). This was validated by Brightwell, Daniel and Stewart (2004), who found that some students took longer than the 60-minute time limit of the test. Another study found that students spent an average of five minutes per question on an open book exam as opposed to 50- 75 seconds per question on a closed book exam. This was due to the fact the students frequently consulted their resources on OBEs. Unfortunately for the students, looking up the resource for almost every question failed to result in a change in their test score (Westerkamp, Heijne-Penninga, Kuks, & Cohen-Schotanus, 2013). This concern can be minimized by introducing a time limit for each test (Phillips, 2006) (Heijne-Penninga et al., 2011). Another concern is that tests scores will be inflated, which both studies found to be false (Brightwell et al., 2004) (Westerkamp et al., 2013). Research also shows that students may study less for an openbook than a closed-book exam (Agarwal et al., 2008). A final concern is the public perception that open book exams are less vigorous and/or less valid than a proctored exam (Durning et al., 2016). Faculty Roles and Challenges In education, students need to possess basic facts and understanding (Eilertsen & Valdermo). Heijne-Penninga, Kuks, Schonrock-Adema, Snijders and Cohen-Schotanus (2008) describe this as core knowledge; it must be known without references. This is contrasted with backup knowledge, where understanding is required, but references can be used. Core knowledge is best assessed with CBE. Backup knowledge may be tested with either approach. It is the job of teachers and experts to differentiate between the two types of knowledge and exams and plan assessments accordingly. Educators are responsible for the creation of valid and accurate quizzes and tests. Questions should be tied to course objectives, which are often based on Bloom’s Taxonomy. Although knowledge-based questions have their place, the goal should be to progress to questions that involve higher levels of critical thinking. The challenge for faculty is to learn and become skilled in the construction of open-book exams (Vanderburgh, 2005). OBEs allow for questions to focus on problem solving and higher order thinking, rather than rote memorization (Stalnaker & Stalnaker, 1934). In short, none of the test answers on an OBE should be able to be directly retrieved from the textbook or course notes (Vanderburgh, 2005).

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The use of OBE may be new for the students as well as faculty members. Eilertsen and Valdermo (2000) found that although OBE reduces test anxiety, the introduction of unfamiliar processes can produce student anxiety. Therefore, it is important for faculty members to spend time ensuring students have adequate study skills (Phillips, 2006) and are familiar with how OBEs differ from CBEs. This could include a focus on teaching deep learning techniques that may be unfamiliar to students. It is also important to understand which institutional resources are available to students outside the classroom to enhance their academic performance. Conclusion The movement of students through Bloom’s Taxonomy from simple knowledge to higher order thinking, such as analysis and evaluation, is a goal of educators. It’s imperative that instructors test students’ understanding of core and backup knowledge within their courses to ensure students continue that upward movement. The two ways of testing this knowledge are through closed and open book exams, the latter of which has benefits specific to its nature. The use of open book exams may be an option for educators looking to add a new testing tool to their classroom, and the American Heart Association has shifted from not only allowing but also preferring this examination method. As with any new intervention, careful evaluation and assessment is important to ensure the desired effect is met. Agarwal, P. K., Karpicke, J. D., Kang, S. H. K., Roediger III, H. L., & McDermott, K. B. (2008). Examining the Testing Effect with Open- and Closed-Book Test. Applied Cognitive Journal, 22, 861-876. doi:10.1002/acp.1391 Bhanji, F., Donoghue, A. J., Wolff, M. S., Flores, G. E., Halamek, L. P., Berman, J. M., . . . Cheng, A. (2015). Part 14: Education: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 132(18 Suppl 2), S561-573. doi:10.1161/ CIR.0000000000000268 Brightwell, R., Daniel, J.-H., & Stewart, A. (2004). Evaluation: is ;an open book examination easier? Bioscience Education, 3(1), 1-10. doi:10.3108/ beej.2004.03000004 Carrier, L. M. (2003). College students’ choices of study strategies. Percept Mot Skills, 96(1), 54-56. doi:10.2466/pms.2003.96.1.54 Durning, S. J., Dong, T., Ratcliffe, T., Schuwirth, L., Artino, A. R., Jr., Boulet, J. R., & Eva, K. (2016). Comparing Open-Book and Closed-Book Examinations: A Systematic Review. Acad Med, 91(4), 583-599. doi:10.1097/ACM.0000000000000977 Eilertsen, T. V., & Valdermo, O. Open-Book Assessment: A Contribution to Improved Learning? Studies in Educational Evaluation, 26(2), 91-103. Heijne-Penninga, M., Kuks, J. B., Hofman, W. H., & Cohen-Schotanus, J. (2011). Directing students to profound open-book test preparation: the relationship between deep learning and open-book test time. Med Teach, 33(1), e16-21. doi:10. 3109/0142159X.2011.530315 Heijne-Penninga, M., Kuks, J. B., Schonrock-Adema, J., Snijders, T. A., & Co hen-Schotanus, J. (2008). Open-book tests to complement assessment-programmes: analysis of open and closed-book tests. Adv Health Sci Educ Theory Pract, 13(3), 263-273. doi:10.1007/s10459-006-9038-y Phillips, G. (2006). Using Open-Book Tests to Strengthen the Study Skills of Com munity-College Biology Students. Journal of Adolescent & Adult Literacy, 49(7), 574-582. Stalnaker, J. M., & Stalnaker, R. C. (1934). Open-Book Examinations. The Journal of Higher Education, 5(3), 117-120. doi:10.2307/1975651 Theophilides, C., & Dionysiou, O. (1996). The Major Functions of the Open-Book Examination at the University Level: A Factor Analytic Study. Studies in Educational Evaluation, 22(2), 157-170. Vanderburgh, P. M. (2005). Open-book tests and student-authored exam ques tions as useful tools to increase critical thinking. Adv Physiol Educ, 29(3), 183184. doi:10.1152/advan.00024.2005 Westerkamp, A. C., Heijne-Penninga, M., Kuks, J. B., & Cohen-Schotanus, J. (2013). Open-book tests: search behaviour, time used and test scores. Med Teach, 35(4), 330-332. doi:10.3109/0142159X.2013.759641


DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

Relevant Leadership Theories for EMS Education Program Directors By: Gordon A. Kokx, PhD, NRP and Laura B. Holyoke, PhD Introduction Roles and responsibilities of paramedic education program directors are often outlined in institutional job descriptions, state rules, and accreditation standards, however formal study regarding necessary leadership practices of program directors remains negligible. Practice is informed by knowledge and theory, and though leadership theories abound, none directly study the connection to paramedic program directors. Addressing the research gap, Kokx (2016) studied the relevance of leadership theory specific to paramedic program directors. In the study, twelve elite (uniquely qualified) individuals, based on their extensive professional knowledge and experience in EMS education, participated in a series of qualitative interviews to determine those leadership theories and practices that were viewed to be most important by directors of paramedic education programs. Data analysis revealed four leadership theories that the directors viewed to be most significant to fulfilling their roles as EMS program directors. Leadership Theories Leadership skills theory. A theoretical skills approach to leadership served as an initial framework for the study, which was drawn largely from Skills of an Effective Administrator by Katz (1955 & 1974). Katz’ theory, initially written in 1955, held premise that leaders need not be born with special traits, but rather can learn effective skills and become successful in leadership endeavors. Specified in the theory, three categories of leadership skills (i.e., technical, human, and conceptual) are necessary for all leaders to possess (Katz, 1955). Originally, Katz thought these skills were required in differing degrees for different levels of management. After further study, Katz revised the theory and declared that all of those skills are necessary at all levels (Katz, 1974). Human skills, the ability to relate to others, are necessary in all management positions. Technical skills are especially important for administrative positions since such administrators must be able to understand the necessary tasks to be performed by employees at all levels.

Conceptual skills, the ability to formulate concepts and ideas, are important for administrators to assist in developing visions for organizations and assist administrators in understanding how various pieces of an organization relate to one another towards achieving a greater purpose. By framing leadership skills in these categories, Katz offered a conceptual framework addressing vital components for all administrators and kept the framework logical and readily applicable. Because EMS program directors fall into the administrative category, they must possess a significant amount of each skill. EMS program director responsibilities include such technical skills as completing and managing budgets, completing and submitting annual accreditation reports, seeking and writing grants, and conducting employer, graduate and student surveys. Human skills required in this leadership position include forming and maintaining quality relationships with faculty, administrators, students, advisory committees and other stakeholders. Conceptually, program directors need to be able to view their programs from an objective standpoint as well, allowing them to reflectively see in the past, the present, and the future. By doing so, directors can effectively position their programs for a success by learning from experience and adapting to a changing environment and challenges through a panoramic reflective lens with an effective skills toolbox. Closely related to Katz’s model of leadership skills are what Heifetz and Linsky (2002) described as recognizing and treating technical problems (routine management) versus adaptive challenges (issues of leadership). Whereas technical issues can often be remedied by following established processes and procedures, adaptive challenges require learning new ways to change behaviors often tied to an individual’s identity, heritage, and values (p. 14). Since the latter is much harder to “fix,” a leader must strive to understand background and history of a problem before attempting to move towards a solution. The ability to understand differences between technical and adaptive problems is significant due to the high resource cost of failure. “Indeed the single most common source of leadership failure we’ve been able to identify – in politics, community life, business or the nonprofit sector – is that people, especially those in positions of authority, treat adaptive challenges like technical problems” (Heifetz & Linsky, 2002, p. 14). Because adaptive change requires individuals to lose or change something they are vested in and/or have strong beliefs about, it takes “an extraordinary level of presence, time, and artful communication” (Heifetz & Linsky, 2002, p. 15) to bring about such change.

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DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

Effective leaders thrive in disequilibrium resulting from potential loss through adaptive change and, in doing so, also help followers through the process as well. Successful EMS program directors develop skills of ascertaining what others may be willing to give up and, alternatively, what must be kept. For example, issues of budgets, teaching loads, faculty assignments, new curriculum implementation, and rank promotion may all arise as adaptive challenges rather than technical problems. A program director possessing skills to make a proper differentiation between technical and adaptive situations--and subsequently develop the appropriate solutions--may avoid serious issues and have a positive for the EMS program.

Avolio (2005) suggested a blend of skills and traits are needed to become a successful authentic leader. Rather than referring to individuals as being born as leaders, Avolio, similar to George’s “journey,” suggested leaders are in a constant “state of becoming” (p. 3).

Positive leadership theory. Known for their research in authentic leadership, Avolio and Gardner (2005) also described “positive forms of leadership.” In addition to authentic leadership they broadened the scope to include positive definition models of servant, charismatic, transformational and spiritual leadership. Fattig (2012) added the theory of ethical leadership to the definition of positive leadership. Of the positive theories, Kokx (2016) revealed the most valuable to EMS program directors were authentic, ethical, and servant theories.

Luthans and Avolio (2003) described an authentic leader as “confident, hopeful, optimistic, resilient, moral/ethical, future-oriented, and gives priority to developing associates as leaders. The authentic leader is true to him/ herself and the exhibited behavior positively transforms or develops associates into leaders themselves” (p. 243). Their descriptions clearly suggest a significant role of positive behaviors and a concern for others resulting in benefits for the entire organization.

Authentic leadership theory. The authentic leadership theory (George, 2003) offered another angle to view EMS program director leadership augmenting Katz’ (1974) leadership skills approach by considering leader behaviors. Since a program director’s functions involve working with stakeholders (i.e. students, faculty, administration, staff, advisory committee members, and one’s self), authentic behavior is also crucial to success. George (2003) defined authentic as “genuine; worthy of trust, reliance, or belief” (p. xvii). Much of authentic leadership theory was born out of the need for genuine leaders following the uprise of corporate scandals and improprieties (Cooper, Scandura, & Schriesheim, 2005). Regarding educational administration, Begley (2006) described authentic leadership as “a metaphor for professionally effective, ethically sound, and consciously reflective practices…” (p. 570). The authentic leadership approach takes time to be developed as George (2003) articulated: “In my experience it takes many years of personal development, experience, and just plain hard work. Although we may be born with leadership potential, all of us have to develop ourselves to become good leaders. The medium for developing into an authentic leader is not the destination but the journey itself – a journey to find your true self and purpose of your life’s work.” (p. 27)

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Echoing a similar theme, Eriksen (2011) asserted a need for leaders to continuously develop their “self-awareness of and movement toward one’s ideal self” (p. 699). This concept posits that no one of authenticity ever attains a place of ultimate leadership, but rather is always learning, developing, and reflecting on how to become a better leader.

George and Sims (2007) suggested the metaphorical authentic leadership model of a compass, emphasizing the concept of self-awareness surrounded by an integrated life to the west, a support team to the south, motivations to the east, and values and principles to the north (p. xxxv). With self-awareness at the compass center; a leader always seeks perspective of where he or she is in relation to the compass. Moreover, an individual’s values and principles serve as a reference point or the “True North.” By possessing and utilizing such a compass, leaders can stay true to their direction no matter what internal or external disorientations may arise. Purpose drives authentic leaders; when purpose is absent, positive outcomes become minimal. Establishing a purpose means a leader also develops passion for the purpose. “Passion for your purpose comes when you are highly motivated by your work because you believe in its intrinsic worth, and you can use your abilities to maximize effect” (George, 2003, pp. 36-37). Relationships are also vital to authentic leaders. A solid foundation of transparency and trust among peers, colleagues, and followers allows a leader to operate in a supportive team environment that includes all members of an organization or educational program. Although critical to authentic leadership, establishing relationships may be tougher for women as well as members of non-traditional outsider groups (Eagly, 2005). Besides establishing strong relationships with others, maintaining a healthy self-relationship remains vital.


DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

The concept of self-awareness is consistently observed throughout authentic leadership literature and “is ultimately about knowing him- or herself, and being transparent in linking inner desires, expectations, and values to the way the leader behaves every day, in each and every interaction” (May et al., 2003, p. 248). Not only do authentic leaders practice self-knowing and transparency when it serves them best, but during every encounter. This pattern optimizes authenticity, relational trust, and stronger leadership. Ethical leadership theory. Closely aligned with positive leadership models is the model of ethical leadership, which is based on the premise of leaders doing the right thing. This concept is also vital to leadership as it relates to a leader’s character and conduct, as well as relationships between leaders and followers. Kouzes and Posner (2007) determined “There is an ethical dimension to leadership that neither leaders nor constituents should take lightly” (p. 345). Without good character and conduct, a leader fails, and betrays those who entrusted him or her to go the right direction. Theoretical research about ethical leadership represents a newer field, the first studies dating only back to the late 1990s. Evidence from the research indicates ethical leaders are more likely to engage followers in a positive way towards common goals while not veering from the organization’s values (Brown & Treviño, 2006). Several leadership researchers with overlapping theories show tangential relationships to ethical leadership. Heifetz (1994) focused on leader /follower/organizational values and how leaders help followers resolve conflicts within a set of values. Burns’ (1978) transformational leadership theory focused on the importance of leaders helping followers when their values are conflicted. Greenleaf’s (1970) servant theory went a bit further by encouraging leaders to nurture their followers by assuming the role of a servant. Five principles of ethical leadership date back to Aristotle. They include respect, service, justice, honesty, and community (Northouse, 2007). These foundational principles afford leaders a strong place in their organizations by treating others fairly. Servant leadership theory. Servant leadership theory was first developed by Robert Greenleaf in 1970. He posited that leaders are assigned their roles based upon an ability to serve others (Greenleaf, 1970). Northouse (2007) summarized the approach, stating leaders “should be attentive to the concerns of their followers and empathize with them; they should take care of them and nurture them.” (p. 348).

Servant leadership means developing individuals being served and includes a social justice component considering the underserved. Servant leaders serve others, regardless of position, and provide a positive role model to inspire those being served to do the same. Strong examples of servant leaders in history include Abraham Lincoln, Martin Luther King, Jr., Albert Schweitzer, Mother Teresa, and Jesus Christ (Brown, 2013). Servant leaders enhance others through their actions and inspire individuals around them to serve. Servant leaders earn their followers’ respect because they are viewed as individuals willing to work at the same jobs as their followers. The nature of servant leadership is exemplified by the EMS profession and by the EMT Code of Ethics, requiring the pledge of all EMS professionals to “provide services based on human need, with compassion and respect for human dignity, unrestricted by consideration of nationality, race, creed, color, or status…”(NAEMT, 2013). Accordingly and by position, program directors serve as role models of servanthood to their stakeholders and the greater profession. Conclusion EMS program director positions involve both following administrative directives and leading stakeholders. McClinchey (2002) described an administrator role as “the logistical engineer for a training program” (p. 271). Leadership responsibilities require organizational, technical, analytical and human skills; vision formulation and implementation; relationship building with stakeholders; and the ability to communicate with future students, current students, graduates, faculty, administration, and various other medical professionals. A program director’s solid grasp of relevant skill, authentic, ethical, and servant leadership theory allows for effective practice of leadership responsibilities and moves his or her program toward ensuring a quality EMS education. Bibliography - Avolio, B. J. (2005). Leadership development in balance. Mahwah, NJ: Lawrence Earlbaum Associates. - Avolio, B. J., & Gardner, W. L. (2005). Authentic leadership development: Getting to the root of positive forms of leadership. The Leadership Quarterly, 16(3), 315-338. doi: 10.1016/j.leaqua.2005.03.001 - Begley, P. T. (2006). Self-knowledge, capacity and sensitivity: Prerequisites to authentic leadership by school principals. Journal of Educational Administration, 44(6), 570-589. http://dx.doi. org/10.1108/09578230610704792

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DOMAIN3

To inspire and promote excellence in EMS education and lifelong learning within the global community

Bibliography (CON’T) - Brown, J. (2013). Who are these servant leaders? Benedictine University Blog. Retrieved from http://online. ben.edu/leadership/who-are-these-servant-leaders - Burns, J. M. (1978). Leadership. New York, NY: Harper and Row. - Cooper, C. D., Scandura, T. A., & Schriesheim, C. A. (2005). Looking forward but learning from our past: Potential challenges to developing authentic leadership theory and authentic leaders. The Leadership Quarterly, 16(3), 475-493. doi:10.1016/j.leaqua.2005.03.008

Kouzes, J., & Posner, B. (2007). The leadership challenge. San Francisco, CA: Jossey-Bass/John Wiley & Sons. Luthans, F., & Avolio, B. (2003). Authentic leadership: A positive leadership approach. In K. S. Cameron, J. E. Dutton, & R. E. Quinn (Eds.), Positive organizational scholarship: Foundations of a new discipline (pp 241261). San Francisco, CA: Berrett-Koehler. May, D. R., Chan, A. Y., Hodges, T. D., & Avolio, B. J. (2003). Developing the moral component of authentic leadership. Organizational Dynamics, 32(3), 247-260. doi:10.1016/S0090-2616(03)00032-9

- Eagly, A. H. (2005). Achieving relational authenticity in leadership: Does gender matter? The Leadership Quarterly, 16(3), 459-474. doi: 10.1016/j.leaqua.2005.03.007

McClinchy, W. D. (2002). Instructional methods in emergency services. Upper Saddle River, NJ: Prentice Hall.

Eriksen, M. (2011). Facilitating authentic becoming. Journal of Management Education, 36(5), 698-736. doi: 10.1177/1052562911423883

NAEMT. (2013). National Association of Emergency Medical Technicians. EMT Code of ethics. Retrieved from http://www.naemt.org/about_us/emtoath.aspx.

Fattig, T. L. (2013). Formal leadership of departmental chairpersons. (Doctoral Dissertation). University of Idaho, Moscow, ID.

Northouse, P. G. (2007). Leadership theory and practice (4th ed.). Thousand Oaks, CA: Sage.

George, B. (2003). Authentic leadership: Rediscovering the secrets to creating lasting value. San Francisco, CA: Jossey-Bass. George, B., & Sims, P. (2007). True north: Discover your authentic leadership. San Francisco, CA: Jossey-Bass. Greenleaf, R. K. (1970). The servant as leader. Cambridge, MA: Center for Applied Studies. Heifetz, R. A. (1994). Leadership without easy answers. Cambridge, MA: Harvard University. Heifetz, R. A., & Linsky, M. (2002). Leadership on the line. Boston, MA: Harvard Business School. Katz, R. L. (1955). Skills of an effective administrator. Harvard Business Review, 33(1), 33-42. Katz, R. L. (1974). Skills of an effective administrator. Harvard Business Review, 52(5), 90-102. Kokx, G. A. (2016). An exploration of program director leadership practices in nationally accredited paramedic education programs. (Doctoral Dissertation). University of Idaho, Moscow, ID.

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THE VICARIOUS TRAUMA TOOLKIT (VTT)

The Vicarious Trauma Toolkit (VTT), A Free Online Resource, Is Now Available by Karen Owens, Emergency Operations Manager, Virginia Office of EMS, VTT Committee NASEMSO Representative Since 2014, funded by the federal Office for Victims of Crime, the Institute on Urban Health Research and Practice at Northeastern University has led the effort to create a first-of-its-kind, state-of-the-field online resource for law enforcement, emergency medical, fire and victim services organizations to address vicarious trauma. The toolkit was developed in partnership with National Association of State EMS Officials (NASEMSO) and other national/international organizations including the International Association of Chiefs of Police, the International Association of Fire Chiefs, the International Society for Traumatic Stress Studies, the National Association of State EMS Officials, the National Center for Victims of Crime, and the National Children’s Advocacy Center. Boston Area partners included the Center for Violence Prevention & Recovery at Beth Israel Deaconess Medical Center and the Boston Area Rape Crisis Center. The team widely researched, compiled and vetted literature and resource materials on vicarious trauma. The toolkit was piloted in seven communities across the United States, heterogeneous in terms of their location, demographics and size. Representatives from ISTSS and all other partner organizations participated in two National Summits to synthesize resources and feedback and guide final toolkit development. The Vicarious Trauma Toolkit (VTT) is now freely available to the public for use. The VTT provides a repository of evidence-informed tools to address the impact of vicarious trauma on staff and volunteers. The VTT is for organizations seeking to become vicarious trauma-informed by proactively raising awareness and addressing the impact of critical incidents and ongoing exposure to traumatic events on the job. It is also for independent clinicians looking for ways to enhance their work with first responder and victim services organizations, by improving employee learning and performance, team development, career management and overall organizational resilience.

Moving beyond the sole focus on individual staff “self-care,” the VTT attends to the duty and responsibility of professional organizations to sustain their staff through vicarious trauma informed policies, practices and programs. VTT materials include agency guidelines, presentations with detailed instructor notes, videos, and a newly created organizational assessment tool to determine an agency’s strengths and gaps in staff support. Specific resources include: • Vicarious Trauma Organizational Readiness Guide (VT-ORG) is an assessment tool your organization can use that measures five evidence-informed areas of organizational health. Assessment results can then be used to identify gaps and prioritize next steps to address them. • Compendium of Resources contains nearly 500 tools that organizations can use to become more informed about vicarious trauma, including policies, research literature, training materials and links to websites, podcasts, and videos. The Compendium can be searched by organizational strategy, topic, and discipline, so organizations can find appropriate tools for their agency to use to address identified gaps. * Resources created for this toolkit include: VT 101, an introductory PowerPoint presentation for each discipline (with notes for presenters); and guidelines for VT-informed supervision, family support, employee and volunteer assistance, among others. Explore the Vicarious Trauma Toolkit (https://vtt.ovc.ojp.gov/) to help guide your organization toward becoming vicarious trauma-informed. For more information, contact Karen Owens at Karen.Owens@vdh.virginia.gov or VTToolkit@neu.edu.

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WHAT HAPPENS TO THE BRAIN WHEN WE LEARN?

What Happens to the Brain When We Learn? by Dr. Bill Young, NRP, Director of Paramedicine Department, Eastern Kentucky University, Richmond, Kentucky For hundreds of years, scientists and educators have known that learning takes place within the confines of the human brain. However, until the development of the functional magnetic resonance imaging (fMRI) have neuroscientists been able to determine what happens when we learn at a cellular level? The educator who fails to consider the physiological impact of learning on brain is at a severe disadvantage when it comes to the development of sound learning strategies for his or her students. This article reviews the latest science in regards to that process. To fully understand the method by which the brain acquires and learns information, a brief review of neurological physiology is helpful. The brain contains a thick neural network of pathways made of nerve fibers. These fibers combine to create approximately 100 billion (1010) neurons. It consists of three primary sections, the brain stem, cerebellum and cerebrum. Of these three, higher level activities of learning occur within the cerebrum. This includes the use of memory and reasoning. The cerebrum is divided into further specialized areas that deal with particular functions important to the learning process including sight, touch, speech, short and long term memory as well as language and reasoning abilities (Partridge, 2009). How then does learning take place in the brain? A network of neural pathways exists, along which sensory information is taken in and then transmitted by tiny junctions between the pathways. These tiny junctions are called synapses. This information is then stored within our short term memory. A number of changes occur at both the cellular and molecular level within the first few moments of learning a new skill and new information. This results in both a change in the structural as well as functional make-up of the nerve cells. A network of neurons forms by which sensory laden data is conducted via the synapses.

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This data is then stored for a short period of time with the short term memory. This short term memory center is a very volatile section of the brain that functions much like a receiving warehouse for the massive amount of information that one might encounter throughout the normal course of the day. Upon deposit within this short term memory center, the neural pathways conduct the new, temporary memories to the structural core of the brain. Once there, these new memories are compared with memories that previously existed and are stored within the long term memory center. For the most part, this electrical learning process occurs almost instantaneously, however, there are times when errors in memory develop. One major problem is that, much like the signal being conducted over an actual copper or other metal based conduit, the degradation of the electrical signal that is being conducted tends to occur as it moves across the billions of brain neurons. As a result, many of the memories that are stored within the brain are either imperfect or may include portions that are falsely made up by the learner to fill in the gaps that occur. Learning does not refer to a single experience but takes into consideration all of the information that he brain receives and processes on a daily basis. The regions of the brain necessary for this to be consolidated into long term memory depend on various characteristics of the memory formed. This type of learning is functionally dependent upon the region of the brain called the hippocampus (Eichenbaum 2002). If one were to be able to see into the brain at the cellular level, memory would be seen as changes to the makeup and roles of cerebral neurons. For example, the junctions between cells and how they transmit information is called a synapse. New synapses are formed when new networks of brain cells are brought into alignment to communicate with each other. In a like matter, synapses that already exist are strengthened with repetition. This allows for enhanced and quicker exchange of communication and information between the two neurons. Combining these changes within the synaptic junctions demands the development of new Ribonucleic acid (RNA) as well as various other proteins within the hippocampus. With the formation of these new alterations occur in transmission along the synaptic junctions. For example, when the synthesis of new proteins in the brains of mice was inhibited, did not appear to cause a deficit in the short term memory or a change in the hippocampal neuronal make up.


WHAT HAPPENS TO THE BRAIN WHEN WE LEARN? An important process that does occur is that the formation of new, long-term consolidation of spatial memories is decreased exponentially. As time passes, these brain systems begin to change as a result of consolidation processes. At the outset, the hippocampus works together with the regions that process sensory input. These are located in the most exterior layer of the brain, called the neocortex. It is here that the new learning experiences begin the process to become a new memory. Found within the neocortex, the parts of an event that one would consider as an important event in one’s life is shared across specific brain regions based upon their content. To illustrate this, the information that one gathers through the use of sight is sent to be processed by the visual cortex which is situated in the rear of the brain, also called the occipital lobe (Phelps, 2007). At the same time, any auditory input is channeled along the nervous pathways to the primary auditory cortex placed located within the temporal lobes. These lie on either side of the human brain. During the formation of a new memory, the hippocampus quickly combines all the associated information into a single memory. The end product of this serves as a type of an index to what is contained within the sensory processing regions. With the passage of time, both cellular as well as molecular changes within the brain begin to make the connections among the neocortex regions much stronger than initially. The end result of this is a memory that recalled without the help of the cells of the hippocampus. When the hippocampus is damaged, either by direct trauma or by a neurodegenerative disease such as Alzheimer’s disease, a condition called anterograde amnesia can result. Anterograde amnesia is the inability to form new memories that can be recalled (Graf & Schacter, (1985). Examples of this type of memory, also called declarative or explicit memory would be the opportunity to recall facts and knowledge, two important components of the learning process. This declarative memory is the process by which humans are able to verbally state facts recalled from memory, while the explicit memory might be characterized as the purposeful recall of components of information that one would recognize as a memory.

As a result of this trauma or disease process, the hippocampus can no longer connect information located in the neocortex. It is important to note that this particular disruption does not appear to impact or disrupt a person’s memory regarding facts or events that have been embedded prior to the sentinel event. In other words, a person might not be able to learn the names of recent political candidates, but would be able to remember and recall facts about early American history. A very important part of the brain focuses on the Reticular Activating System (RAS). The RAS is part of the brain that begins in the brain stem and extends to the midbrain and thalamus. Its primary purpose is the control of the central nervous system in regulating sleep versus wakefulness as well as the transition between these two states of awareness. In addition the RAS has the responsibility to filter stimuli coming into the brain, sorting through these stimuli and deciding as to its importance regarding whether the brain pays attention to it or simply ignores the stimuli. The brain has a tendency to incline towards novelty and newness. This seems to be an important part of the mind’s function. Novelty tends to indicate the unknown. The unknown is very attractive to the brain. Young children are very fun to watch. They seem to look at the world around them by looking at the new, begin to understand them and then move on to a new and different experience. The challenge for today’s educator is that students are bombarded during their waking hours with new, novel and exciting experiences. The RAS can become overwhelmed as students attempt to sort out the important from trivial. One of the problems that the education of these students face is that their brains are not yet developed enough maturity to do that process effectively (Sercombe, 2009). This is nice to know information, but could it also be important to know? If so, what might be some implications that an educator could take increase the likelihood of the success of the students under their direction? Understanding how the brain functions in regards to learning should help educators to tailor lessons specifically for individual students. The argument against this might be that it would be time consuming. However, the process that has been used in the past has not been entirely effective, therefore, new strategies must be explored.

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WHAT HAPPENS TO THE BRAIN WHEN WE LEARN? “In the United States, most schools prepare for standardized tests by spending a large amount of time a few months prior to testing on review,” observes brain expert Marilee Sprenger (1999). “Although that has been known to raise test scores in comparison to schools that do not follow that process, it does not put information into longterm memory. Because working memory can hold information for just days or weeks, most of the time, the information is forgotten after the test.”

Future research may reveal new strategies for how to deal with students who have suffered traumatic brain injuries, older adults who have an onset of dementia or Alzheimer’s disease or the first grade student whose teacher just doesn’t know how to reach. New models will direct how to best maximize the educational process for these and other students. The use of these new models will help to better customize and enhance the educational experience by targeting the best methods by which they learn.

Recent educational psychology research postulates that if educators are able to use techniques to improve student’s working memories, a commensurate increase in IQ scores as well as other cognitive abilities will occur. One way of doing this would be to look upon improving the working memory by using the principle of simple rehearsal or the improvement of the working memory of the student’s brain. Practices such as scaffolding, building new learning modules upon previously acquired information or the use of “chunking”, delivering didactic material in small sections or “chunks” of information can be effective in this practice. Examples of this practice include requiring students to break down a long poem into shorter, easily memorized sections. This will help them to develop realistic strategies to more effectively store the material in the short term memory section of the brain and then easily transfer them to the long term memory section.

References

Humor and the resulting laughter that accompanies it can be an excellent catalyst to learning (Sprenger, 2005). When a student finds something funny and laughs, the brain releases endorphins, such as norepinephrine and dopamine that make them feel good. Recognizing the relationship between this pleasant feeling and the acquisition of information essential to learning, the brain quickly moves the memory from the short term section into the long term. The use of humor in the classroom can be a two edged sword. Many times humor can be an effective method of securing information within the long term memory of the brain, however, educators must take a great deal of caution in this area. In conclusion, current research on how the brain is constructed, the biology of how and why it works continues to have a directed impact on the techniques educators use in teaching students. EducatorUpdate Update| |www.naemse.org www.naemse.org 1920| |Educator

Eichenbaum, H. (2012). The cognitive neuroscience of memory an introduction. (2nd ed.). Oxford: Oxford University Press. Gilmore, J. (2008). Temporal and Spatial Development of Axonal Maturation and Myelination of White Matter in the Developing Brain. American Journal of Neuroradiology, 290-296 Graf, P., & Schacter, D. L. (1985). Implicit and explicit memory for new associations in normal and amnesic subjects. Journal of Experimental Psychology: Learning, Memory, and Cognition. (3), 501-518. Phelps, E. A. (Director) (2007, April 12). How Personal Experience Modulates The Neural Circuitry Of Memories Of September 11. Lecture conducted from National Academy of the Sciences, Denver. Sercombe, H. (2009). The Gift and the Trap: Work ing the “Teen Brain” Into Our Concept of Youth. Journal of Adolescent Research, 25(1), 31-47. Sprenger, M. (2005). How to teach so students re member. Alexandria, Va.: Association for Supervision and Curriculum Development. Sprenger, M. (1999). Learning and memory the brain in action. Alexandria, Va., USA: Association for Supervision and Curriculum Development.

About the Author Dr. Bill Young began his EMS career in 1975 with a small fire department near Williamsburg, KY. They began running first responder calls long before the phrase ever existed. In addition to Kentucky, his career has taken him to Tennessee, Colorado, Georgia, and Kansas. He has served as a street medic, training officer, supervisor, state regulator, and educator. He recently completed his doctoral studies in education at the University of the Cumberlands. Currently, he is an Associate Professor and the Program Director at Eastern Kentucky University in the Fire Protection and Paramedicine Science Department.


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