Hilary Gates: So excited to be here today hosting another EMS Educator podcast with my guest host who's not a guest host anymore. I don't know why we really ever said that, because she really is a host. And that's Maya Dorset from Prodigy and many other places. And Rob is on other duties as a sign, but we're glad to have Ginger back doing the medic mindset. And thank you for listening. Today we're going to talk about the role of the clinical coordinator in EMS education programs. And we have with us two really esteemed guests who have done a lot of work in this field and will very likely blow your minds with the knowledge that they have about this clinical coordinator role and hopefully give you some advice on how to make it the best you can for your program. And so I'm gonna have them introduce themselves, We have with us Mike Miller from C O A E S P. And Mike, can you introduce yourself, please?

Mike Miller: Sure, thanks Hillary. My name is Mike Miller, associate director at the COA EMSP. been in that role now for five years, and prior to that, a longtime program director, educator, and and clinician in a multitude of roles, supervising students in the in the immersion department, clinical environments, as well as on the ambulance.

Hilary Gates: Thanks, Mike. And we also have with us Tim Hutchings, but he goes by Hutch, so that's what you will hear today. Tim is from the Rochester area and the Monroe Community College program. Tim, can you introduce yourself?

Tim Hutchings: Hi, I'm Hutch. I am the clinical coordinator for the Metro Community College Paramedic Program. I've been in EMS now since two thousand and one and been practicing as a paramedic since twenty twenty. and just shortly after that is when I took over the role as the clinical coordinator.

Hilary Gates: Thanks for being here. So when we decide what the topic is for our monthly podcast, we have a lot of back and forth on the Prodigy team about what is getting us excited and what are some things that are maybe challenges in our daily lives as people who work in EMS. And so I'm gonna have Maya explain that decision for this month's podcast and also launch kind of our first questions. Over to you, Maya.

Maia Dorsett: gonna start by saying I'm super excited because what Hutch did not say is that he graduated from the paramedic program where I had the pleasure of being his medical director and now has the unfortunate role of having to work with me and all my anxieties on a daily basis. But I feel very lucky to to have him and he laughs because he knows it's true. the the reason I wanted to do an episode on the role of the clinical coordinators because if I reflected on the topics that we've covered in the last year or two on the clin on the EMS Educator, we spent a lot of time talking about clinical education and how do we create meaningful experiences for students. we recently did an episode about how do we kind of give feedback when they come back and tell us about their experiences. We talk about preceptor education, but one of the things that we had not talked about is kind of the ringleader of the circus of the person who coordinates all these experiences for the students. and that's the clinical coordinator. And that's the person we'll talk about is building all these relationships behind the scenes, making sure that the students have these opportunities, coordinating the feedback from these opportunities, doing a huge amount of work. And I think it's one of those roles that when it's done well, nobody talks about how well it's being done because everything is working. And when it's not done well, like everybody notices cause the key components of a program fall apart. And so I think it's really valuable to go through like what is this role, and also give some key pointers about like how do you do this role really well. And so I approached Mike because in addition to His experience as a very successful program director in a lar large program, he gets to look at this from the accreditation standpoint. And there have been, I think, some changes recently to the standards that gives more guidance about what this role is that I think are really valuable for everybody to hear. And he also sees this in a bunch of different programs. And then Hutch, I know does this really well. and I know this because I see him do it and I see how well he coordinates these experiences for. our our students and coordinates feedback and progress reports and all of that. And so I think having both of their perspectives is really valuable for people to to hear.

Hilary Gates: And I would like to also make sure that Mike explains the C O A E S P responsibilities and roles, especially as it regards this, because I'm not sure everyone listening is familiar. So that's an important part of this next step. Before we start with diving into the clinical coordinator role, I do think it's important that we explain C O A E S P and by we I mean Mike. And we're gonna be throwing around the term accreditation and K HEP. So Mike, if you could give us those quick answers there before we get started, that would be really helpful. Go ahead.

Mike Miller: Yeah, thanks Hilary. So KHEP, or the Commission on Accreditation of Allied Health Education Programs, is the accreditor and has been for many years for paramedic education programs throughout the United States. And actually we have one international program as well. As it pertains to the The Committee on Accreditation of EMS programs, which is who I work for, we provide the day-to-day operational support to programs that are seeking accreditation or are accredited by by KHAP. there is a New initiative that started back in 2025, January 1st of 2025, we also started to offer voluntary accreditation services for advanced EMT programs. And so right now, as of today, there are probably around 30 or so programs that have the letter of review and are on a pathway to KIP accreditation. And there's actually a couple of programs that are KIEP accredited at the moment.

Hilary Gates: And that's for the AEMT, but for paramedic programs much larger, right?

Mike Miller: Yeah, there are just under around eight eight hundred programs that are accredited by KHAP currently or possess the COA EMSP letter of review. and in all we're probably around eight hundred and fifteen to eight hundred and twenty programs with the AEMT programs that are part of the process as well.

Hilary Gates: Thanks, Mike. So Maya, let's now that we have some of the these letters figured out, let's dive into the the clinical coordinator role and some of the topics you want to discuss here.

Maia Dorsett: Yep. And I also want to add to what Mike said is that while a lot of what we're going to be talking about is think more formal because of the national accreditation that is available to paramedic programs, right? And is required of paramedic programs for their graduates to take the national registry. I think thinking about what is best practice in coordinating clinical experiences for your students applies to all programs, including at the BLS or the the EMT level. One of the things I wanted to talk about, one of the things that made it front of mind recently is I do do site visits for Koei, because I'm just gonna call it Koei if it's okay with Mike. and as I was updating my knowledge, right, within it was twenty twenty three Mike, the new standards or twenty twenty four?

Mike Miller: January first of twenty twenty three, the new standards went into effect.

Maia Dorsett: Yeah, so there was new new standards. and one of the the I would say important changes that happened with the new standards was the formal recognition of the clinical coordinator role with specific responsibilities and qualifications. and while it doesn't say you have to have somebody who's designated to be the clinical coordinator, it does say that these are roles and responsibilities that might be met. And Mike, I'd like to ask you why do you think that change happened, you know, what is the significance? What does it say about the evolution of paramedic education to formalize that as a role?

Mike Miller: I think that's a great question, Maya. It was intentional, right? In order to take the approach of codifying in the standards to be an accredited program an emphasis on this role of clinical coordination, that it doesn't happen by accident. It is intentional. You need to have certain processes in place. you need to devote resources in order to be able to have a solid clinical education program for your students. Regardless of the level, whether or not we're talking about EMTs or paramedics or even beyond. And by the way, this is something that happens in all health professions, right? This isn't something that's just unique to us. And there are best practices that happen with nursing students and medical students and all different kinds of disciplines where patient care becomes part of the process. So I've been around for a long time, right? I remember as a paramedic student over 40 years ago, the metric that We utilized was to go sit at an ambulance station or a firehouse or to go to an immersion department and spend a certain amount of hours in the immersion department or labor and delivery or pediatrics or whatever the unit was. There was a recognition decades ago now, but you know, around 2000 or so, that we're really in the healing arts and that we needed to have certain competencies in order to do what we Yeah. We're we're clinicians, after all, at the end of the day. And so there was a recognition that we really needed to examine competencies and not just punching a clock and doing hours. So this emphasis on a competency outcome focus really resulted in the need to look beyond just tracking hours. And so I think that's where it all started. But as we have continued to evolve and recognize the complexities that are Involved in having a good clinical education program for your students, it was really focused in recognizing the clinical judgment that must be developed in our students and where do they do that best. And they really do that in real patient care areas being supervised by other clinicians that take care of patients. It doesn't get any more real than that. We can do certain things in simulation, but at the end of the day, the student knows, the instructors know that that's still not. A real human being, right? The stakes are not the same. And so it is really an all-important application of what the student is learning in the simulation laboratory, the isolated skills that they're working on in the laboratory environment, and the concepts that they're learning from a theory perspective in the classroom. It really all comes together in the clinical environment. And so I think the standards recognized that, again, that doesn't just happen. It's because of intention. decisions that are made, other people that are monitoring what's going on. So that's why the standards reflect the important roles that a clinical coordinator plays.

Maia Dorsett: So I think the when you know you know something is done well because you look at the outcomes of the program. So when you go on site visits or when you review a program, while there are kind of defined roles and responsibilities, overall there's like a stalt, like this program does clinical coordination well. Like these roles and responsibilities are being performed well. How do you know that? Like what are the things that you look at that say like your gut sense, you know, like sick or not sick, like done well, not done well,

Mike Miller: Yeah.

Maia Dorsett: in terms of clinical coordination.

Mike Miller: Well, there's a lot of ways that we we try to get at the heart of that, right? There's a lot of things that happen during, for example, a site visit. So when a team of site visitors goes to visit a program, they talk to a number of people, they engage in conversations, and they're looking to get a lived experience from the people that are Engaged in the coordination of the clinical program. So they will talk to the clinical coordinator of of course, which you know Hutch does in his current role and he can share that perspective. But we're also gonna talk to currently enrolled students. We're gonna talk to graduates of the program. They're the ones that were on the receiving end of the clinical educational experience that. They had at the program. They're gonna be brutally honest and they're gonna say, you know, how was scheduling? What type of feedback did you get? How were the evaluations? Were you, did you feel as though you were supported during your clinical education? All of those kinds of things are going to be part of that conversation. We will talk to preceptors as well, the clinical and field preceptors that are responsible for supervising the students in these all-import areas. In some cases, there are a handful of programs that have the good fortune to have their Their instructors go to the clinical sites and supervise, especially in a hospital environment, but that's not a majority. The majority are still relying on volunteer people that happen to work for that site, both on the ambience as well as in hospital environments. Beyond the conversations, beyond talking with people, they will also look at certain artifacts that the program has. Everything from manuals to the onboarding and practices that a student has to. To go through in order to be able to start doing patient care activities. They're going to look at the liaison orientation training program materials and the the capstone field internship training materials that they're they're utilizing to educate how people supervise their students. They're gonna look at the scheduling processes, the evaluation processes, the tracking systems that are involved. Once they start to look at all those artifacts and they talk to the people that are on the receiving end of all of that. I think they get a really good idea of the picture and the quality of the clinical education program that is being provided to the students.

Hilary Gates: Struck so much here by the system design and how important it is and how difficult it is and complicated and so many moving parts and people who you are relying upon that you might not have ever met. and so I I just want to make note of the the tremendous efforts that go into this entire program and especially of course the clinical coordinator and it it kind of reminds me of my my previous lives when I was a high school teacher being accredited in a high school is a very similar you know in a s in a similar fashion to have a a company come in and and look at all of exactly what you just said. Or when I was a server in a restaurant or a bartender and the same kind of thing you think about when a restaurant gets reviewed or whether when you go to the restaurant. Of course you got to talk to the customers and see how the food is made and make sure the health department is there and hope you know everybody's getting paid properly and the it's safe to go in and you know all those types of things. It's it's a it's an incredible thing to sort of Hover over as a 30,000-foot view of systems here, Mike. So I I just wanted to say that it was going through my brain.

Mike Miller: Great.

Maia Dorsett: I want to make sure we take a little time and hear from Hutch because I think there's like what does good look like from I come in and I'm looking broadly through the lens of accreditation, right? Which is fundamentally about protecting the the public and the students and making sure that people are putting being put out and they are competent, but also that the students are adequately supported through that process. Hutch, like, you know, th there's been you took on this role, and you really had to build this role. Hutch was actually our first person who had a full-time role. And Hutch has, this is not his full time job. He has lots of other roles rolled up into his full-time role with MCC. He runs our simulation program. He does all the lab coordination for the BLS programs. He's doing a lot. but I'm interested in like how do you know that it's going well from a clinical coordinator perspective? Like how do you know that you're doing a good job and like what what does that What are the things that you look at to know that?

Tim Hutchings: So I think it it comes from a different couple of different points. the students will certainly let you know. And it's it's important to just always be available to them so that they have that ability to to have that conversation with you. so I I find myself spending a lot of time in the classroom, regardless of if it's lab related or not, just so that they have the opportunity to have that discussion. And that often accomplishes a couple things. It lets me know if I'm doing my job, but it also lets me know if the preceptors and the hospitals and everyone else is doing their job, because I'm getting first hand accounts from the students and their experiences. And that helps me guide where to go and who to talk to when issues do arise. And then the other half of it is going out and talking to the preceptors and the hospitals and and spending time with our affiliates who help us mold this program. So, you know, each week I try to stop at at least a hospital or an agency and say, Hey, what's going on? What are you seeing? What can we do a little bit better? You know, are there trends with our students that you're noticing? Are there things that, you know, we're teaching that you're like, Why is it this way? And and spending a lot of time out in the field gathering the data so that I can assess that we're hitting the benchmarks that we think we're setting.

Maia Dorsett: That's such an important perspective because I think people think of this as a primarily an administrative role, and they think of the role of the clinical coordinator as sitting in front of a spreadsheet and scheduling people, and that is a part of the role, but to do the role well, I think that's exactly it is which you epitomize, right? Which is like building the relationships and getting the first hand knowledge and having, I would say, true psychological safety on both ends for both the people we're asking to volunteer their time to help train our folks as well as the students. to yes, they they they are the most honest, right? Like they will they will tell you whether or not they have had a good clinical experience. which is something that you have to when you ask the feedback, you gotta you gotta be open to what they have to So

Hilary Gates: Or not. They might not share if it's not psychologically safe, right? Or if they're in if they're afraid of in endangering their own education or getting someone else in trouble or being in a s situation where there are people who are much senior to them that might be doing something wrong that they want to tell you about. I mean, there's a lot of hierarchy and you know, kind of the Paramilitary structure that you see in some fire departments in EMS that can really get in the way of this. So Hutch, I don't I don't know that we need war stories, but I always like kind of specific examples around especially successes and times when you feel like the process really worked. I know when I was teaching in EMS and we did not have a dedicated clinical coordinator and so there was a lot of us doing spreadsheets and scheduling and listening to our students as they come came back and trying to coordinate in the field. But how do you not you know, take one story and say, no, it must be happening throughout the entire program. You know, how do you get enough gather enough data without overwhelming yourself? what are some ways you can give advice to our our listeners on that?

Tim Hutchings: Yeah, it's a great question. And it's something that's taken a lot of trial and error to figure out what the right balance is. I I find that the availability and just an infinite level of patience is is really, really important here. because you know, you will get the I had a terrible experience and this is why and you realize that it was, you know, the the experience was what you brought to it. If you come into it with a bad attitude, you're gonna have a bad time. So having that that ability to go out and the flexibility to meet with the preceptors as well as the students and regularly meet with all of these folks and making yourself available to all of them is paramount to understanding where the real problems are and where, you know, is it more an affective thing than a a structural problem with the the site visit there.

Hilary Gates: So now that we've kind of established what a clin clinical coordinator role looks like and heard a little from Hutch as well as from Mike, let's talk about the actual standards that have been established. And Mike, I'll have you go through those and then Maya, we can dive into each of them a little bit more specifically.

Mike Miller: Yeah, thanks Hiller. There are essentially four components to this. And appreciate that they're kind of high-level, 30,000 foot view kinds of descriptions. That is by design. We want to give programs some level of flexibility and understand that programs are very different. There are some programs that may enroll 10 or 12 paramedic students a year and others that enroll 120 paramedic students a year. So the needs are gonna be vastly different depending upon those types of circumstances. So the four items include first and foremost just an overarching responsibility to coordinate clinical education and how the program views that and and looks at that. Number two is to ensure documentation of the evaluation and progression of students throughout the clinical performance. There's a lot of ways that programs may approach that. Three is to ensure orientation of the program's clinical liaison in the case of a hospital environment. And then as it pertains to capstone field internship, is the training of each individual capstone field internship preceptor that is going to be responsible. For supervising the students. And then last but not least is the piece of this that's about coordinating the assignment of students at the various sites that the program utilizes. Those are the four different responsibilities that the clinical coordinator has.

Maia Dorsett: So why don't we go through each one? and I think maybe for each one what we can do is say what do we think is like one of the most important types of things that is done for that responsibility, like an example of what good looks like. and then if there are kind of common barriers or common challenges and how you've seen people overcome those common barriers and common challenges. Because I think everything that we're talking about is something that takes a lot of time. And I'm very well aware because our program didn't have this for a long time that Not every paramedic program has a full time, I don't even know what percentage. I doubt it's the majority of them even who have a full time clinical coordinator, depending on what the size of the program is. And sometimes these responsibilities are divided amongst multiple people. Sometimes there's like a one man or one woman show for a smaller program where there's somebody is the program director and the lead instructor and the clinical coordinator. So bandwidth is always an issue. So I think talking about You know, what does good look like in these cases and what are some actionable things that folks can do, particularly when there's challenges? Because I think there's challenges for meeting every single one of these. So why don't we talk about coordinating clinical education? that's kind of a big umbrella term. Like what does that mean? Like what does good look like there? Like what is an example of the activity of coordinating clinical education?

Tim Hutchings: so I I would say good coordination of clinical education is having good resources, right? understanding that the the people involved, it's it's much more than one person, even in smaller programs. the ability to coordinate with all of the preceptors, lab instructors, hospitalists, anybody that you're dealing with that are involved in the clinical education. and having them have a decent understanding of the job of a paramedic or EMT or AEMT and the goal of that clinical experience. So again, that that ability to speak to them and have regular conversations about what the role is and the purpose of this clinical experience is really the the thing that that pushes okay to great.

Maia Dorsett: One of the challenges that happens is within this responsibility is making sure the clinical experiences align with the didactic curriculum, right? So that we don't throw our students into PEADs before they've had PEADS education, all right? Or they're not in the neuro ICU and they haven't done the neurology didactic block. and I think this is true, right, for both the simulation component of your education, which for us is like very coordinated there. It's under actually clinical coordination because of the way it works. but particularly for the clinical, or knowing like your student cannot have a team lead in something that they have not had the didactic knowledge, right? Because they can't lead the call from start to finish. How do you solve those challenges? Like what How does that how does that happen? Like how do you ensure that students aren't being asked to, for example, do things in the field that they have not been prepared to do, both in terms of cognitive knowledge or skill?

Tim Hutchings: That again comes down to you're speaking with the students regularly and and letting them know every expectation that is laid out and then following up with their preceptors and the people who are responsible for helping them grow that education, letting the program the program will tell people where they are in the class so far. So, you know, they're not tackling neurotype calls if they haven't covered that in the didactic portion yet. so it's regular messages to training directors and whoever's coordinating for the preceptors out in the field, as well as talking to the students and letting them know, hey, this is where you're cleared. you know, each year we give the students little punch cards that say like you're allowed to do this set of skills so far. And as they click those off, they know that, you know, it's a quick, easy reference for somebody who may not be as enveloped in the paramedic education. to know that okay, yes, they're at the point where they can read and interpret an EKG and and and analyze all of that that comes with it.

Maia Dorsett: actually something that was a one of the benefits of being a site visitor plug Is that you get to go around

Hilary Gates: Hmm.

Maia Dorsett: to different programs and see how they do

Hilary Gates: Yeah.

Maia Dorsett: this. And I was at a program with that had this magic punch card and I was like, that's brilliant. I've seen other programs more recently do QR codes, where the student has a QR code on their badge and it allows a preceptor to verify like, they have done array management or they have done IVs or this person is allowed to do that, much like you might credential somebody to do something. I don't know if there's other practices that you've seen that you think are well done.

Mike Miller: Yeah, those those those are great examples. Maya, the the having some form of documentation or electronic resource that the preceptors can look up in real time and see where the students are at. even having resource manuals, right? some some programs will develop a resource manual that is a a document, maybe it's in a binder or something that they will put at the different stations or on the various units in a hospital. It may have resources in it, everything from, hey, this is what our uniform is. If the student doesn't look like this and they'll have a picture of the student in there. They're not in uniform, send them home. They don't have their name tag, send them home. Call us, but but send them home. because they're expected to show up and and be ready to go. And if they're not, then let's address that. They will also oftentimes then put in, for example, a schedule that says, Hey, this is our normal cadence and sequence of things. So you'll have a general idea that once we've gotten here and they'll list out these are the things that the student should be able to competently perform for you because we have. Evaluated their performance in the classroom portion, both with written examinations and psychomotor examinations that have been evaluated by faculty that says they can start IVs, they can safely administer medications. Don't expect them to know how to interpret a 12-leave yet because we haven't gotten there. That comes in two months from now. So laying those things out and providing those resources to the preceptors is definitely a best practice.

Maia Dorsett: I think there's a of communication that goes with who's ever the lead instructor or program director about when clinical experiences open. I know Hutch does a lot of work in like building the yearly schedule of and coordinating with locations. Like we expect to be sending our students to the ICU. We have things like attending shifts with physicians. We don't open those up until later on because really we want them to be able to have higher level clinical decision making, to be thinking about differential. So that they're maximizing what they're gonna get out of the clinical experience when they're, for example, with like the physician and they're thinking about higher management. So I think a lot of it is commu it sounds like a lot of it is communication. whether that is in-person communication, discussion, and coordination with what's being taught in the class or other forms of asynchronous communication like the punch cards or the QR codes or resource binders. but it's an important consideration because also if you put a student somewhere where they expect a student to be able to do something and then they fall on their face because they were never trained to do that and they're not gonna be like, I'm to you know like I'm not gonna take it then somebody might have a sense that that person is a poor performer when really they were never given that chance and so it affects both the person's the student's self confidence but also like the value of the feedback. Like if I'm gonna give you feedback, I should have a sense of where you're supposed to be to be able to give you feedback. And also as a preceptor I shouldn't be putting you in circumstances that you're in no way no way prepared for. so It's important.

Mike Miller: Yeah, that that's right. my one of the other things that that I think can sometimes get a student sideways and struggle right out of the gate is that they don't have really good solid BLS skills, right? So if you send a paramedic student, for example, to a site, I don't care if it's a hospital or or an ambulance service, and they're fumbling around trying to figure out how to take a blood pressure. Guess what? That preceptor is not going to feel real confident giving them needles or medications to administer. So those fundamental basic sound BLS skills are paramount because that's really where they're going to prove themselves and then ultimately graduate to do those other kinds of things.

Hilary Gates: That. Let's move on to the next standard here, which is everyone's favorite word documentation. but ensuring documentation of evaluation and progression of clinical performance, and you know, from the days back in back in the day when there were paper forms, and there probably still are out there, and then moving towards spreadsheets or you know portals that you're doing evaluations on and relying on again. likely preceptors or folks in the clinical field who don't work for you or not being paid f by you or or whatever it is to fill out paperwork in a timely fashion. I know that's always a challenge. Mike, what are some of the things you see in your work that are good hallmarks of documentation being done well and evaluation and progression being measured effectively?

Mike Miller: Thanks Hillary. Yeah, so a lot of programs, and I would say the majority of programs, I don't know know about all of them, but the majority of programs now utilize some form of electronic documentation to keep track of things. While that's a good thing because of the complexity of all the different competencies that students have these days, I also think that our reliance on that has made people focus very much on checking boxes, right? It's not about the quality of what they're doing that's basically saying, Yep, I started an IV or I saw this cardiac patient. And so the reliance on these electronic systems has also, I think, caused because programs, program directors, faculty, clinical coordinators, they're all really big. Busy, right? They're getting pulled in a lot of different directions. We understand that. But they've also kind of begun to rely on those systems and tell the students: if you want to know where you stand, go look it up. You have access to it. And so what one caution that I would have is that students still need to be nudged along and nurtured. And the only way for that to happen is with personal conversations. There needs to be periodic conversations with the student, with what they are accomplishing. by a faculty member. It doesn't have to all be on the clinical coordinator. The clinical coordinator may have that as one of their responsibilities, but others can step in and help out and lead those conversations. They they gotta know, they gotta have those conversations about the documentation that's being done. Well, one other thing that I think I just heard this recently from from a a program director where you know they'll have evaluation forms, paper forms that that get filled out, as well as electronic tracking stuff that they do. And they'll talk about how somebody will put an X at the top of a column with multiple things and just draw a line to the bottom and put another X. Like that's not meaningful. So So the narrative comments, the qualitative comments that a preceptor provides are oftentimes more valuable than the rating that they're giving in any particular area. The other thing is that sometimes people will have Likert scales that are five-point or eight-point or ten point or whatever point Likert scale you want to put in there. That does not lead to a lot of good integrated reliability. So I always try to devise programs when you're developing these evaluations. Instruments, be simple about it. I I used to have basically three categories, and the student was need needed improvement, was not doing it, not doing it well, whatever you want to want to call that. There's an area where they're doing what they're supposed to be doing as expected, and then some category because preceptors are oftentimes looking for it, and I think students are as well, where they're exceeding expectations. they're they're doing excellent work, they're actually beyond where you would expect them to be. as a student. So, you know, two or three points and keeping it really, really simple with very clear definitions about how a preceptor is rating students, I think are a couple of recommendations I would make.

Maia Dorsett: Do you wanna talk a little bit about the nudge, which is your special power?

Tim Hutchings: Yes. Yeah. Yeah. So you know, for the first couple of years I was in this role, I operated under the mindset of no news is good news and I I found that students really struggled with that. so it was a big learning point for me was how to let the students who were performing well still know that they were doing the things that they needed and then the ones who maybe were falling aha behind how to talk to them and and Originally it was, you know, broad statements to the classroom, hey, you guys gotta step it up here and there, but I found that that wasn't very effective either. So again, making yourself available, I kinda sound like a broken record here, but being available to the students and and being in the classroom so that they have that opportunity during a break before and after class to sit down and have ten, fifteen, twenty minute discussions with you about their progress and exactly where they are. is is great. And then always following that up with some type of written documentation. anytime I have those conversations with them, they get an email within the day saying, hey, this is what we talked about, here's where you're at, here's some data to back that up. So this wasn't just our, you know, our my recollection of the conversation and then rolling that out to them so that they have a a a transparent log throughout the throughout the entire year. and it's my goal that every student gets something every month from me. you know, and I I'm lucky, I'm in a program where we only have twenty-five students a year, so that's it's a little bit easier to attain, but somebody is hearing from me at least once a month on their progress and where they go because that that no news is good news paradigm just wasn't working the way I I had hoped it would.

Maia Dorsett: People people seek tons of feedback and I think one of the things that's helpful is you know, we have like our our monthly meetings, which is the medical right? One of the medical director roles and responsibilities is that you're paying attention to the progress of your students, including clinicals. and we have our monthly faculty meeting. and the nice thing is we go through like how are people doing in the class portion, and then how are people doing in the clinical portion? And sometimes it's like somebody is struggling in both. sometimes somebody is struggling in one part versus the other, but it allows us to have a conversation about how do we approach this and like how do we recognize these ones who are doing really well but then also for the people who are struggling, can we get to the the diagnose, the problem of the struggle? Is it like a broad thing that's affecting everything or are they having time management issues and not being able to get to get to clinical? and I think it it's allowed us to take this kind of team approach, like mom, dad and uncle Hutch to like how do we get them through the through the program?

Tim Hutchings: You know, that's something that

Hilary Gates: daddy.

Tim Hutchings: I I really l learned from from Dr. Dorset and and our paramedic program director, Bill. was I I did. I did.

Maia Dorsett: Did you just call me Doctor Dorset? That is

Hilary Gates: Yep, he did.

Tim Hutchings: you know, but to take away, you know, it was I came into it with the assumption that people who weren't doing the job were just being lazy. And I learned very quickly that there was often other factors into that. So it was it was a great eye opener to learn that like, no, it's Nobody wants to do a bad job at this. They all want to succeed and there's often something else happening here.

Mike Miller: Yeah.

Tim Hutchings: So understanding where your students are coming from so that they can have the most opportunity to learn and grow is really, really

Mike Miller: Yeah.

Tim Hutchings: important.

Hilary Gates: Yep, we we hear it all the time on our team. Unconditional, positive regard and you know, never assume malice when it can be chalked up to in ignorance. Clear is kind, right? And of course everyone seeks feedback. You you don't wanna be living in the world of guessing whether you're doing well. all

Tim Hutchings: Right.

Hilary Gates: students want that. All learners and humans want that. Let's move on to the third standard, which of course this is a big one, how to ensure orientation to the program's requirements of the personnel who supervise students. So essentially making sure your preceptors and in the hospital or the field are trained well and providing a quality educational experience. Hutch, what's your approach to that in terms of what you found that that works or best practice?

Tim Hutchings: So this is honestly one of the most challenging parts of my job because there's so much turnover in all areas. so getting the message to the the boots on the ground, whether it's the folks in the hospital, you know, the nurses who are with the students, or the pre paramedics out in the field is really, really challenging. so I I'd love to hear what Mike's seeing across the country because frankly we need a better system for this. I know each year I start out by contacting the leads of all the departments that we work with and saying, Hey, here, you know, the new cohorts in, here's our students, here's our clinical manual, any important updates that have come out with that. Here's our expectations going forward. Here's the documentation platform and some videos that'll help here. but making sure that that gets rolled out to all the individuals is been a a s a supreme challenge.

Hilary Gates: Talk to us, Mike.

Mike Miller: Yeah, and Hutch, I wish I had all the answers for you here, right? But but I don't. And

Tim Hutchings: Yeah.

Mike Miller: I I think part of the challenge is it's it's an ever-evolving door, right? Just as you get certain preceptors up to speed, they retire, they get a different job, they go somewhere else, and now there's new people coming in. And so it's just a constant churn. And so I don't have a great answer. Well, one thing though that I do point out to programs and and try to bring up, oftentimes A program is not just the only program that's working with a multitude of ambulance services or hospitals and in those kinds of sites. So the other thing I try to tell programs to do, because we're all busy, work smarter, not harder. So if you can there there are oftentimes going to be commonalities about providing good feedback, right, to students and how preceptors should approach that. There's going to be general guidance about evaluation programs and maybe Are using the same tracking system in the same form. If that's the case and you have multiple programs in a community, share that responsibility. tag team it if you can in order to keep up with people. Now, there's going to be some program-specific items like who do you contact in an emergency, those kinds of things that are going to be unique, but when you can share or partner with some other program or programs in that responsibility, do so. We know of some places where all the programs in a state have a copy. Common preceptor training program that they deploy, and then they provide the program-specific pieces, the schedule, the cadence, when students can do certain things, who to contact in any emergency, and that those those kinds of things. And then one other point that I want to mention that I think fits in this particular category is that we oftentimes talk about the pro. programs doing a a lot of this training, right? And that's certainly great. And usually the clinical coordinator gets tagged with making sure that the students know how to use these systems and do them well. I would always look at my clinical coordinator and say, you know, when's the last time that you actually filled out the evaluation? When's the last time that you had to put stuff into your account for tracking and stuff? Who does that all the time? The students. We would bring in a panel of four or six students during orientation for field and clinical that just graduated from the program, that got really, really good at using whatever the systems were, documentation, the tracking system. and everything else and have them share their experiences with the students. They're much more likely to listen to it from them because they have a lived experience that's very recent compared to us that, you know, are sitting in offices all the time.

Hilary Gates: Go walk a mile in their shoes. That's such a

Maia Dorsett: Credit. Okay.

Hilary Gates: great piece of advice, Mike. Thank you.

Maia Dorsett: The last one is coordinate assignment of students to clinical and field internship sites. So What does this mean? How is this different? and what are some of the the challenges and best practices here? Mike, do you wanna go first?

Mike Miller: Sure. So you know One of the things that we we always try to recommend during the capstone field internship component is to limit the number of preceptors that are ultimately providing evaluation in supervision to the student. It's really difficult if they're getting handed off to different people every single shift for them to really know how they're progressing through that all-important bookend to the program. So I'm not saying that it only has to be one. That that is not a standard, but if you can limit it to one or two or maybe three people during that experience. Would strongly make that suggestion. The other thing is remember that the program has a responsibility to ensure that all of the students that need these experiences are meeting the educational objectives. So if a student decides that they're going to schedule with the same preceptor all the time, the same hospital all the time because they have a good rapport there, sometimes that means that they're missing out on certain aspects of those educational objectives, right? So If they're never scheduling a shift at the trauma center, that is where I think the clinical coordinator or whoever is in in charge of scheduling can make sure that those experiences are accessible to everybody. So sometimes you need to be the person, the mom, the dad, the uncle that is saying, No, you're gonna go here because we want you to get this experience, that you're not gonna get where you're at right now.

Tim Hutchings: Yeah, I think finding the the availability of spaces for enough students each semester is really, really important. taking the time to allow the students a variety of shifts to match their hectic schedules as well is is is going to be a big part of this. I know one of our b biggest challenges is space. we have our primary hospital that we work through is a teaching hospital also. So they're a lot of their time is is dedicated to their students who are paying to go there, which makes sense, right? You know, so the opportunity for our students gets less and less o over time. So the logistics of of finding the space for the students and enough opportunities for them throughout the year so that they do get that variety of experiences and they're seeing different people. is really important.

Maia Dorsett: I think that comes up for like special populations like pediatrics. You know, for a while, particularly like our our pediatric ED just had so many learners that we found a pediatric urgent care that was gonna take our learners and our students were able to see a lot of patients and actually do a lot of stuff going to the pediatric urgent care. and those are some of the required live contacts that you have, right? You can't simulate every single pediatric patient that you have. You have to have students and ex take care of or assess patients of all those different age groups. And so there is some creativity that sometimes comes into this of like where can I send the students so that they get this experience and and And there's some things that you're continually advocating for. Like our students still don't have OR time. I can't figure it out. I'm working on trying to get our students back into obstetrics because they got kind of fate pushed out because of teaching requirements. But there's a lot of advocacy and and challenge here.

Tim Hutchings: mentioned getting creative. One of the things that we've been I've been looking into is local daycares. The the Y offers

Hilary Gates: Exactly.

Tim Hutchings: a great opportunity and a lot of students or a lot of children there, so getting the kids in to see actual human patients who aren't sick, just being able to to coordinate with them has been a really fun challenge so far. So we'll see.

Hilary Gates: Hutch, I was gonna also I was reminded of my experience when I was teaching in the fire department and my fellow instructor was pregnant and when she had her baby, she was very excited to quickly bring that child into the classroom so that students who had never touched a baby in their lives and you know, especially understand how to do that, she was very comfortable with that. So a lot of times we're volunteering our own children and than our own family members. But that's that's one of the wonderful things about EMS, right? as we as we conclude this discussion on the role of the clinical coordinator, I want to thank of course Mike Miller and Tim Hutchings for joining us. But we always love to give them the last word and ask them to distill some advice or maybe maybe tell a story or an anecdote of of a something that's illustrative of of what they've experienced about this topic so that those who are listening can say, I'm gonna you know, press pause and take off out my headphones and go, you know, change the world based on what Hutch and Mike said to us today. So no pressure. Mike, let's start with you.

Mike Miller: Yeah, three three quick things. I think one of the most important things, and and Hutch mentioned this earlier, is to recognize the importance of relationships. Relationships with the facilities, relationships with the students, relationships with the preceptors. That's what these successful programs are all about. The the other stuff that's that's operational is certainly important, but I can't underscore the importance of of relationships throughout this process. The other thing is to just to advocate for programs to invest Resources in order to make your clinical educational component of your program just as successful as you've invested resources into simulation and lab space and classroom space and flipped classrooms and everything else that you're doing. don't just expect these programs to happen automatically. It's intentional that that they're good. And the last plug that I would make is recognize your preceptors if you can, somehow, some way. It could be an annual award, it's your certificate ceremony, graduation ceremony, whatever you have it. But do something in order to recognize the important contributions that they make to the program and the education of future clinicians.

Hilary Gates: That's terrific. Thank you, Mike, for your passion there. Hutch, over to you.

Tim Hutchings: Mike, I gotta say you're still one of my big ones, recognizing

Mike Miller: Mm.

Tim Hutchings: your preceptors. that is is so important to to recognize the hard work that they do because they they are often the unsung heroes of the program. You know, they're the ones dragging and and cr growing and and creating so much of what's happening throughout throughout the year. and I would say the the other big pointer that I have is don't be afraid to fail. Right. you you learn so much from those failures and and there's always an opportunity for yourself to grow. You're not gonna get it right the first year. It's going to take some time to to figure this out. So be patient, don't be afraid to fail and and have no fear. It it it takes a little bit of a gusto to walk into a a clinical site and say, Hey, I'm the new guy here, what's going on? And you know, you know, it's really, really important to build those relationships.

Hilary Gates: I want to thank Maya for showing the importance of relationships as she always does and elevating her own folks here and really bringing to the table the importance of of of grace and of humanity. and and Hutch and Mike, you embody that. So thank you for that. All of you who are listening, please be sure to like, follow, and subscribe on your podcast platform. Let us know what you're enjoying about the podcast. ask Ask us questions. we'll have contact information as well as resources in the show notes, of course. And we wanna thank you again for listening to the EMS Educator podcast. Bye for now.