Training my medics

[KoKoOnaJo]

My medics are very green. They are young puppies in life and newborn puppies in medicine. Most are motivated to learn, at worst some are not motivated and actively cut corners.

I’ve taught them BOLDCAAARTS and how to take a history. They’re Dx are lacking, the written note is MS1-2 level.

Does anyone have any advice how to train them?
And links to useful diadic material?

I’m worrries when they go out to support unit functions…like what are they really doing????

-Very worried

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[DMBandFan86]

They are taught to stop bleeding, apply tourniquets, place IV, esophageal intubate, apply blanket, CPR. Many aren’t all that good at it after training. If you’re talking reserves, many don’t even work in medicine and only do a little practice each year.

I’d focus on mastering the basics for the E1-E3 and starting to add in higher level stuff for higher ranks or motivated soldiers. but you haven’t said what kind of unit you have and what you hope your medics can do.

 

[DeadCactus]

There's not a lot of details here but I worry you have unrealistic expectations. Writing notes at the medical student level and being bad at diagnosis seem like odd criticisms. I would skim through an EMT book to get an idea of the level they are supposed to operate on.

 

[Fluidity of Movement]

EMT-B level, plus special training for combat injuries / emergency surgeries. It's supposed to be a grunt position until you hear your callsign in the field. They've pivoted to "healthcare specialist" since there aren't a huge need for combat medics and nurses are expensive.

Writing notes at medical school level sounds like a HUGE compliment. Any level of diagnostic ability beyond "he's shot!" also a huge plus.

It sounds like you have some capable Whiskeys on your hands!

 

[DrMetal]

Writing notes at

I'm hardly good at writing notes as a trained internist. Ours notes/documentation have become an abomination.

 

[pgg]

My medics are very green. They are young puppies in life and newborn puppies in medicine. Most are motivated to learn, at worst some are not motivated and actively cut corners.

I’ve taught them BOLDCAAARTS and how to take a history. They’re Dx are lacking, the written note is MS1-2 level.

Does anyone have any advice how to train them?
And links to useful diadic material?

I’m worrries when they go out to support unit functions…like what are they really doing????

-Very worried

Dude

First, WTF is BOLDCAAARTS?

Second, they're high school grads who got a few weeks of medical training. Some of them will be brilliant and hungry. Some will have trouble remembering to put socks on before boots.

You're a doctor, and it took you 8 years of post-high-school education and a year of internship to develop adequate diagnostic and exam abilities that aren't sufficient to legally practice independently in most states[1] and you think you can teach them to come up with a good differential, and write notes better than medical students?

You've got some wildly unrealistic expectations.

They need the skills and knowledge to be first responder trauma managers in the field. As far as sick call and medical complaints go, cover some rudimentary basics like URIs and derm, and help them make the sick-or-not-sick call that would warrant immediate referral to a more qualified person, vs eventual referral to a more qualified person.

In a supervised setting, there's value in training them to take vitals, get a basic chief complaint, maybe even ask some focused questions there, and bring you a skeletonized SO part of a SOAP note. If they can consistently do that, gold.

EMT level knowledge and care is an attainable but probably optimistic goal. Training materials beyond what they already have? Maybe get some EMT course manuals and start with that as step 1.

Step 0, recalibrate what you expect them to be able to do, and what you count on them to do. You really can't offload your job to them.


[1] most states require two years of GME to obtain a state license

 

[DrMetal]

Dude

First, WTF is BOLDCAAARTS?

Probably another douchey mnemonic that we love to teach, b/c we love to teach in medicine using mnemonics instead of logical thinking.

It's an interesting phenomena we see in the new GMO, the "hero" complex, where he thinks he's the ultimate in medical authority and teaching, and all his subordinates must follow his suit. It's our own fault for putting them in such positions. And of course their expectations of their enlisted are very skewed. What's worse is when the GMO gets "very worried" and "very stressed" about it all. It's not good for their own mental health.

A wise Chief once said to me: "Sir, they're junior corpsman: pretend like you're playing basketball with mentally-challenged kids. If you call 'em out for double dribble and traveling on every play, you'll never finish the game."

 

[Onefellswoop87]

1st Google hit:
Bold Carts (only 1 A): “premium” vape materials

BOLD Premium vape hardware- cartridges-batteries for plant based oil extracts

BOLD manufactures premium vape cartridges, batteries and hardware for plant based oil extracts, designed to provide a smooth and reliable vaping experience for premium extracts. BOLD technology combines quality, durability and innovation in its vape hardware to support the plant based oil extract

boldcarts.com

OLDCARTS is a medical mnemonic (but no B and still only 1 A). I have no idea what you are trying to teach your medics

 

[DMBandFan86]

Let’s not overshort the training. Unless something has recently changed, they get 8 weeks to become an NR-EMT (must pass) and then 8 weeks to apply that training as a combat medic. That’s about 4 months of medic training. They actually learn skills above a basic EMT.

As far as note writing, they learn only very basic SOAP notes and filling out combat casualty cards. OPQRSTE was the pneumonic they used to learn. They also spend weeks practicing calling in 9 lines. But realize they haven’t seen any actual patients before.

68W’s don’t learn anything about medications. They also aren’t diagnosticians and you really shouldn’t want them to be.

Does anyone have any advice how to train them?

Find out what your medics know. Have realistic expectations. Train them for the role they serve (not the PA level you seemed to imply).

The next level for an EMT is to become a paramedic. Which is a ton more training. So maybe read some paramedic stuff and occasionally incorporate that into the higher level training sessions.

They also used to train up some 68W to add on a M6. That’s also quite a bit more training. That could add some LPN training to your medics. So maybe learn about some LPN training to apply to a select few of your medics who are interested in nursing.

But the bread and butter 68w skills is where you should focus your efforts. And that is combat casualty care (mostly trauma care), transportation, and wartime evacuations.

 

[KoKoOnaJo]

I lol’ed a bit. But Thank you for helping me put it into perspective.