This document provides guidance for instructors teaching the PHTLS (Prehospital Trauma Life Support) course. It discusses principles of adult learning, effective teaching methods like lecturing and skills demonstrations, and strategies for evaluation. The goal is to prepare instructors to enhance the teaching-learning experience through organized presentation of content, engagement of participants, and provision of feedback to improve trauma management skills.
63. Prepared, enthusiastic instructors create a positive, enjoyable environment for the teaching – learning transaction.
Notas del editor
Instructor Notes: Introduce yourself if not previously done.
Key Points: Lesson presents basic, but important, information
Key Points: All learning occurs through experience Reflection on experience allows us to associate meaning with the experience Understanding learning is essential to good instruction
Key Points: Teaching is about the participants’ learning Definitions provide a framework for the instructor’s role
Key Points: Teaching only occurs in the interest of learning Learning and teaching are intertwined Teaching-learning transaction requires active participation by instructor and course participants
Key Points: An activity may include learning in all three domains There are levels, from simple to complex, within each domain Successful learning and teaching proceed from simpler levels to complex levels
Key Points: Knowledge : basic recall of facts, such as defining shock Comprehension : attaching meaning to knowledge, such as understanding that shock is a life threatening condition, as opposed to just being able to define it Application : using information to solve problems, such as initiating rapid transport as a result of knowing that uncontrolled hemorrhage quickly leads to death Analysis: Taking a whole and breaking it down into its component parts, such as starting with the concept of shock, and then explaining how hypoperfusion and anabolic metabolism lead to cell, tissue, organ, and organism death Synthesis : Putting together a big picture from individual parts, such as using the physical exam findings to arrive at a conclusion about a patient’s condition Evaluation : The ability to judge something according to principles, such as determining the necessity and feasibility of air medical transport, or evaluating one’s own performance on a call
Key Points: Imitation : performing a skill as it was demonstrated, e.g., rapid extrication Manipulation : adapting the skill to one’s own style Precision : the skill has been practiced until it is “second nature” Articulation : the skill is combined in sequence with other skills; e.g., auscultation of breath sounds becomes part of patient assessment Naturalization: the skill is used in different settings or contexts; using a realistic context for teaching enhances naturalization; e.g., using actual crashed vehicles for teaching rapid extrication rather than simulating a vehicle
Key Points: The best way to teach is through role modeling Receiving, responding, valuing, organization, characterization Affective components are taught along with cognitive and psychomotor knowledge, largely by the way of perceptions of the instructor’s attitude toward the knowledge and skills being presented Receiving : willingness to attend to stimuli; e.g., a participant demonstrates receiving by coming to class Responding: interacting with the situation; e.g., a participant begins to ask questions about PHTLS Valuing: believing in the importance or worth of a concept; e.g., a participant tells someone else that PHTLS is an important course for improving prehospital care of the trauma patient Organization: the value is integrated into the person’s system of values and is prioritized among them; e.g., the participant believes in saving both life and limb, but makes the appropriate choice when necessary Characterization: the attitude is pervasive and demonstrated consistently; e.g., the EMT-B who never fails to check his equipment at the beginning of a shift Slide 10: Affective Domain Levels Content: The best way to teach is through role modeling Receiving, responding, valuing, organization, characterization Supporting Points: Affective components are taught along with cognitive & psychomotor knowledge, largely by the way of perceptions of the instructor’s attitude toward the knowledge and skills being presented Receiving: willingness to attend to stimuli, e.g., a participant demonstrates receiving by coming to class Responding: interacting with the situation, e.g., a participant begins to ask questions about PHTLS Valuing: believing in the importance or worth of a concept, e.g., a participant tells someone else that PHTLS is an important course for improving prehospital care of the trauma patient Organization: the value is integrated into the person’s system of values & is prioritized among them, e.g., the participant believes in saving both life and limb, but makes the appropriate choice when necessary Characterization: the attitude is pervasive and demonstrated consistently, e.g., the EMT-B who never fails to check his equipment at the beginning of a shift Notes:
Key Points: An individual cannot learn until he/she believes what is to be learned has an important purpose — to himself or herself — and until he/she recognizes what it is he/she doesn’t know
Key Points: Everyone can learn using a variety of approaches but prefers to learn one way more than others and probably learns better that way.
Key Points: One way to categorize learning styles is through sensory or perceptual modalities, or “AVK” The auditory learner prefers to listen to lecture and engage in discussion The visual learner prefers to read, study diagrams, and watch presentations The kinesthetic learner prefers to learn by touching and manipulating equipment
Key Points The left and right hemispheres function differently, but in a complimentary manner to each other Differences are more pronounced in youth, but become less prominent as we age and gain experiences in activities that require the skills of the nondominant hemisphere
Key Points: Adults and children learn in the same ways, but adults have different needs and characteristics that must be appealed to in order to create a learning environment Adults are motivated to learn when they understand why the information or skill is important to them Adults need to be self-directing, e.g., need an opportunity to ask questions that are of interest to them Adults have experiences, which can act as a foundation for further learning, or if what is being taught conflicts with previous experience, such experience may become a barrier to learning
Key Points: The teaching-learning transaction is directed at filling the participant’s gap in knowledge
Key Points: Everyone has or will develop their own style of presenting information
Key Points: The PHTLS case-based lessons have been carefully created to bring out specific discussion points The lesson plans provide key questions to ask participants, allowing assessment of participant knowledge and providing an engaging learning experience The lesson plans appear both in the PowerPoint speaker notes and the printed Instructor’s Manual
Key Points: Instructors can write notes on the printed lesson plans, including other questions that will stimulate discussion
Key Points: PowerPoint notes can be printed out or, if your computer allows, viewed on the computer screen as the presentation is projected to the audience
Key Points: If possible, meet and talk to a few people in the course before your lecture; it will give you a few friendly faces to focus on in the audience Ask questions; generate discussion No one knows everything Eye contact shows confidence in yourself and your knowledge of the topic Be aware of mannerisms, habits, extraneous noise
Key Points: Give about 8 seconds to answer “ I’d like to hear what someone else has to say on the topic.” Ask the participant to repeat what was said for emphasis: “Did everyone hear that? Mark, could you please repeat what you just said?” Or, rephrase the response for emphasis
Key Points: The participants must have enough information to answer and must know in what context you are asking the question Try rephrasing the question
Key Points: Examples for each stem Can you give me an example of a situation that would call for rapid extrication? What do you mean by “going down the tube”? Could you be more specific? What would be the consequences for the patient with on-going hemorrhage if we stayed on the scene to start IVs? What would we have to assume in order to rely on air transportation for this patient? What are some other possible causes of absent breath sounds on one side of the chest?
Key Points: Examples for each stem How do you know that auscultating the chest prior to rapid extrication is right? If you had the situation to do over, would you make the same decisions? Why/why not? Why do you say that splinting extremities is not a priority for this patient?
Key Points: Sufficient lighting allows you to see your notes; most lecterns have a reading lamp Don’t read from your notes, but do use them to keep on track and make important points
Key Points:
Key Points: The more realistic the setting of practice, the more likely the skills will be transferred to the real world Participants must know the rationale and context of the skill to understand its importance and application
Key Points: Seeing the big picture allows the learner to place the steps in context and to understand the importance of the steps to the final result Demonstrating the skill in real time gives an overview Demonstrating and discussing each step provides analysis Putting the steps together in a real-time demonstration provides synthesis Videos allow for consistency from instructor to instructor
Key Points: Learning occurs in stages from simple to complex Automatization : the knowledge of the steps of the skill become tacit (can perform the task without thinking about how to do it) Generalization: the skill is adapted for use in various situations
Key Points: Skills instructors sometimes stray from the purpose of the skills station; individuals who are able to stay on task and heed the rotation schedule will do well with these stations Participants will have seen a video skills demonstration prior to the rotation; instructors must be familiar with these videos The emphasis is on participants doing the skills, not talking through them
Key Points: Having to improvise when equipment doesn’t work or is missing takes the focus away from learning If resources allow, acting or talent agencies in your area often have “starving actors” who will work inexpensively and usually do a great job of acting out the parts Provide a safe environment
Key Points: Demonstrate the skill: whole-part-whole Correct errors immediately so they are not reinforced through practice
Key Points: The PHTLS card indicates successful completion of the PHTLS program Successful performance on written and practical evaluations
Key Points: Process increases validity of exam as an instrument to measure course learning Instructor Notes: Many instructors call the table of exam specifications a “test blueprint “
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Key Points: Additional information on final assessments is presented separately
Key Points: A major obstacle to practical exam validity, and thus the meaning we can attribute to practical evaluations, is reliability — both inter-rater reliability and intra-rater reliability
Key Points:
Key Points: We are interested in principles of trauma care above preferences for employing the principles in specific ways. For example, there are principles of securing patients to a long backboard. As long as the principles are applied, the exact configuration of the straps does not matter — it is a preference If you believe participants are doing something wrong, ask yourself, “Is this a problem with principles or preferences?”
Instructor Notes: Distribute final evaluation forms Instruct participants to view the video as if they were viewing an actual final evaluation performance and to use the evaluation form to rate the performance Play the video Discuss how the participants rated on each criterion and what their rationales were; promote critical discussion of principles and preferences
Key Points: Cognitive — knowing what Psychomotor — knowing how Affective — valuing learning
Key Points: Instructors must ask questions to stimulate reflection Simple to complex organization of material, “natural” sequence Drawing on and using the experiences of participants
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