Building Medics Who Think When Everything Goes Wrong

Chaos does not automatically break people. Sometimes it reveals who they are. We sit down with Malinda Whipple, program director of the Utah Tech University EMS program, to unpack what makes a great medic when the scene is loud, the patient is crashing, and the “right answer” is not sitting on a slide. We talk candidly about critical thinking in EMS, why judgment matters more than trivia, and how training has to match the reality of the street.

We also go deeper than tactics. A lot of people drawn to emergency medical services, fire, law enforcement, and the military carry a history of trauma or chronic stress. Malinda shares how that background can shape focus, stress responses, and even career fit. We get honest about the question every instructor wrestles with: are 18-year-olds ready for death, pediatric arrests, and the kinds of calls that mature you overnight? The answer is not a simple yes or no, and we explore the nuance without sugarcoating the cost.

If you care about EMS training, paramedic school, or building confident EMTs who can think under pressure, this one is for you. Subscribe, share it with your crew, and leave a review so more people find the conversation.

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0:00 Welcome and Intro
7:46 Are Young EMTs Ready For Death
14:43 Why EMT Training Helps Everyone
17:39 The Wild West Of Early Paramedics
23:58 Leaving The Field Then Coming Back
26:40 Fixing The Program Without PowerPoint
29:19 Flipped Classroom With Sticks Of Fate
37:43 Choosing Paramedic School And Prereqs

Transcript

SPEAKER_06 0:00

The critical thinking aspect of something that's so important as you know in the field, if you can't critical think, you're you're you're game of you're worthless. And my theory is that I've been teaching a long time and I get bored easily and then back to the whole ADHD thing, right? If my instructors are bored, the students are gonna be bored. And I have people like Brennan that are super dynamic, super animated, cannot pay attention with the shit, right? I'm surprised he's been focused this long. But a lot of people that are attracted to EMS, military, police fire come from backgrounds of trauma. As I meet with students and get to know them, you know, a lot of them do come from trauma. And so it's really interesting because at first, like, yeah, nothing really exciting ever happens to me. And then you start talking to them, and it's like, oh, you know, I can kind of see the catalyst that has made it so that you can handle seeing those days.

SPEAKER_04 0:46

Yeah, and brought them to that point. Yeah.

SPEAKER_06 0:48

I mean, it doesn't mean it doesn't mess you up. I mean, we're all messed up.

SPEAKER_05 0:51

Yeah, or that you'll even fit in EMS. You can be exposed first things, and then you get re-exposed and it's triggering for whatever reason, and yeah, it's not the right career for you, but I think more often than not, it prepares you better to process that and handle it when you do inevitably come across it.

SPEAKER_06 1:06

Oh, for sure.

SPEAKER_02 1:20

Welcome back to another episode of the Spiked Out Podcast. Uh with Brennan and Brennan, Tyler, and then we have Melinda on today. Thanks for coming on.

SPEAKER_06 1:30

Thanks. Thanks for having me.

SPEAKER_02 1:31

Yeah. Uh so Melinda and I met. I came through your paramedic program back in 2020, the COVID year. It was the best year.

SPEAKER_06 1:40

I want to forget about that year. So you were me too. You were his teacher. I was his teacher, and I lived to tell about it.

SPEAKER_03 1:46

I lived to tell. We're gonna learn something. Yeah, yeah.

SPEAKER_02 1:49

Uh just as a quick background before you kind of give it yourself, Melinda Whipple is the program director for the Utah Tech University EMS program. And you've been doing it now for since 2019?

SPEAKER_06 2:01

Yeah, full time since 2019.

SPEAKER_02 2:03

And then before that, you had a long career in EMS as a paramedic.

SPEAKER_06 2:08

Correct.

SPEAKER_02 2:08

Yeah. I mean, if you just want to take the next two minutes and kind of give us what your background is.

SPEAKER_06 2:12

Sure. Yeah. So I became an EMT in 1991. So before all you guys were born, I know. I don't want okay. All right. So Brennan was here. Um, I literally had braces and a training bra. Like I was so young. I have like my pictures are hilarious. And I was like repping like the 1980s hair. I mean, it was 91 in Utah. So we're a little behind. Oh, yeah. A lot of volume. Big hair. Yeah, tons of volume, tons of aqua nit. Yeah. Yeah. Super young. I'd been out of high school like a year or so when I went through the EMT class. Really kind of struggled with school. I was I was a solid C student. C's get degrees. C well, yeah, barely. I mean, thank heavens for PE.

SPEAKER_05 2:55

You know, like kept that GPA.

SPEAKER_06 2:57

Right. Yeah. Like it kept me at like a 2.0. So uh yeah, I I I struggled in school, uh, went to college, graduated when I was 17 uh from high school. Uh went to college. Uh really just I don't know. I was kind of lost. Um, you know, at the time ADHD wasn't really like a thing. We didn't really know anything about it. And so I just kind of I had crappy study skills, uh, little understanding of who I was. Um my dad was actually the attorney for a private ambulance company here in town and said, Hey, they're having an open house, you ought to go check it out. Uh, they just moved into their new station. And so I showed up, took a tour, and signed up for the EMT class, and uh was immediately hooked. Like I had found my people.

SPEAKER_02 3:44

Um You guys have ADHD too. I know.

SPEAKER_06 3:47

I was like, oh my gosh, like there's people like me that can't sit still and have like really like sarcasm and dark humor and you know, maybe a little irreverent about life. Yeah. So I was like, hey, I found my people and uh started running ambulance at age 18 and uh went through paramedics or became an advanced CMT. Um, oh, one thing that was interesting, and this will probably interest your readers or your listeners, is that um, you know, I told you like I'd always struggled through school, always struggled. I got the second highest score in the state ever on my practical exam. And I'm not saying that to brag. I'm just saying, like, like if you struggle in school, if you struggle not understanding things, it's not because you're stupid, it's because you're probably in the wrong field. Yeah, you're not passionate about it. Yeah, I wasn't passionate about it. I didn't, it it wasn't something that clicked with me. And so um, yeah, that was like a real like I was completely shocked. Like I couldn't even wrap my brain around like how did I do so well? Um, so I ran Amulence for two years, then I went through the advanced DMT course, ran as an advanced for a few more years, and then I went through paramedic school. Um, that was you're gonna hear like all the mom stories, but I was breastfeeding a newborn. Well, I was in paramedic school, that was pretty tough. I had a five-year-old and a newborn. Um, but I knew life wasn't gonna get any easier. My kids were gonna get busier. Uh, went through the paramedic program lots and lots of hours, as Brennan can tell you. Um, lots of sleepless nights, long shifts, 24, 36 hour shifts.

SPEAKER_05 5:18

Where were you at at that time when I was here in St.

SPEAKER_06 5:21

George?

SPEAKER_05 5:21

Okay.

SPEAKER_06 5:22

Yeah. I was here in St. George. I went to Dixie, then Dixie College. Um nice thing about the program then is we had uh clinicals in Las Vegas who are down at a level one trauma center, had a lot of experience that way. Um, beautiful thing about the area here in St. George, and it's still this way to some degree, is that we I got a lot of experience in rural medicine because we had really long transport times. You'd be hiking for miles and miles to find your patient, you know, predated the cell phones and GPS. So you didn't always know.

SPEAKER_05 5:51

You still got map quests and like directions to turn right at the road.

SPEAKER_06 5:55

Okay, this is like before the internet. Okay. Like we were like the Fred Flintstone, like, you know, like running the um but yeah, so uh anyway, yeah, went through paramedic school and then ran as a medic for about 20 years or about 20 years total on the ambulance. And yeah, I've got the back pain to prove it. So yeah, yeah.

SPEAKER_05 6:15

That long end and it's it's funny you mentioned the the school thing because it was very similar for me in high school. I wasn't a very good student, then did the Marine Corps, got out and tried to go back to engineering school, and it was the same shit. I just couldn't focus, wasn't passionate about it, did bad. But then when I did EMT in paramedic school, 4.0. Like you just you gotta find something you like doing, and it makes a world of difference for school.

SPEAKER_06 6:37

Yeah, it's crazy. And like we have parents, like I've I've actually received a uh a letter from a student who's or from their parents, who a student from Alaska, and his parents wrote me the nicest letter, and they're like, he always thought he was dumb. He grew up thought he, you know, thinking he was dumb. And I'm like, that is like so awesome for me. Like that's so fulfilling for me to take kids that were like me that that kind of got treated like slackers, you know.

SPEAKER_05 7:04

I mean, I was pushing the side.

SPEAKER_06 7:06

Yeah, and and and that they get in there and they excel, you know, and one of the things that's interesting about our about people with ADHD or that are neurodivergent in in any realm is that when it comes to having a lot of stimuli, they can focus really, really well, you know. So you get on scene, and as you know, you know, you're cutting a patient out of a car and and there's people yelling and the patients screaming and and people are talking and there's a lot going on, and if you've got bystanders and maybe the media, and there's things, and and you can just hone in, and that's a super skill. Yeah, you know, that's that's your superpower. And so, you know, really being able to channel that is is a gift.

SPEAKER_00 7:45

Absolutely. I have a question, uh, something I've always thought about. Uh do you think 18-year-olds are ready for all those things you just said? Trauma, death, chaotic scenes. Obviously, 18-year-olds can join the military, but I think they more so know what they're getting into doing that. Whereas I've taught some EMT classes and you see some very young faces, and just like, man, I don't know if that person's gonna keep their composure when it's going down.

SPEAKER_06 8:15

Yeah, I I you know, when you first asked that question, my first impulse is absolutely not.

SPEAKER_02 8:20

I mean, you've had 18-year-olds and you know what? Can we swear on this podcast?

SPEAKER_06 8:24

Yes, yeah, okay, because you don't know your ass from a hole in the ground, right? You really don't when you're 18. Um, you know, my it was interesting, my first patient was a a trauma one patient. She was uh she was ejected from a vehicle on I-15 just south of Leeds and uh uh unconscious, combative. She was decorticate posturing, and um, you know, we had her trauma naked on a backboard and going to the hospital. I'm looking at this girl who's my age, you know, dying, like literally right in front of us. And that was that was that was kind of crazy. That was kind of crazy. Um, you know, just I guess a little bit to go to my backstory a little bit is that um my sister had cancer when she was 16, I was 14, and she went through a year of chemotherapy, and uh her cancer was advanced enough that that it was pretty aggressive and and um really, really brutal. And they would sedate her quite heavily just so that she could tolerate the chemotherapy. And she would uh lay on the couch outside um in the in the room outside my parents' bedroom, uh, just so that they could be right there to help her. And I would just sit on the floor um next to her, laying on the couch, and I would just watch her breathe all night long because I was so afraid she'd stop breathing.

SPEAKER_05 9:45

Well, and chemo back then was a whole different ballgame. Yeah, it's it was brutal. Yeah. I mean, it was I mean it still is. Tyler can attest to some of it.

SPEAKER_06 9:53

But I mean it is, but that you know, they'd give enough to kill a rhinoceros. And and you know, she'd just be vomiting or stomach lining, and I'd be with her all night long. And and I and I learned very early on that that was something that I could handle. And so kind of back to your question, yes and no. I mean, I think that um that yeah, you can no, we're not prepared because we we're stupid when we're 18. Um just no experience.

SPEAKER_05 10:23

And no experience, just no life experience.

SPEAKER_06 10:25

However, I think that there were things in life that had kind of prepared me for that. And um, I don't know if you guys have ever read The Body Keeps the Score, um, but it it there talks a lot about the military and about um PTSD, and it talks about how, you know, your body just basically tracks and internalizes all these things that have happened to you in your life. Um and it's interesting, you know, coming from trauma and and other um, you know, my mom had a had was a cancer survivor as well, had some very serious health problems uh as a result of that. And so being kind of growing up in a kind of a traumatic household where things were so severely disrupted, um really kind of prepared me for that. And and you learn in that book, The Body Keeps the Score, uh, where a lot of people that are attracted to EMS, military, police fire come from backgrounds of trauma. And so um our amygdala is damaged. And um, if we when they do functional MRIs, they find that it takes trauma for us to fire at a normal level, um, for our brains to fire at the same level as it would with somebody who hasn't experienced trauma before. And as you know, we feel more alive, you know, when our pants are on fire. You know, that's when we truly feel like we're alive. And so, um, so it's interesting as, you know, I as I meet with students and and get to know them over the course of their uh time and training, you know, a lot of them do come from trauma, you know, whether it's sexual abuse, physical abuse, whether it comes from um having a sibling or a parent die, um, having um witnessing a traumatic event um or being involved in a traumatic event themselves, whether it's, you know, a car accident or or you know, a serious trauma of some sort. Um, a lot of them do come from from something like that. And so it's really interesting because at first, like, yeah, I'm you know, nothing really exciting ever happens to me. And then you start talking to them, and it's like, oh, you know, I can kind of see the catalyst that has has made it so that you can handle seeing those things.

SPEAKER_04 12:31

Yeah, and brought them to that point.

SPEAKER_05 12:33

Yeah. Yeah.

SPEAKER_06 12:33

I mean, it doesn't mean it doesn't mess you up. I mean, we're all we're all messed up.

SPEAKER_05 12:37

Yeah, or that you'll even fit in EMS. So you can be exposed to those things, and then you get re-exposed and it's triggering for whatever reason, and yeah, it's not the right, right career for you. But I think more often than not, it prepares you better to process that and handle it when you do inevitably come across it.

SPEAKER_06 12:53

Oh, for sure. I would agree a hundred percent.

SPEAKER_02 12:55

And you grow. I think you know, we had uh JJ in my class, and after paramedic school, he went out to Kansas City on a contract for six months. And when he got back, we went out to lunch just to catch up. And uh I think JJ was 21 when he came through. And he very specifically told me about this incident where some lady came out with her kid, because it was, I think it was like a nine-month-old, right? Just crumping, like no airway, no nothing. And she puts it in JJ's arms, and JJ's like, uh, I don't know what to do.

unknown 13:25

Yeah.

SPEAKER_02 13:26

That bird's Pete's call, really. It's like you're jumping into the deep end of the pool. And he's like, I'm 21. Why am I being entrusted with this to get this dying kid to a provider? Like, this is wild. So I think you do have those sobering experiences very early on if you're coming into EMS at a very young age. You mature very rapidly, I think, than a lot of other people in your peer group at that same age in other professions. Your first PEED, your first cardiac arrest, the first deep, you know, your first ejection out of a vehicle or like suicide. You know, all those calls are the ones that you're just like, oh.

SPEAKER_00 14:02

I think if you are new and you are serious about this and you want to get into it, because we see a lot of people get their EMT to do wildland fire and they come with no experience. I think you need to go jump into the deep end of the pool, take a contract somewhere exotic, or get the level one trauma experience you had to one, see if it's for you, and then if or once it is for you, you only get good at this by getting reps and making mistakes, and like I'm not gonna do that one again. Um and wild and fire austere environment is not the place to make mistakes.

SPEAKER_05 14:40

Frequency can happen. Yeah.

SPEAKER_06 14:42

Well, it's interesting that you mention mentioned the EMT because I really think every adult should be certified as an EMT. Yeah. I mean, if especially, I mean, when you're looking at wildland, but you're looking at, you know, emergent situations where things happen. But you know, if you're a climber, a hiker, or uh, an athlete, or if you like the outdoors, or if you plan on having children or or living in society, you're gonna involve you're gonna encounter people in emergent situations. And just having that EMT training is so valuable.

SPEAKER_07 15:12

Yep.

SPEAKER_06 15:12

You know, I don't I I can't think of an adult that I've met that has never encountered a medical emergency in some capacity. And just to have, you know, that base knowledge is so valuable.

SPEAKER_00 15:24

Yeah. One time I was driving home uh and I just see a mass of people at this intersection, and I it looked like a medical emergency, and I ran up there, and a lady just been hit on her bicycle by a car, her helmet was off, she was decorative posturing, and no one was doing anything. No one knew what to do. Uh, I did, so I hopped in, and then all of a sudden someone else comes over my shoulder, EMT showed up, uh, another guy hopped over my shoulder. He's like, I'm a doctor. I'm like, all right, cool. I'm like doing a trauma assessment. I pretty laid back and just started talking to the doc. Hey, you know, what do you what kind of doctor are you? He's like, I'm an optometrist. I was waiting for dentists. Um glad to have him, but also I wish he said ER doc at the same time. Yeah. So I could have been like, all right, what are we doing? Yeah. You charge, take charge. Yeah. Um, I love a good EMS story when or when you talk to someone who why did you get into EMS? And then they had something like I saw a car accident or something like that, and then that prompted them to get into EMS. I'm sure you've had quite a few students come through that had that.

SPEAKER_06 16:42

Yeah. Yeah. I mean, students will tell us things like, um, you know, like there was a farming accident and I didn't know what to do. Or um, you know, my sibling was involved in a car accident and or we were involved in a car accident. My sibling was critically injured and and none of us knew what to do. There was no help. And a lot of times it comes from a feeling of helplessness as well. And so they say, Well, I wanna, you know, I don't ever want to feel helpless again. I don't ever want to feel helpless. And and and it's empowering the more knowledge you gain. But I also think, and and maybe you guys have experienced this, is that sometimes the more you learn, the more you realize how much you don't know.

SPEAKER_05 17:23

Oh, 100%. And it's like it goes for everything. Yeah, medicine.

SPEAKER_06 17:27

Yeah. And you know, I'm like, man, I'm so freaking smart. And then it's like you start to learn more, and then you're like, I am I am so dumb.

SPEAKER_01 17:34

I am so dumb. It's just a fact I've accepted about my life.

SPEAKER_00 17:39

When you started EMT, did you know you were gonna become a paramedic, or did you take it step by step? All right, I'm gonna try my advanced, sink into that. Okay, I think I'm ready to be a medic. Sounds like you kind of took your time getting there.

SPEAKER_06 17:51

Yeah. So at the time there weren't any paramedics in southern Utah. So Salt Lake City fire was the only ones in the state that had paramedic service.

SPEAKER_07 18:00

Wow.

SPEAKER_06 18:00

So paramedicine was fairly new to to I mean, it was still, I mean, okay, this is the early 90s. So I mean, the first paramedic program was in like what 1977 or something. I mean, so we're not I mean, not too far out. Paramedicine's still in its infancy.

SPEAKER_01 18:16

Yeah, right.

SPEAKER_06 18:16

I mean, this the white paper was written in 66. That's when EMS started. So I'm I'm really aging myself. Um but honestly, I didn't have the self-confidence because I was so I did so poorly in school and I still just didn't really have the confidence. It's not like I graduated with my EMT and was like, oh my gosh, this is so great. Like I had found my people, I had found my niche, but I still didn't have the confidence to to say, yeah, I'm gonna, you know, be a paramedic or I'm gonna do whatever. Um, and again, like paramedicine wasn't really in southern Utah yet. Um, but yeah, I ran for about two years, did my advanced, and then um I think I was in the second paramedic class in southern Utah that it come. So yeah, it was second or third class.

SPEAKER_05 19:04

Of course, like back then versus what it's turned into and what you've helped build today.

SPEAKER_06 19:10

It was a little bit like the Wild West, just because paramedicine was still again so new, it was being developed. We um didn't have a lot of um the parameters weren't as clear as they are now.

SPEAKER_05 19:23

Um like with the protocols and things like that.

SPEAKER_06 19:25

With the protocols, yeah, protocols and skills. Um our skill set was was broader in some areas than it is now um just because nothing had really been decided as far as like what could what what can paramedics do and what can they not do. Um you know, we were taught pericardiocentesis and and different things like that that that aren't in a general scope of practice anymore. Um so yeah, I I would say it was definitely more I wouldn't say lax because I was trained by her name is Betty Wallace and she was a 90-pound army nurse, and we were all terrified of her, like absolutely terrified. Nobody crossed Betty Wallace. Like I worked with her in the emergency department um uh on the night shift, and so she and I got to spend a lot of time together, and then she was the director when I went through paramedic school, and so she ran a pretty tight ship as far as that went. But and so she had very high expectations of what she expected of us. Um, but there it was really there were a lot of loose ends. There it wasn't really structured the way it is now. So um had a lot of great experiences. We had such a large uh service area that um we we we just had uh we had really high call volume, even though the community, the St. George community was still very small, but because our service area was so large, we actually ran, you know, 10, 12 calls a day sometimes.

SPEAKER_02 20:59

Yeah.

SPEAKER_06 20:59

So we were busy.

SPEAKER_02 21:02

Yeah. Trying to imagine what that would be like down here. Yeah, so we ran so large now.

SPEAKER_06 21:07

Yeah, I mean, we ran all the way down I-15 gorged into Arizona. We ran um Old 91 into Nevada, um, and we ran in Nevada, even though we weren't licensed in Nevada because people would people would drive all the way into Gunlock and call 911. Well, they didn't know where the wreck had happened. They were so I mean they were like, let's just out that way. And so we would drive. Yeah, and they would say that, and then we'd we'd keep going and end up almost in mesquite before we'd find the patient. And so then we ran up SR18 all the way up to Central. And then we ran uh we had all of Washington County except for hurricane. Yeah. So we ran up into Leeds and up to I think Mile Marker 24 up into Leeds. So we had a we had a huge service area.

SPEAKER_02 21:55

Yeah, that's impressive. You know, when I think about uh like just kind of like your immediate family, like your Whole family has been first responders. I mean, your husband spent how many years at the sheriff's department down here?

SPEAKER_06 22:05

So he started in law enforcement, uh, spent 30 years total in public safety. Yeah. Did uh became went to bomb school in uh 96 and functioned as the bomb squad commander for many, many years. Uh switched over to fire department, retired as a captain there, then went back into emergency management for Washington County.

SPEAKER_02 22:28

Those were the best field trips in paramedic school, going out and getting to blow stuff up.

SPEAKER_06 22:31

Blowing stuff up.

SPEAKER_05 22:35

Yeah, I don't, right? Come to Utah Tech. Yeah.

SPEAKER_06 22:37

It's big boys and their big toys. You know, we yeah, we actually had an ambulance donated to us that was a total piece of shit. And um the FBI, because my husband uh was did uh taught for the FBI as well, and uh they they were coming to do a large vehicle bomb class, and so we drove the ambulance out in the middle of the desert and they blew it up with 300 pounds of amphibio.

SPEAKER_05 23:03

Oh, that'd be so good. So you've only taken your fax or copying machine out into the field and beating it with a bat.

SPEAKER_02 23:09

Exactly. Which is different. And now you've got your son working for Hurricane Valley. Yes, you've got a daughter who's a cop, uh, and she's out at Santa Clara. Santa Clara Ivans. And then your youngest son is now doing wildland fire with Santa Clara Ivans as well.

SPEAKER_06 23:23

Yeah.

SPEAKER_02 23:24

I mean, you I feel like you guys might have had just a little bit of an influence on your kids.

SPEAKER_06 23:28

Yeah. Well, our oldest daughter, she's so traumatized by our career that she went and got an MBA and she she works at the for the legal team of Inner Mount uh Inner Mountain. Yeah. She's like, I'm out. Like you people are all crazy.

SPEAKER_02 23:41

The black sheep now, actually. Like, yeah.

SPEAKER_06 23:44

I don't know if she's the black sheep because she makes twice what money is. Yeah, right.

SPEAKER_02 23:49

Well, that's really cool. Cause I mean, you've been in this for so long. Uh, when did you start transitioning from like running as a medic into the education side of things?

SPEAKER_06 23:58

So, um so right after I graduated, I started teaching as an adjunct instructor, just primarily with skills. I'd come in and help with the skills labs and you know that kind of thing. Uh, and then I moved into more of a uh a permanent part-time role. I was a 0.74 employee because the college couldn't pay me, they couldn't make me a 0.75 employee or higher because I'd have to pay benefits. So I was a I was a little less than a three-quarter employee. And I did that for several years. And I I did the field internship and and uh and then taught. Yeah. And then I went back into the field. I just missed the field so much. I missed working on a truck uh and went back out on a truck for six years full time. And um, and during that time while I was at the university, I was still running primarily, I was still running most of that time. Also worked in the emergency department and ICU as well.

SPEAKER_07 24:51

No, nice.

SPEAKER_06 24:52

And that was that was fun too, because that was a little like the Wild West as well, because uh there weren't a lot of protocols for paramedics in the ER. And so they're just kind of like, How about it? Like, we don't know. Can you? I'm like, can I do this?

SPEAKER_05 25:03

And they're like, Can you send me?

SPEAKER_06 25:05

I don't know, can you? I'll tell you how I'll let you know how you did, you know. And so there was just a lot of, you know, I medicine was just so different back then. You know, we used to, I don't know if if uh if you guys were around when, you know, you'd work a cardiac arrest and you'd bring him to the hospital and they'd work the code and then they'd call the code and then you would it sounds so awful. But I'm gonna say we can we might need to edit this out. But um, we would all line up and we'd innovate that patient over and over and over again just to practice getting innovations. And then I mean, we were respectful with the body, right? We weren't like making fun or jokes or whatever. But then as that body would become rigored and become more stiff, it it taught us like difficult airways, right? We were able to intubate. So we got dang good at innovating because you know, you'd you'd get, you know, 30 innovations in a year because of the cardiac arrest that you'd bring in. And then, like I said, over the course of of an hour or two, as they started to rigor, you would learn like if the airway got progressively harder, you would get just better at managing that airway. And you know, now we know that that's just so disrespectful that we need to have the consent of the family to do that. But you know, things were just different back then. You know, in the Victorian era, they used to bloodlet people. So, you know, I mean, we just we know better and so we do better.

SPEAKER_02 26:26

But I've seen some medics bloodlet with trying to get an IV. It still happens.

SPEAKER_06 26:31

That's why when we practice IVs with our students, we're on the linoleum flooring, we're not on the carpet, we're not in the classroom.

SPEAKER_02 26:39

Yeah, it's kind of crazy.

SPEAKER_06 26:40

Yeah.

SPEAKER_02 26:40

So, I mean, how has it been for you like since 2019 taking over the paramedic program? Because when I went through, it was Dixie State University, and obviously we've had the rebranding as Utah Tech. Like, what is your experience building it with the students coming in? Tell us about that.

SPEAKER_06 26:56

Um, so I was hired on a six-month contract to just kind of be a holdover. I actually had every intention of going back on a truck full time. Um, but they they were working on getting another program director in and they'd asked if I'd just take over. And I went in and the format wasn't something that was conducive to what I could function in. And so I just said, you know, what can I do? What kind of changes can I make, you know, just so that I can function for six months. And they said, have at it. And so I went in and and hired almost all new instructors because I wanted people that were active in the field that were currently working in the field, um, got rid of a ton of equipment, brought in a bunch of new equipment, uh, purchased an ambulance, got it refurbished down in Las Vegas, and um and and started to get rid of PowerPoint.

SPEAKER_07 27:54

Yeah.

SPEAKER_06 27:55

Because death by PowerPoint, I mean, we know, you know, education, best practice is that we we retain less than 20% of what we see on a PowerPoint slide. And why are we doing that? And the publishers, and this is nationwide, but these publishers put out these textbooks, you know. I think the cardiology slides are like 600 slides or something. And it's like it's it's ridiculous. And so we one of the first things we did is I'm like, we got to start phasing out PowerPoint and getting more and more hands-on and more and more lab. And we weren't doing nearly as much lab when you went through as we are now, because that wasn't really considered the best practice. And now we know, I mean, now we've flipped it. We have two hours of, I call it quote unquote lecture. Um, it's not, um, but then it's three hours of lab. So in a five-hour time, you're spending the majority of your time hands-on, and it's scenario-based instruction. Our mannequins are not sitting on tables, right? You know, they're out in the parking lot, they're under cars, they're in our our extrication uh vehicle that we have, they're in out in the dirt, they're, you know, um under a stairwell, they're, you know, in all sorts of different places. And so really for me, it was um bringing realism into instruction because they're not going to learn if they're if they have a PowerPoint. So we utilized what's called the flipped classroom. And the publisher, initially we were using the flipped classroom that the public our publisher was putting out. Um, but they had things like arts and crafts, which kind of went over like a fart in church. So we didn't, we got rid of we got rid of arts and crafts pretty quick. Um, because that was silly. And um so before the students come to class, they have to read a segment of the chapter or an entire chapter. It just depends on on what their reading assignment is. So they read, watch, and submit. So they'll they'll have a reading assignment and it might be a part of the chapter and then an article, like an EMS article or an EMS journal, something that's really recent. Um, and then they'll watch YouTube videos that we give them. And so if it's on abdominal trauma, they'll watch some videos on abdominal trauma and then they submit. So read, watch, submit. And so then they submit a pre-quiz. It's just a pre-test, it's just a 10 question quiz and they can take it twice. It's designed, it's the intent is for it to not be open book, but let's get real. I mean, they probably are open book because everybody's getting 10 out of 10 by the time they come to class. Um, and then the first thing we do when we come to class is say, all right, you got any questions? And if they don't, then we say, okay, take a test. And then we give them a quiz. And it's based on read, watch, submit. It's based on all of that, just to see if they've done the material. Because people don't need, especially adults and adults with ADHD or people that don't just have ants in their pants that just don't want to sit still, right? Whether you have ADHD or not. If you don't like to sit still, you're gonna make a great medic. And um, and so then we we quiz them on that. It's just a 10 question quiz, and then we get right into discussion and we have what's called the sticks of fate, and they're tongue blades that we write all the students' names on them. And then, and this is where PowerPoint is like there's like maybe 15 slides. But what happens is a PowerPoint will pop up and it'll say, you know, you respond to I-15 Southbound, mile marker 12 on a motor vehicle accident where there was a rollover and the patient was partially ejected from the vehicle. Um, what are your priorities? And then I'll draw, draw out of the sticks of fate, I'll draw a name and I'll be like, okay, Brennan, um, what are your priorities? And then I'll ask him a question. And he'll be like, okay, these are my priorities. I'm gonna make sure that traffic's stopped. I'm gonna make sure that there's access for the engine to gain access to the patient. I'm gonna make sure that the vehicle is stable. I'm gonna make sure that the bystanders are in a safe place. Whatever his priorities are, we can talk to him. And he might, you know, as a new student, he might come in and be like, ABCs, is the airway, I'm gonna manage the airway. And we're like, whoa, hold on a minute.

SPEAKER_05 31:52

BS I scene safe.

SPEAKER_06 31:53

Right, VSI seen safe. And and it's like, okay, the scene's not safe. You've got to do these scene considerations. Okay, so then Brennan will say that. And then the next slide will be up, and then it's like, okay, your patient's partially ejected with their their legs trapped under the vehicle and their airways gurgling. What are you gonna do? And then I'll draw another stick and I'll say, okay, Katie, what are what what are your priorities now? And then we'll work through that scenario. And instead of saying, like, this is an abdomen and this is the, these are the organs that can get damaged and this is what it can do. You know, I mean, that's that's what the chapter's for. That's what the YouTube videos are some of them are for. You know, that's what these activities, those things that we have, that's what that's for. They've already done that when they come to class. Um hopefully. And if they haven't, and if they haven't, and nobody wants parents. Well, and and that's the nice thing. And and we've switched to the sticks of fate because there's always that one student that knows everything and they're gonna talk the whole time. But if they wait for the sticks of fate, then the student who's the quietest still has to answer the same amount of times that the student who wants to talk all the time does. And so the sticks of fate have worked really, really well. So we'll work through the scenario, and it's okay to say I don't know, because and that's one thing that I've impressed with my instructors. And I tell them all the time, there is a lot of power in the phrase, I don't know. Because then your students know you're not full of crap, you know, because then you're saying, Well, I'm gonna go look, let's go look this up together. Or I might tell a student, hey, I want you to go look that up and get back to me and let me know what you find out and we're gonna learn together.

SPEAKER_02 33:23

That's my favorite part about teaching at Utah Tech is there's oftentimes I'm stomped. I'm like, bro, let's get on chat GBT because I don't even know what you're talking about.

SPEAKER_06 33:32

I mean, they ask, they ask some tough questions and it's it's good because it keeps you sharp. And you know, the other thing too with doing the sticks of fate and those few slides. So we'll go through maybe two or three scenarios like that, and then we'll discuss the physiology. So then I'll ask you, well, tell me the pathophysiology behind hemorrhagic shock. You know, let's talk about it and you tell me. And so then it's more of a discussion. And so the teacher's more of a facilitator, more like an orchestra, like a band leader than they are an actual teacher, because that's what we want. We want it to the students to ask the questions. We want the students to, you know, if if you ask a question, I want you to answer it. What would you do in that situation? You know, and you might be like, well, I would do this and this. And somebody says, Well, I wouldn't do that, I would do this. And then, like, well, okay, let's let's compare and contrast and let's talk about it. Maybe you're both right. Maybe you're both right for different reasons. And let's talk about that because the critical thinking aspect is something that's so important as you know in the field, if you can't critical think, you're you're you're game over you're worthless. Um, and then the other thing with the flipped classroom is, and my theory is, and I've been teaching a long time. So I've been teaching for over 20 years now, whether it's part-time or full-time, and and I get bored easily. I mean, back to the whole ADHD thing, right? Is that if my instructors are bored, the students are gonna be bored. And and so, and I have people like Brennan that are super dynamic, super animated, cannot pay attention worth a shit. Like, literally cannot pay attention, I mean, at all, right? I'm surprised he's been focused this long. But um, and which is great. But that's but he's also a dynamic instructor, and the students love him.

SPEAKER_05 35:14

They're engaged there. Oh, yeah.

SPEAKER_06 35:16

100% because he he moves and he's going and he's looking stuff up and he's pulling, he's pulling information in from different areas, and the students are like, man, I gotta be engaged or I'm not gonna be able to keep up. And so I you know, I make fun of him because he's here, but um and behind your back. Right. But it but you know what it's but that's the that's what we look for in my instructors is I want somebody that, you know, like I said, that their pants are on fire, that that can go in and and that are passionate about the profession. Um if if you're if teaching for me is not a retirement job. So if you've been, and I've been in the field a long time, right? But uh, or I've been in EMS for a long time, but I don't ever want this to be like the retirement job because everybody knows those fire chiefs that are in there for that, they're coasting till retirement, you know. And so I don't want instructors, I don't want to surround myself with people that are just biting their time until they retire. Yeah. Because that carries on that apathy carries to the students and then they carry that into the field. And our profession is so important in what we do. We just it we just can't afford to do that, to to have that mentality.

SPEAKER_00 36:25

I want to go back to medical school, but in your program and blow up an ambulance.

SPEAKER_06 36:31

I know. Well, so that's the one that you all know about. You know, one thing that I tell my students is I say, you know, my first obligation is to you as a student first off. But my second obligation, and they're they're tied, they're very they're they're parallel. So it's one B. So you're one A as a student, right? That's what I'm paid to teach you as a student. But one B is I have an obligation to your patience. Like I feel obligated to your patience.

SPEAKER_07 36:57

By extension, yeah.

SPEAKER_06 36:58

Correct. By extension. And and um, you know, they're they're the end user of our product, if you will. And so I have an obligation to that end user, and I and I and I never forget that. I try not to forget that. And and you know, there are days when I don't care where I'm tired, I'm burned out, and I don't want to teach, but you know, I can pull in people like Brennan, I can pull in some of these other instructors and be like, hey, you know, carry me for a bit. Like, is it okay if you, you know, can you step in while I take a break? Because it it's a huge responsibility. And, you know, if Brennan needs to step back for a while and do things, then then we can step in and cover him. But um, it's really just staying actively engaged and and and and and curious too.

SPEAKER_02 37:42

Yeah. There's a lot of VMTs in the profession that we work in. And I think a lot of them are either afraid to go to paramedic school or maybe it's a time commitment that they're struggling with. Uh but ultimately, like, once you get your medic, you're you're so this is gonna sound no offense.

SPEAKER_05 37:57

I can have taken it. I gotta tell you.

SPEAKER_02 37:59

You're way more valuable to a team, right? When you have more medics, more heads to bounce ideas off of what's going on with this patient. Well, I think extra like, oh, I didn't even catch that. Because it's easy to get zoned into one thing and have somebody, a voice of reason that might understand a higher level of pathophys than just an EMT. So, what would your recommendation or recommendation be to people who are wanting to get into paramedic school, where to look, how to do it, if they want to take that next step in their career?

SPEAKER_06 38:25

Um that's a really good question. I, you know, I would hope that I it it really is beneficial for people that want to are considering paramedic to work in the field as an EMT first. That's not always that.

SPEAKER_05 38:36

Yeah. Like what's the comparison of just EMT versus worked as EMT going through the class? And yeah.

SPEAKER_06 38:42

You know, and that's and and it's so predictable. And every year, you know, I have students that come to me every year because we'll accept students that have experience and some that don't. And what happens is is the students that have experience kind of start, you know, they they have a leg up, and the students that have no experience are kind of at the bottom. And and they're like, oh, and they'll come to me, and it's usually about week two or three, because we we get into patient assessment week one, like we're right into it. And um, and they'll come to me, it's usually week two or three, and they'll be like, you know, Melinda, like I just don't know if I belong, if this is for me, and everybody's so much smarter than me, and I just don't know if I can do it. And I'm like, you know, hold my beer. Hang on a minute, you know, because I'm like, trust me, this is how it goes is that you have the EMTs that have experience and then you have the ones that don't, is that they'll build the ones that don't have experience will build, build, build, build, build if they have that personal effort that they put into it. And then by about midterm, and it happens every year, the ones at midterm are at that same level as the ones that have experience because oftentimes what happens is the ones that come in with experience think, oh, this is just EMT super school. Yep. It's not like it's EMT plus or A EMT plus. And and it levels the level, the playing field gets leveled so quickly.

SPEAKER_05 40:03

And bad habits. You get some EMTs that just had bad partners and they didn't know the difference between right and wrong, and then they get in there versus a newer EMT. Yeah, they're learning that from scratch.

SPEAKER_06 40:13

Yeah. Yeah, absolutely. And so um, you know, I so I would just say, you know, if you're considering paramedic, um, don't let your lack of experience stop you. But having experience can be really beneficial because you do have a point of reference. You know, it is beneficial. Um, our program, we require anatomy with a lab, physiology with the lab, English 1010, and math 1010 or higher. Um, and you were asking, you had asked earlier about like what's different in paramedic education now versus back then, is that there is the breadth and depth of what is expected of us is so much broader and deeper than it was in 1998 when I went to paramedic school. Um, where the the knowledge that you're expected to know is is much deeper and broader. And so some paramedic programs don't require anatomy and physiology. However, we hit the floor running. And so you have to have that background to have that anatomy and physiology. And some students will take it once or twice just because they don't, you know, they might take it a couple of times.

SPEAKER_05 41:19

A lot of information.

SPEAKER_06 41:20

It is a lot of information, and that's okay, you know, especially if you're not, if you're a student that doesn't do well in school. But I wouldn't, if it's something that you're passionate about, I wouldn't let, you know, taking a hard class stop you from doing that. Um, it's interesting because our program was just featured in the Journal of Emergency Medical Services as one of 33 programs in the country. There's over 600 paramedic programs in the country, and we're one of only 33 that has a first time pass rate of over 80% for three consecutive years or more. And the one of the identifiers was the programs that require anatomy and physiology as a prerequisite.