Education vs Training: The “Professional Ambulance Cleaner”

Imagine if you will this hypothetical scenario:

You and your roommate have just graduated EMT school together and go to work at competing ambulance companies in the same city. He works for HIS ambulance service, and you work for YOUR ambulance service. Both services have similar fleets, similar deployment patterns, and similar call-volumes. In fact, there’s really no way to tell them apart other than the fact that the HIS ambulance service uniforms are sickly green jumpsuits, and YOUR ambulance uniforms are Macho Blue Shirts with navy blue pants.

You both go off for your first day on the job which understandably includes several hours of training on company policies. For both of you, the whole day turns out to be a long class on how to clean the inside of ambulances.

Here’s the differences, though. At YOUR ambulance, you learn about the biological functions of bacteria and viruses. You learn their strengths, their weaknesses, how they reproduce on inanimate environmental surfaces, how they create biofilms to increase their reproductive capabilities and life span, and how pervasive they are in randomized samples from real-life ambulances. You learn how grime collects in the ambulances, how it adheres to the surfaces that you will be cleaning, and what the various types of substances are that you will most commonly find in real-world applications. The whole first day is spent on nothing but learning about dirt, grime, and germs and how they contaminate ambulance interiors. They even threw in the types of materials that the ambulance interior is made from and what the specific dirt-holding and germ-breeding properties of each material are. You see samples and scenarios pertaining to germ and dirt proliferation on ambulance interiors.

Not only that, there’s homework, reading material, and a report due the next day.

The second day that you report to YOUR ambulance service, you learn all about different types of cleaning products, tools, and disinfectants. You learn how to properly choose the detergent needed for optimum dirt-dissolving power on what type of surfaces you may have to clean; You learn the proper disinfectant to choose for each type of commonly encountered bacteria, virus, and fungi spore; and you learn the proper contact times to leave each product on for optimal disinfection and/or dirt dissolving power. Then you learn about every different type of sponge, mop, rag, fabric, and tool used to clean the ambulances. You spend a few hours in the laboratory they have testing out the material and performing experiments in the name of learning.

Oh, and after that day too, there’s a lot of homework and reading material.

Your roommate, on the other hand, went to work and found out that he too had to learn about ambulance cleaning. He learned that they also expect clean ambulances, however his choices and training are much simpler. He is told to clean the ambulance using two bottles: One marked “Cleaner” and the other marked “Germ Killer”. He is given ten rags and is told to clean the ambulance for inspection by the owner of the company using the tools given in the time allowed. He does so and is told “Good, now do it again tomorrow”. The next day, he again cleans the ambulances using the tools and training provided, and is again told “You did a good job”

In the above scenario, the first ambulance service, “YOUR Ambulance, uses a form of advanced education to teach their people how properly to clean the ambulances to their specifications. The education is rigorous and in-depth.

At “HIS Ambulance” they use training, and vocational experience to teach their employees how to properly clean the ambulances.

Here’s some questions I have:

  1. Which ambulance service do you think will have cleaner ambulances in the long run?
  2. Which employee do you think will do an overall better job in cleaning the ambulances?
  3. Which employer, “YOUR Ambulance” or “HIS Ambulance” do you think has the better philosophy?
  4. Which ambulance cleaning class will result in the better, more motivated, happier employee?

Anyone else see the relationship to EMS training/education here? Which one results in a more “Professional Ambulance Cleaner” that is better equipped to handle the job?

  • tclemans

    I can't properly answer any of the four questions because I haven't conducted science-based experiments on the issue.

    To me rigorous training is students are showed what the result of their cleaning should look like, the most effective and efficient method of cleaning, and then practice over and over and over cleaning focusing their problem areas. Olympic athletes don't win gold medals by reading physics and anatomy books but by practicing the skills they aren't good at and analyzing mistakes.

    Source: “The Making of An Expert” by K. Anders Ericsson, Michael J. Prietula, and Edward T. Cokely published in the Harvard Business Review http://www.washingtonbaseballinstruction.com/Th

  • totwtytr

    In the end, the real question becomes which paramedic makes more money? Do employers find that the better educated paramedic is worth more money for his theoretical understanding of the science of ambulance cleaning?

    Which reveals the real problem in EMS education and training.

  • http://twitter.com/gfriese Greg Friese

    I am guessing that at YOUR ambulance service no one will ever get into the driver's seat and while still wearing the same gloves they used to help assess and treat the patient drive to the hospital.

  • roguemedic

    Not only are the educate ambulance cleaners likely to understand the importance of cleaning in the corners and places out of sight, they are likely to come up with ways of improving the way they do their job.

  • roadtoparamedic

    Except that at no point in the above scenario are the educated cleaners actually shown how to clean, or expected to do it!

    Good education is essential, but so is learning practical skills.

  • Pingback: Would you rather be trained or educated? « Dysphoric Mania

  • el quirk

    I am a “why” person. But most, I think, are “what” people. As in, “What do I do”? I tend to need to know, “Why should I do that?”
    Some look at history and say, “I need to know what happened.” I need to know what happened and why it did. However, with the why-ism comes an inevitable set of questions….I sometimes envy “what” people.

  • el quirk

    I am a “why” person. But most, I think, are “what” people. As in, “What do I do”? I tend to need to know, “Why should I do that?”
    Some look at history and say, “I need to know what happened.” I need to know what happened and why it did. However, with the why-ism comes an inevitable set of questions….I sometimes envy “what” people.

  • fire33medic

    Interesting that you should bring up professional athletes, tclemans, as I recently heard an interview with Andre Agassi that immediately came to mind when I read your post. Sure, athletes do not need to become egghead academics on all the factors that affect their performance, but they do need some level of education beyond skills repetition.

    Agassi was already a phenomenal tennis player by the time that he met Gil, the person that would become his coach for the majority of his professional career. Gil's genius was in questioning every aspect of Agassi's intense training routine – a routine that he had been following for years. For instance, why was Agassi running five miles daily if he never ran five miles in a tennis match? Weren't there better ways to train his muscles? Ways that would be directly applicable to the practice of his craft? Agassi says of this revelation: “all of sudden it occurred to me that, you know, I had this asset in my life or access to this asset of understanding my body and being kind of guided and navigating those waters of becoming stronger and fitter.”

    Ultimately, a fine balance must be struck between being technically proficient and being armed with the knowledge to make decisions that matter… whether they be patient care decisions, or why and how to clean the ambo after a call. Both are important, and repetition does increase skill, but it is crucial to have a basic level of education in order to use one's skills to maximum effect.

    Stay safe!

  • fire33medic

    Interesting that you should bring up professional athletes, tclemans, as I recently heard an interview with Andre Agassi that immediately came to mind when I read your post. Sure, athletes do not need to become egghead academics on all the factors that affect their performance, but they do need some level of education beyond skills repetition.

    Agassi was already a phenomenal tennis player by the time that he met Gil, the person that would become his coach for the majority of his professional career. Gil's genius was in questioning every aspect of Agassi's intense training routine – a routine that he had been following for years. For instance, why was Agassi running five miles daily if he never ran five miles in a tennis match? Weren't there better ways to train his muscles? Ways that would be directly applicable to the practice of his craft? Agassi says of this revelation: “all of sudden it occurred to me that, you know, I had this asset in my life or access to this asset of understanding my body and being kind of guided and navigating those waters of becoming stronger and fitter.”

    Ultimately, a fine balance must be struck between being technically proficient and being armed with the knowledge to make decisions that matter… whether they be patient care decisions, or why and how to clean the ambo after a call. Both are important, and repetition does increase skill, but it is crucial to have a basic level of education in order to use one's skills to maximum effect.

    Stay safe!

  • NateEMT_B

    the short answer for me would be this: The “YOUR” understands what the hell he's doing through the education and understands why he is doing it, and can also gain a sense of appreciation for it. Which will lead to healthy patients because of the “YOUR”'s education and respect for a clean ambulance. Where as the “HIS” is just going through the motions, making it a monotonous task and a chore, where he'll probably eventually slack off on doing because he doesn't grasp why it's so important. Which will then lead to sick patients because the “HIS” lacks competence, knowledge, and full understanding as to why he's cleaning the ambulance other than because “he's supposed to”… Apathy kills patients, which is what “HIS”, I think, would be doing in the long run.

  • NateEMT_B

    the short answer for me would be this: The “YOUR” understands what the hell he's doing through the education and understands why he is doing it, and can also gain a sense of appreciation for it. Which will lead to healthy patients because of the “YOUR”'s education and respect for a clean ambulance. Where as the “HIS” is just going through the motions, making it a monotonous task and a chore, where he'll probably eventually slack off on doing because he doesn't grasp why it's so important. Which will then lead to sick patients because the “HIS” lacks competence, knowledge, and full understanding as to why he's cleaning the ambulance other than because “he's supposed to”… Apathy kills patients, which is what “HIS”, I think, would be doing in the long run.

  • NateEMT_B

    the short answer for me would be this: The “YOUR” understands what the hell he's doing through the education and understands why he is doing it, and can also gain a sense of appreciation for it. Which will lead to healthy patients because of the “YOUR”'s education and respect for a clean ambulance. Where as the “HIS” is just going through the motions, making it a monotonous task and a chore, where he'll probably eventually slack off on doing because he doesn't grasp why it's so important. Which will then lead to sick patients because the “HIS” lacks competence, knowledge, and full understanding as to why he's cleaning the ambulance other than because “he's supposed to”… Apathy kills patients, which is what “HIS”, I think, would be doing in the long run.

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  • Wency777

    It should never be a question of which is better. It should always be a combination of both. I have been doing training for 11 years and I know for a fact that if you just train them on the skills without educating them first, they will eventually stagnate because they will never rise to the higher order of thinking. Because they do not know the why’s, they will not move to evaluating, analyzing and creating new ideas on how they can improve their job.

  • http://www.facebook.com/hrfiremedic Nick Jupin

    I think that the real cleaning class would be great.  But even taught properly, how many people are just too lazy to care during their shift.  I worked at a service that had a professional cleaning team.  It was great.  We sanitized after every call, but we had a time limit of 10 minutes at the er before our next dispatch, so you really had to haul but and didnt have enough time to properly clean.  But every night, this cleaning team came and brought a replacement truck to use while they washed and detailed yours… kinda neat.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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  • Comments
    Ckemtp
    I Got Attacked – A Paramedic Speaks About Public Trust
    I somewhat agree, though I assure you I didn't set out to waste your time. I probably should have broken this down into two separate points as the second point was the one I most wanted to emphasize. My bad on this one, I'll do better next time. Thanks for the feedback. If you'd like,…
    2014-12-16 20:25:00
    hawk4080
    I Got Attacked – A Paramedic Speaks About Public Trust
    Wow. That was a total waste to read.
    2014-12-16 19:20:00
    retired ems medic
    I Got Attacked – A Paramedic Speaks About Public Trust
    The radios should have had a trouble button to eliminate the need to key the Mike and talk. Maybe the dispatchers need to be rotated out to the streets to get out of the mode of just getting the calls out and only half listening to the radio.
    2014-12-16 14:50:00
    HybridMedic
    I Got Attacked – A Paramedic Speaks About Public Trust
    We use "Signal C" as a code to relay a crew in distress. Takes a second for the dispatchers to confirm it, but it sends the nearest engine, battalion chief, fire investigator (who are sworn LEO's) and makes an officer in distress call to Memphis Police. The arrival of all those resources is quite... Dramatic.
    2014-12-15 14:29:00
    exmedic
    Welcome to the Club
    Not me anymore
    2014-12-15 09:17:00

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