Emergency Medical Technician - Basic... not yet

If anyone who knows me is reading this, they know I have been going for my EMT-B license for awhile now.My State Licensing test site was this past weekend. The way it works is you have two Practical tests, scenarios with "actors" playing roles as patients, all the real equipment and the proper dummies etc. for intubation, injection and so on, one Medical (complaints such as heart attack, stroke, diabetic emergency, etc.) and one Trauma (injuries, such as gun shot wound, hit by a bus, etc.). Then you have a written test.Right off the bat I failed my Medical scenario - and I knew exactly what I did wrong, as soon as I was out the door. The patient would have died under my care; she was crashing when I gave it up as a complete waste of the proctor’s time for me to continue fucking around.I went straight into the Trauma scenario, and I am feeling pretty confident about that one. It was a GSW to the left thigh, no exit wound. Was a little slow in treating the wound, but I followed my ABC (Airway, Breathing, Circulation) chain to a T. I feel I should have slapped a gloved hand over the wound (or indicated I was having an imaginary partner do it) earlier though, instead of doing it while getting the dressing out. But, long story short, I got it done - got the wound treated, got the patient in MAST pants as indicated by wound and transport time, and kept running vitals on her, going into secondary survey. I feel confident about that one - could have done better, a lot better, but I also feel I successfully treated the patient without wasting too much time or causing any further harm.The written test... well, honestly, I have no clue how I did on it. It is a 125-question test, on which you must score a 70 or better to pass. That means you can miss 37 questions. Did I? I dont know, lost count. I didnt feel as positive as I would have liked about everything I answered, but I am feeling hopeful about the overall result. It is a horribly written test, this states, and the bad use of the English language (and bad spelling of it) contributes greatly to the uncertainty of a great deal of the questions and answer choices. If I failed it, it wont be entirely my fault. Although I must admit, I will be a little surprised if I did fail. Will know for sure when my results get in.Lessons learned from the whole experience. I think the number one thing I took away from it though was the value of Scenario based training in the instructional setting.As it turns out my EMT-B instructor was a fucking lame about scenarios. Several of my classmates were at this test site, in fact I rode out there with one and he ended up talking with some members of another class, from the same school, at the same time as our class, but with a different instructor (who is, incidentally, the program director for the entire EMS program at this institution). These students told my classmate that they were put through Eighteen (18) individual scenarios apiece.We, my classmates any myself, were put through a grand total of six. Two practice, four graded. We were promised more, but we had to wait for our instructors friends who were proctoring these scenarios to show up, and then for him to shoot the shit with them, and then for him to set up each testing station, so in the end the days were at the very least half wasted by the time we actually got to scenarios. He was a fucking lame about scenarios, completely.And that hurt us. I know for a fact it hurt me, and my classmate who failed the same scenario I did is sure it hurt him, and all of our fellow classmates seemed to feel fairly uncertain or unhappy with their performances in scenarios – so I would vouch that it hurt all of us. Simply, we were not ready. We were very nervous about scenarios, about working with a live and responsive “patient” in a situation where we were being graded. On paper, its all great, but when you have a disoriented, scared, and dying old woman on your hands who you are getting practically nothing from but the same repeated questions, and lots of fear, things change – and unless you are ready for that, you are gonna blow it. Just like I did.What that means for the real world is beyond equally bad – it is ten times as bad or more. If you blow a scenario, because the patients actions are out of your scope of expectation and your frame of reference from your academic (and ONLY) EMS experiences, then you will blow it in real life too, when someone’s life may very well depend on you being able to handle the fact that they have gone bat-shit fucking nuts due to irregular glucose/insulin levels in their body, and still do your job.Scenario training is where its at – trust your students to read the book on their own (having a good book helps – Mosby’s EMT textbooks are highly recommended, not the shit we had) and spend less time on lecture, definitely less time on bullshitting and telling war-stories, and more time on scenario practice and scenario testing. When you are having scenario training days, be ready when the students get there – have all your people there, all your stations set up and all your equipment ready to go, and pound them out all damn day long. Don’t fuck around waiting for people, setting things up and getting shit put together – have them there, have it up, have it together at 8 AM when that first student strolls through the door.Students, demand this of your instructors – instructors, demand this of yourselves.Anything less is preparing people to fail.