We Still Aren’t Teaching Enough Pathophysiology

We put weekly poll questions on our EMTReview.com site. They are designed to challenge students or highlight important topics. On one recent pathophysiology question, we noticed that very few students got the correct answer. The answers they chose showed very little understanding of pathophysiology.

We probably don’t have to mention that one of the hallmarks of the current education standards is greater understanding—much of which is based on pathophysiology.

The stem was straightforward:

Which of the following would you expect to see in a trauma patient experiencing blood loss?

The distractors weren’t particularly challenging—some (widening pulse pressure and JVD) were actually opposites of what you would expect to see. Skin turgor can indicate volume depletion but this is a later sign. Increased vascular tone (chosen the least) is an early and predictable reaction to blood loss. It wasn’t a difficult question.

There are a lot of reasons students could get this wrong. They may have read too quickly or just picked any choice so they could see the correct answer. But what about the students who tried and got it wrong? Some of these students didn’t get the pathophysiology they needed in class. This may be because it wasn’t taught in depth or terms like “vascular tone” weren’t used—or weren’t used enough. Students need to know different terms (constriction, resistance and tone) for the same concept to be optimally prepared for the NREMT.

Some educators might be saying, “It isn’t my fault if the students didn’t learn it. I taught it.”

But hold on – sure, the student might have glossed over vascular tone in the depths of that initial pathophysiology presentation. But what about the cardiology presentation, the anaphylaxis presentation, the sepsis presentation and the shock presentation? (Notice we didn’t call them lectures because we hope there are some active components to the classes.) The concept of vascular tone applies in each and every one of those topics too. There is no reason an EMT should get out of class without knowing this concept.

Try giving this question to your students at some point in the upcoming semester to test their knowledge of simple pathophysiology. And while you are preparing for this semester, plan on integrating a bit more pathophysiology. The FREE instructor area on EMTReview.com has some resources to help you teach pathophysiology. You can check out the dynamic learning exercise available to members or sign up for a free account.