Author: ryanhuckle

Problems with EMS Infrastructure and Technology

This episode of Last Week Tonight with John Oliver aired last week, but I thought it was worth sharing as an irreverent but also serious aside.  I am still early in my attempt to navigate the world of emergency medicine, so I am broadly exploring all sorts of topics.  While my aim is to become a paramedic, I also acknowledge that taking a silo’d approach often leaves gaps that harm people.  When there are serious issues with how a service gets deployed to help people, you end up with a lot of avoidable mistakes, like those highlighted in the video.  I hope you had a great long weekend!

 

Stay Awesome,

Ryan

Study Strategies #3 – Build a Schema

When you first start out in any new field of study, it’s easy to be overwhelmed by the sheer volume of content you need to learn.  Everything seems important and complex; you don’t know where to start or what to focus on.  At this stage, an effective strategy is to start building a schema – a system or pattern of organizing information into categories and relationships.  In any mature field of study, you have one thing that is guaranteed: all knowledge gets built upon some sort of bedrock facts, and many complex systems are born from smaller, simpler systems.  All education is structured around this core approach.

Think back to when you started your formal schooling.  You learn math by first:

  • learning the names and symbols for numbers;
  • then learning the cardinal order of numbers;
  • then learning how to sum groups pairs of numbers;
  • then learning how to sum multiple groups of numbers (multiplication);
  • etc.

You can find a similar pattern with almost any subject you have been exposed to.  We sometimes forget this pattern of organization because we take for granted how long it took to ingrain these concepts into our thinking.

Textbooks (at least, at an introductory level) are also organized in this pattern, and by recognizing this, you can use it to build a mental representation of the information.  Textbooks start with defining concepts before moving on to grouping these concepts into meaningful, larger systems, then showing you how to apply these concepts in meaningful ways.  Recognizing this pattern allows you to digest new content much easier than memorizing facts randomly.  The long term benefit of organizing these schemas is you can:

  1. easily assimilate new ideas and facts;
  2. learn and retain more facts
  3. allow cross-domain pollination of ideas to create new insights and assimilate new applications of information

The important thing to remember is to build schemas that make sense to you.  Your instructor or textbook will suggest a way of grasping the concept, but it’s up to you to determine how best to organize your mental models to ensure information is available in your memory when you attempt to recall it.  Employing useful tools such as mnemonic devices, word associations, imagery, auditory cues, etc. can help your mind encode data into useful chunks for storage.  In a future post, I’ll come back to these tools and explore how I’ve applied them in my own studies.  The important lesson for today is to recognize that any body of knowledge has an inherent structure to it.  Once you recognize that structure, you can break big, scary ideas down and tackle each part separately.

 

Study Strategies #2 – Make it about you

A common complaint you hear from students who study abstract concepts is that it’s hard to wrap your mind around ideas that you don’t have immediate (visceral) experience in.  I say this as a person who has an undergraduate and a graduate degree in philosophy; abstract ideas are my bread and butter.  Studying biology falls somewhere in the middle of that field – we all have a body that is a biological system, but outside of our subjective experiences of stimuli and physiological responses, we don’t have a lot of access to the inner mechanics of how the body operates.

(In my humble opinion, philosophy falls to the right of the image… Image: XKCD: https://xkcd.com/435/)

While this tip might be harder to apply in philosophy, a useful trick I’ve tried using recently is trying to break down anatomical and physiological processes in terms of my own personal experience.  Depending on your background, there are a number of ways you can cash this out, but I’ll give you three examples of where I’ve applied my past experiences and hobbies to learn key ideas and concepts.

1.) First Aid

The biggest crossover with studying biology I’ve had is from my experience in first aid.  During my undergrad, I joined a campus first aid team.  It was a team of student volunteers who actively trained throughout the year and covered shifts for events on campus.  Because we trained above the standard first aid level, we would get into topics that required some level of understanding the organism at the physiology level.  To understand how CPR mimicked the beating of a heart, we would learn how a normal heart functioned; to understand how shock affected the body, we would understand the cardiovascular, respiratory and nervous system operated; etc.

First aid is a stripped down version of what paramedicine is, so the two naturally dovetail with each other.  As I work my way through the course material, I’m able to see the connections between the medical interventions I was taught as a first aider and the biological systems the body uses to maintain healthy function (or, related to emergency medicine, how the body adapts to compensate for a loss of homeostasis).

2.) Lifting Weights

This example draws on a narrow set of my course materials, but it still cuts broadly through the textbook.  When you move out of the rookie phase of lifting weights, you naturally drift towards learning about anatomy and physiology.  As of writing this post, I completed a test last week where I labelled a diagram of the posterior superficial muscles entirely based on my experiences with weight-lifting.  As you dive deeper into exercise science, you are exposed to all sorts of cool applications of biology.  You learn about the gross skeletal and muscular anatomy, you learn about cellular metabolism and the use of ATP in muscle contractions, about how micro-tearing of tissues builds muscle and bone density, how nutrition affects the body, etc.  Even learning about exercise recovery helps deepen your exposure, such as learning about massage therapy, stretching any fringe forms of therapy, such as myofascile release and chiropractic medicine.

3.) That time I broke my ankle

A few years back, while out walking the dog during the first snowfall of the season, I was attacked by a roving horde of snow-ninjas who managed to put me down hard.  By that, I mean my foot slipped on a patch of ice, my ankle pivoted, inverted and my bodyweight came down on my ankle.  At the time, it seemed like a sprain because I was able to stand on the ankle and walk down the hill for help.  After a trip to the hospital and a follow-up, x-rays determined that I had a fine fracture in the fibula and I had displaced the talus bone.  It was recommended I have surgery to set the bones back into place with a series of screws and a plate.

The surgery was uneventful and the recovery went as predicted, and I’m now back to 99% (the occasional cold night makes my ankle stiff at work).  There is an element of black box magic that happens when you recover from a broken bone.  You receive a cast, are told to reduce movement for 6 weeks, then rehabilitate the muscles.  Recently, when I was studying the chapter on bones, I learn what happens in those six weeks.  It’s freaking awesome!

Assuming you can see the image above (being new to blogging, I’m not sure what’s considered fair-use for copyright materials – safe to assume, that image is not my creation), you can see the general phases of how bone gets repaired by the body.  When I learned about the process of osteogenesis, I was able to remember the phases of bone repair base on my lived experience of breaking a bone and healing from surgery.  It’s a hard and painful way of learning medicine, but it’ll stick with you!

These are a few examples of how my experiences help me make sense of the complexities of human anatomy and physiology.   What are some of the ways you make the material relevant to your life?  Let me know down below.  Hopefully it’s nothing as bad as physically injuring yourself!

Stay Awesome,

Ryan

Pass the Salt – Public Health and Hidden Prophylaxis

At this stage of the game, almost everything I’m studying comes with “OH! That’s so cool!” moments.  For as weird and complex as things that we engineer are, they pale in comparison to just how marvelous our bodies are.  Through eons of evolution, our bodies have developed finely-tuned, complex systems to keep us going.  In general, our bodies are fairly robust and can tolerate a wide variety of environmental pressures because our bodies have adaptive mechanisms to bring the body into homeostasis, or physiological balance.  Without our conscious thought, our body will enact certain measures to protect us, such as breaking down bone matrix to release stored calcium, or shunting blood from the extremities during extreme cold to protect vital organs.  However, sometimes our bodies need some help.

Humans, in our marvelous capacity, migrated into all sorts of areas that we were not adapted to naturally.  Evolution selects for traits that best ensures reproductive survival in particular environmental conditions.  But evolution is slow in humans because we reproduce fairly slowly, so we often take a long time to develop protection against environmental changes.  To help mitigate harm, modern society has adopted many practices to ensure populations are protected from certain diseases and conditions.  Over time, we grow accustomed to the new norm and collectively forget what life was like before the intervention was introduced.  This is why I find public health so fascinating – there are so many systems built into western societies that we take for granted that were enacted to address specific diseases.

 

Goiters

At the moment, I’m studying for my endocrinology chapter test, so I’m learning about the complex systems of glands and hormones our bodies use.  When I say it’s complex, I mean it’s COMPLEX!  Outside of the nervous system, the endocrine system is what is responsible for keeping our body functioning.  It finely tunes our internal conditions to preserve homeostasis.  It does its best, but sometimes it needs some support.

Vitamin and mineral deficiencies can have dramatic impacts on our bodies.  One in particular is iodine deficiency.  In certain geographic areas, iodine is scarce in the food supply.  This problem doesn’t exist where diets are rich in seafood or foods grown in proximity to saltwater.  However, in the interior regions of North America, iodine is less common in the ground, so the nutrients are not absorbed into the local vegetation.  Humans need iodine in their diet for, among other things, healthy thyroid functioning.  The cells of the thyroid uses iodine in part of protein synthesis, so when iodine levels are low, protein synthesis is stalled and extra material accumulates in the tissues.  This leads to an enlarged thyroid, also known as a goiters.  This effect is so common among people with iodine-deficiency that large geographic populations exhibit similar physical characteristics.  In the United States, the phenomena was so common that the “goiter belt” was used to describe areas of the country where people commonly had the affliction.  In addition to physiological problems that arise from atypical thyroid functioning, iodine-deficiency also can result in impaired cognition.

As a public health measure, it was proposed that iodine be added to table salt, as was done in other countries like Switzerland.  Within a short amount of time, incidents of goiters declined and IQ scores were improved in goiter belts.  The practice is now common in developed nations, but according to estimates iodine-deficiency still afflicts some 2-billion people worldwide.

The funny irony with public health initiatives is that we often forget why the measures were enacted in the first place when we are no longer exposed to the diseases the prophylaxis was implemented to address.  This collective-forgetting of the harm our populations were once exposed to then leads to foolish rejections of those very policies that help keep us healthy, whether it’s rejection of vaccines or decrying fluoride in drinking water.  Legitimate questions of long-term exposure effects aside, knee-jerk reactions to chemicals and scientific illiteracy is reversing decades of public health initiatives that keep us healthy.  The hidden world of public health — when it works, you don’t even know it’s keeping you alive.

So, that’s why my table salt is iodized!  Cool!

Stay Awesome!

Ryan

 

Study Strategies #1 – Flashcards

While we can charitably say I’ve been a student for a long time, it has only been relatively recently that I’ve started paying attention to pedagogy and effective study strategies.  Sure, while I was still an active student, I would be exposed to the usual litany of strategies for student success – read/review text multiple times, practice questions, low-level frequent studying is superior to cramming, etc.  But of course, most of these would get dropped because of my poor time management and I would end up cramming and staying up the night before a paper was due to write in one marathon stretch.  But those were my habits during undergrad and grad school and I haven’t been a student in almost five years.  I know I lack some of the youthful fortitude to carry-on those habits while working a full-time job, part-time job and all of the other fun projects I have on the go.

So, rather than working hard, I’m trying to work smart.  I’m trying to use sound pedagogical approaches to learning that helps me to effectively learn the material on my own and retain it for future application.  Right now, I’m taking a preparatory biology distance education course at the College I work for.  I took physics and chemistry through high school, but I did not think I would need the biology.  If I hope to make a career change towards paramedicine, this is a gate-keeper that I must pass.

Because of the nature of the biology course, most of what I’m dealing with is rote memorization that emphasizes knowing how systems fit together rather than directly applying knowledge.  This means that what I need to know to pass the test will focus more on being able to recite facts, definitions, explain processes and label diagrams.  Understanding and recognizing this is beneficial to how I can structure my homework.

One strategy I’m using for this course is flashcards.  There are two purposes to the flashcard:

  1. The act of creating the flashcard helps in retaining information.  To make useful flashcards, you have to sufficiently understand the material to condense it down into a few meaningful points.  Also, the physical act of writing the cards out helps you to retain the information (over and above just reading highlighted text from your book).
  2. Flashcard drills can reinforce knowledge depending on how you use them.  You can use keywords to trigger a recall of definitions, or use Jeopardy-style recall of knowing a definition to trigger the recall of a technical term.  You can chain cards linearly to help walk you through a multi-stage process (i.e. cellular division, or mitosis), or you can shuffle the cards and break your dependence on moving through memorized steps and sequences.

I found that the more time I spent in designing and creating flashcards, the better I memorized and understood processes.  Take, for instance, protein synthesis.  By copying a diagram from my textbook, I was able to learn:

  • the difference between transcription and translation;
  • the differences between mRNA, tRNA, and ribosomal RNA;
  • the process of how RNA encodes directions from DNA in the nucleus; and
  • how ribosomes outside of the nucleus create proteins.

All of that was memorized from one flashcard!

Everyone has different learning styles and unique ways of absorbing materials.  One way that is highly effective to me is brute force drills.  Once created, I use the flashcards to drill myself until the gaps start to fill in.  I first learned that brute force was effective for me in preparation for a probability course almost ten years ago.

After performing poorly on some quizzes and tests, I took the textbook and every practice question I could get my hands on, sat down in a Tim Horton’s and solved every question (sometimes multiple times!).  I kept solving them until I could instantly recognize which algorithm I needed based on the presented information and what I was asked to solve.  Those lessons I learned from probability theory almost ten years ago have helped me in my self-directed learning  today.

Flashcards are not the only tool you can use, but if you are looking to easily memorize concepts and schemas, they can be a highly effective strategy to help you out.

Stay Awesome,

Ryan

Have you ever used flashcards?  What did you use them for?  What strategies do you use to learn?  I’d be happy to read your input in the comments!

 

Welcome and First Post!

Hello and thank-you for stopping by my page!  I’m Ryan and as of this writing I am a hopeful future candidate for a path into paramedicine.

In a future post, I will go into a little more detail about who I am and my story into why I want to be a paramedic, but for now I will try to paint a picture of what I want to do with this website.

I’m looking to do a career shift and plan to apply to colleges early next year to be admitted into a paramedic program here in Ontario, Canada.  To date, I’ve been working on a number of fronts to prepare myself for my application – I’ve been organizing my finances to give myself a leg-up to return to school, I’ve been exercising to prepare my body for the job, and I’m currently taking a distance education course to get the biology credit I need to satisfy most school’s program pre-requisites.

While there is some element of vanity in this, I think this site would be a great opportunity to chronicle my journey.  I think writing about the things I do professionally and learn along the way will not only help me become a better paramedic, but it might also help educate and inspire others along their journeys.  I’m a student at heart and I love to share the things I learn along the way.  Despite my baser instincts towards laziness, I think this site might help push me to work a little harder.

I hope you find value in this passion project of mine, and maybe we can learn and laugh along the way.  For now, let’s just see if I can put some momentum on this beast.

Stay Awesome,

Ryan