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EMS World Expo Quick Take: 5 ingredients for psychomotor mastery

Competence is the minimum goal for EMT and paramedic students. EMS educators need to put their students on the path to mastery

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In a presentation at EMS World Expo, Ginger Locke, MS, NRP, described the five ingredients she and other instructors use to achieve psychomotor mastery.


NASHVILLE — Ensuring students’ skill competence is an essential responsibility for EMT and paramedic educators, but achieving competence may not be enough to start students on the path to professional mastery. Ginger Locke, BA, NRP, a paramedic educator, is infatuated with the minds of medics, and has studied how medics think and perform in stressful environments.

In a presentation at EMS World Expo, Locke described the five ingredients she and other instructors use to achieve psychomotor mastery. Locke is an associate professor of EMS Professions at Austin (Texas) Community College and the creator of the Medic Mindset podcast.

Memorable quotes on psychomotor mastery

Here are three memorable quotes from Locke on teaching psychomotor skills to achieve competence and prepare paramedics for mastery.

“Unconscious competence is at the end of expertise.”

“When we’re laying down the ‘rebar’ – the neurons – an instructor performs the skill while a student reads out loud each step in the task analysis.”

“Cramming doesn’t work. You want to space (skill instruction) out over days. It’s much better to have five one-hour blocks instead of a single five-hour block.”

Top takeaways on achieving psychomotor mastery

Locke’s presentation was tightly focused on the difference between competence and mastery, and the five ingredients for achieving mastery.

1. Skill competence is a milestone

EMT and paramedic practice is rich with skills that require competence. Competence is tested for graduation and certification. Reaching competence is worth celebrating, but it’s on the way to mastery, which is a long-range goal for a professional.

Simply achieving competence doesn’t mean a paramedic is on the way to mastery. Locke believes EMS educators are potentially doing a disservice to paramedics by not putting them on the road to mastery.

2. Locke’s ingredients for mastery

Locke described five ingredients to achieve mastery. Those ingredients are:

Growth mindset is student readiness for learning. It’s also a willingness to acquire new information, and practice the skill and its components.

Task analysis is the detailed set of steps to perform the skills. Locke creates task analysis documents for each skill by talking to clinical site personnel, reviewing manufacturer recommendations, reading relevant research and discussing the skill with other experts who perform the task.

Prompt expert feedback comes quickly and must be constructive to help the student’s next learning attempt.

Time is necessary for neurons to organize and make sense of the skill they are learning. Short blocks of instruction are better and switching to unrelated tasks – interleaving – pushes recently learned information out of short-term memory and into long-term memory. When the student returns to the previous skill, the action of retrieving long-term memory builds neural connections towards mastery.

Variable environments are used after the student achieves competence and works towards mastery. Instructors should change locations for skill performance, play different sounds – Locke recommended searching YouTube for different ambient sound environments – and adjust the lighting to slightly tweak the performance environment for the skill.

3. What questions do you have?

Locke ended her presentation with the amazing question, “What questions do you have?” rather than, “Do you have any questions?”

A “yes” or “no” question almost always results in a “yes” or “no” answer. Asking, “What questions do you have?” almost always leads to a question and the balance of Locke’s time was spent answering excellent questions from the audience about psychomotor instruction.

Learn more about psychomotor instruction and education

Here are some other articles from EMS1 on teaching psychomotor skills to EMT and paramedic students:

This article was originally posted Nov. 1, 2018. It has been updated.
Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.