Continuing Education Course

How to Avoid Training Scars BY CHRISTOPHER BRENNAN

TRAINING THE FIRE SERVICE FOR 136 YEARS

To earn continuing education credits, you must successfully complete the course examination. The cost for this CE exam is $25.00. For group rates, call (973) 251-5055. AVOIDING TRAINING SCARS ●

methodology was Donald Meichenbaum, who initially “fo- ally five or 10 push-ups. The initial time standards are very How to Avoid cused on cognitive-emotional theory of anxiety and learning generous, 90 seconds or so, to train the student to handle the approaches for the development of cognitive and relaxation stress. We could, of course, make the initial time standard 60 coping skills for anxiety reduction.”1 Survival skills instruc- seconds (which is the minimum passing time), but then there tors have used variations on SIT from the days of ancient would be a lot of push-ups done and a great increase in anxi- warrior cultures without having a specific label for it. ety. Once we warm the group up with a few 90-second drills Training Scars From the brutal rites of passage that are part of initiation (which generally everyone passes), we can then slowly work into elite military organizations through the burn tower evo- our way toward the 60-second mark. As the time standard lutions with recruit academy candidates to law enforcement gets closer to the neurological skill capacity of the students, defensive tactics courses, those who are expected to place their anxiety will increase (they don’t want to do push-ups). their bodies in harm’s way have attempted from time imme- We coach them to control their breathing and focus on their morial to develop a mental toughness in their students. This procedures. By the time this initial SIT phase is complete, is a noble effort. However, ineffective or poorly designed/ex- most of our students will have done some push-ups, and a few ecuted attempts to use SIT can do more harm than good. will have become quite stressed out. We go back to a slow, Educational Objectives mentored approach, without the time standard and reinforce On completion of this course, students will PSYCHOLOGICAL SCARS quality mechanics in donning, leaving the students aware of The second type of performance scar I see in firefighters their difficulties but with the knowledge that they did in fact 1) Recognize the instructor’s objective when the student leaves 3) Discover the benefits of Stress-Inoculation Training a training drill or shift is psychological. It is likely that psychological training scars meet the time standard several times when it was manageable 4) Understand the impact of psychological scars lead to a young firefighter burning out so early in his career. and that their skills are improving. 2) Learn how to recognize and reduce performance s cars The difficulty with SIT is that it cannot be implemented hap- I liken this process to training someone who is learning hazardly or you run the real risk of damaging people psycho- how to lift weights. When someone begins learning how to logically, which can happen without the instructor or student squat or dead lift, he is initially weak relative to his potential. being aware that it has happened. However, these scars can The reason is that he has neither the technical proficiency become ticking time bombs that increase an individual’s or the neurological pattern to move the load efficiently nor BY CHRISTOPHER BRENNAN contained breathing apparatus (SCBA), or back squatting, in stress level and increase risk of injury or illness and, depend- the contractile muscle force. As he begins training, he will their first 50 hours. Most of the learning is neurological. The ing on how deeply you care to examine the issue, perhaps initially see a large increase in the load he can move as he met a young firefighter some months ago trouble is, if we allow improper or inefficient patterns to be even lead to an increased chance of heart disease and cancer becomes neurologically adapted to moving the weight. How- who was in a difficult place—early 20s, sincere in desire implanted then, that’s what our firefighter will walk away with. (which have been linked to stress). ever, he will then plateau unless he increases the load he is I and drive to succeed in the fire service, but feeling burned This can also be the case if we try and insert new procedures The first critical element in effective SIT is to prepare the moving and forces the body to adapt. out far too early. What had led to this burnout? Was it a string into an existing routine. I’m not sure if there is any citable students for what they are going to experience and what their Adaptation is adaptation—it doesn’t happen overnight. of difficult calls that opened up emotions that were overwhelm- source for this, but it’s accepted that one of the reasons that expected action should be. This has to be done step by step. Whether learning how to powerlift or practice SIT, we need a ing? Maybe the reality of the job didn’t fully match up with this personal alert safety systems (PASS) have become integrated When teaching new recruits SCBA emergency procedures, the slow, steady increase in the stress load that disrupts homeo- firefighter’s perception. Perhaps there was just a bad attitude at into SCBAs is that firefighters were not turning them on. Why culmination is having a recruit reestablish his air supply while stasis but does not overload the system to cause damage. the root of this discontent! No, the answer was “D. None of the weren’t they? Quite simply because during their 200 repetitions in a live fire environment. I have heard military instructors above,” but it didn’t take more than a five-minute conversation of donning, they didn’t have a PASS device to turn on. De- refer to the fine line between “hard and dumb” when it comes THE ISLAND OF MISFIT TOYS to diagnose the root cause: training scars. pending on the study you read, it takes 3,000 to 5,000 repeti- to challenging routines. A surefire way to leave a training scar Instructors who will use SIT in their programs (and we I’ve heard it said that “experience is what you get when tions of practice to replace a habit that has become automatic. (i.e., the dumb approach) would be to take your candidates should) must have more than a basic understanding of the you don’t get what you want,” and there is a certain degree of This is the reason it is critical that our instructors be dedi- with their newly minted SCBA donning skills into a burning human animal and the effects of stress on the body. I have accuracy in that for my life. What I’ve observed and experi- cated to maximizing the effectiveness of their instruction. building and shut off their air. You watch them thrash around examined this in some detail in The Combat Position: Achiev- enced, though, is that “experience” in the context of a fire We must ensure that the mantra “Amateurs train until they for a few seconds, turn their SCBA back on, drag them outside, ing Firefighter Readiness (Fire Engineering, 2011) and highly department training session often leaves a scar. Training scars get it right; professionals train until they can’t get it wrong” and then berate them in front of the other students and instruc- encourage instructors to look deeply at works like On Combat are the leftover performance and physiological damage that is implemented in our training academies and in our station tors for “trying to get themselves killed!” They actually have by Lieutenant Colonel Dave Grossman and Loren Christensen; can occur when our instructors or peers fail to help us come and company drills. Whether career or on-call, the stakes for behaved exactly how we expect the human animal to behave Warrior Mindset by Mike Asken (with Dave and Loren); Bruce back from a drill as a winner. Now, before I raise everyone’s accepting error (what is known in the engineering commu- when threatened and feel as if they can’t breathe—sheer panic. Siddle’s Sharpening the Warrior’s Edge; and articles by Donald hackles here, I am not talking about the fire service variation nity as “normalization of deviance”) are far too great. The smart-but-hard routine is systematic. For the sake of Meichenbaum, Jerry Deffenbacher, and their colleagues who are of youth soccer, in which everyone is a winner just for show- Basic skill acquisition must be followed by a progressively illustration, I will briefly go over how I train new candidates looking into effective methods for implementing SIT. ing up. However, we need to recognize that the firefighter more challenging set of drills to develop highly effective fire- on SCBA donning and emergency procedures. It begins with What we must avoid in our training is turning firefighters we are training is going to leave us at the end of the drill or ground application. This should begin with a solid foundation a classroom presentation about the SCBA, moving on to a into a living, breathing version of the Island of Misfit Toys shift, and our objective should always be to help that member in the fire academy and continue as our firefighters are inte- hands-on review. With an instructor leading, we show them from the Rudolph the Red-Nosed Reindeer TV special—big- improve, not leave him broken. grated with the line companies with which they will respond. and have them find for themselves every part on their SCBA. hearted but damaged. It is relatively easy to create a stress- Among the critical components you must integrate into this From here, we guide them through donning their SCBA, one inducing drill; the challenge is doing it in a manner that will PERFORMANCE SCARS applied skills training is stress-inoculation training. step at a time, as they are instructed to. This method allows allow the firefighter to grow, learn, and emerge stronger. That Performance scars happen when we allow improper actions us to prevent performance scars right away. Through dozens should be our ultimate goal. to become habit. It takes roughly 200 repetitions of a given STRESS-INOCULATION TRAINING of repetitions in the classroom and a solid hundred more for skill for automaticity (the ability to perform a task without Stress-inoculation training (SIT) is a collection of meth- homework, we lay the foundation for effective donning. After PRIMUM NON NOCERE thinking specifically about the steps) to kick in. That is the ods instructors use to train students to reduce anxiety and six or seven hours, we will begin to add an initial layer of “First, do no harm” is the translation of the Latin phrase reason we see great strides in people’s skill in donning a self- increase performance. Among the early developers of the stress—time. Timed donning drills have a consequence, usu- above. It’s found in many ethical codes, including those of www.FireEngineeringUniversity.com www.FireEngineeringUniversity.com ● AVOIDING TRAINING SCARS Continuing Education first responders. The Hippocratic Oath of the physician in HELPING THEM HEAL part states, “I will do no harm ....” 2 It’s a reasonable way to If you spend much time teaching firefighters, you will How to Avoid Training Scars live your life: Try hard not to hurt people. find yourself with a student who is already damaged. As As instructors, this must be among our primary concerns, an instructor, what do you do? You help him heal. I have COURSE EXAMINATION INFORMATION and yet we still hear of reckless instructors who injure or kill corresponded on occasion with the firefighter I told you To receive credit and your certificate of completion for participation in this educational activity, you must complete the program post exami- students during poorly planned evolutions. It’s often easy for about earlier. Although there are still struggles, things to nation and receive a score of 70% or better. You have the following options for completion. us to look at training burns where fatalities occur and spot learn, and healing to happen, I don’t see the same sense of Option One: Online Completion the errors. This is not always the case in a poorly designed frustration and fear. Why not? We started to get on the right Use this page to review the questions and mark your answers. Return to www.FireEngineeringUniversity.com and sign in. If you have not SIT scenario. However, you can look around a firehouse fairly side of the problem. First and foremost, I acknowledged for previously purchased the program, select it from the “Online Courses” listing and complete the online purchase process. Once purchased, the program will be added to your User History page where a Take Exam link will be provided. Click on the “Take Exam” link, complete all quickly and spot the damaged firefighter. He is the one who this firefighter that not every hard routine is the right one the program questions, and submit your answers. An immediate grade report will be provided; on receiving a passing grade, your “Cer- doesn’t participate, is unwilling to engage in the discussion, and that while we need to have an intense level of mental tificate of Completion” will be provided immediately for viewing and/or printing. Certificates may be viewed and/or printed anytime in the or issues the “Training is stupid—I know my job” statement. and physical toughness, it must be mentored. Second, I used future by returning to the site and signing in. Although there will always be lazy people in any profession, a process commonly used in SIT circles: Lay a cognitive Option Two: Traditional Completion I have seen that in an environment where firefighters are foundation to help the student understand how and why You may fax or mail your answers with payment to PennWell (see Traditional Completion Information on following page). All information requested must be provided to process the program for certification and credit. Be sure to complete ALL “Payment,” “Personal Certification encouraged to participate, to learn, and to make reasonable stress reactions occur; then instruct in skills for managing Information,” “Answers,” and “Evaluation” forms. Your exam will be graded within 72 hours of receipt. On successful completion of the posttest mistakes, far fewer withdraw from training. the anxiety; finally, place him in an environment where he (70% or higher), a “Certificate of Completion” will be mailed to the address provided. has to practice. COURSE EXAMINATION BREATHING CONTROL AND VISUALIZATION The single most important factor as an instructor is to 1) The objective should always be to help a member improve, not 8 Another type of performance scar found is: A full treatment on techniques for mastery of stress control remove your ego from the process. Focus on positive learn- leave him broken after a firefighter leaves a training drill or shift is beyond the scope of this article; however, I can introduce ing outcomes and understand that every word you use and a. Psychological Scars a. True b. Physiological Scars two topics that have tremendously positive effects. Breathing every move you make will have an effect. Carelessness in b. False c. Recreational Scars is the only function of our autonomic nervous system that word or action can leave a training scar. As instructors, d. Relationship Scars we can control voluntarily. Training your students to control we are preparing our firefighters to make the fireground 2) Performance Scars happen when we allow: their breathing during SIT drills is the first key step in help- a place where they can thrive. It is incumbent on us to in- a. Student interruptions 9) It is likely that psychological training scars lead to a young firefighter burning out so early in his career ing them manage their stress. I use two drills. struct and not injure. b. Instructor bias The first breathing control drill I teach is drawn from On I have found over the course of a decade that the simplest c. Improper actions to become habit a. True d. Informal leaders to interject their ideas and philosophies b. False Combat and used with the permission of Dave Grossman. means of accomplishing this is with SCBA donning and emer- Have your students close their eyes. Instruct them to in- gency procedure drills, like those I described earlier. Why? 3) It takes approximately ______repetitions of a given 10) The difficulty with Stress Inoculation Training is that it cannot hale through the nose for a count of four, pause for a count Human beings hate having their faces covered, hate being in skill for automaticity be implemented haphazardly, or you run the risk of: of four, exhale through the mouth for a count of four, and an enclosed space (even if they don’t have a phobic reaction), a. 1000 a. The training not being stressful enough pause for a count of four. This four-count breathing exercise and hate the thought of consequences for poor performance. b. 200 b. Not enough stress-inducing drills to foster automaticity has been shown to help reduce anxiety and anxiety-induced On a bright sunny day, I can “create” stress just by holding a c. 20 c. Burning-out firefighters d. 10 d. Damaging people psychologically heart rate increases. This drill is excellent when the student stopwatch. They know from the classroom that the stress is is beginning to experience anxiety—for example, before an manufactured inside them, not by an outside antagonist. With 4) It can be assumed that personal alert safety systems have become 11) The first critical element in effective Stress-Inoculation Training evaluation or when a call is dispatched. this knowledge, I can train my students to manage the stress integrated into SCBAs due to the fact that firefighters were not is to prepare the student for what they are going to experience The second breathing control drill I teach is for emergen- they have created: Perfect practice, breathing control, and turning them on and what their expected action should be cies that occur in an immediately dangerous to life or health visualization are all tools. ● a. True a. True b. False b. False (IDLH) environment. I teach them to inhale deeply through the nose and try to fill their belly with air. This is a form of 5) Basic skill acquisition must be followed by a progressively more 12) Preparing students for what they are about to experience should diaphragmatic breathing that encourages filling the lungs fully; Endnotes challenging set of ______to develop highly effective fire be done: ground application when the lungs are completely full, exhale by humming your 1. Meichenbaum, Donald H. and Jerry L. Deffenbacher. “Stress Inoculation a. As quickly as possible breath or through your lips. This method is based on the Reilly Training.” The Counseling Psychologist, Vol 16, No 1, January 1988, 69-90. a. Drills b. Step-by-step b. Curriculum Emergency Breathing Technique.3 It is effective in scenarios 2. North, Michael (trans.) “Hippocratic Oath,” National Library of Medicine, c. Gradually National Institutes c. Instructors d. None of the above where you have to focus on getting tasks accomplished and of Health, www.nlm.nih.gov/hmd/greek/greek_oath. d. None of the above html, 2002. cannot afford to devote working memory to counting. 13) The ______approach is systematic 3. Gagliano, Mike, et al. Air Management for the Fire Service. Fire Engineer- 6) ______is a collection of methods instructors use to Warriors have used visualization drills since antiquity, and a. Hard and dumb ing, (2008) 527-528. train students to reduce anxiety and increase performance high-performing athletes use them to produce results. A way b. Dumb to learn this skill is to have your students mentally rehearse a. Cataloguing c. Smart-but-hard b. Stress-Inoculation Training donning their SCBA. It is a skill in which participants must ● CHRISTOPHER BRENNAN is a 14-year fire service d. None of the above veteran, a firefighter in the suburbs of Chicago, and the c. Physiological Stress Inducing perform specific steps in a particular sequence. Once they d. Psychological Stress Inoculation president of Spartan Concepts, Inc. He is a field instruc- 14) When practicing Stress-Inoculation Training, it is advised to have a sense of proper donning, have them close their eyes tor with the Illinois Fire Service Institute and has con- provide a stress load that disrupts homeostasis, but does not and visualize donning the SCBA. Once they have understood 7) Ineffective or poorly designed/executed attempts to use Stress- overload the system to cause damage tributed articles to Fire Engineering. He maintains the Inoculation Training can do more harm than good the basics, they can use these same techniques to practice a. True Web site www.fireservicewarrior.com and is the author emergency procedures and Mayday drills. a. True b. False of The Combat Position: Achieving Firefighter Readiness b. False Coupling breathing control and visualization is a key in (Fire Engineering, 2011). managing stress responses.

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15) It is relatively easy to create a stress-inducing drill; the challenge 18) ______is the only function of our autonomic nervous PROGRAM COMPLETION INFORMATION is doing it in a manner that will allow the firefighter to grow, system that we can control voluntarily If you wish to purchase and complete this activity traditionally (mail or fax) rather than Online, you must provide the information requested learn, and emerge stronger below. Please be sure to select your answers carefully and complete the evaluation information. To receive credit, you must receive a score of a. Laughing 70% or better. a. True b. Breathing a. False c. Seeing Complete online at: www.FireEngineeringUniversity.com d. Hearing 16) As an instructor, one of the primary concerns in preventing Training Scars is: 19) Visualization drills are used by high-performing athletes to PERSONAL CERTIFICATION INFORMATION: Answer Form a. “First, do no harm” mentally rehearse Please check the correct box for each question below. b. Have a lesson plan a. True c. Incorporating Stress-Inoculation into every drill b. False Last Name (PLEASE PRINT CLEARLY OR TYPE) 1. ❑ A ❑ B ❑ C ❑ D 11. ❑ A ❑ B ❑ C ❑ D d. None of the above 2. ❑ A ❑ B ❑ C ❑ D 12. ❑ A ❑ B ❑ C ❑ D 20) The single most important factor as an instructor is to remove First Name 17) Which of the following are symptoms of a “damaged” firefighter: ______from the training process 3. ❑ A ❑ B ❑ C ❑ D 13. ❑ A ❑ B ❑ C ❑ D a. Doesn’t participate a. Disruptive students 4. ❑ A ❑ B ❑ C ❑ D 14. ❑ A ❑ B ❑ C ❑ D Profession/Credentials License Number b. Unwilling to engage in the discussion b. Experiences 5. ❑ A ❑ B ❑ C ❑ D 15. ❑ A ❑ B ❑ C ❑ D c. Makes comment such as, “training is stupid – I know my c. Ego job” d. Anxiety Street Address 6. ❑ A ❑ B ❑ C ❑ D 16. ❑ A ❑ B ❑ C ❑ D d. All of the above 7. ❑ A ❑ B ❑ C ❑ D 17. ❑ A ❑ B ❑ C ❑ D Suite or Apartment Number 8. ❑ A ❑ B ❑ C ❑ D 18. ❑ A ❑ B ❑ C ❑ D 9. ❑ A ❑ B ❑ C ❑ D 19. ❑ A ❑ B ❑ C ❑ D Notes City/State Zip Code 10. ❑ A ❑ B ❑ C ❑ D 20. ❑ A ❑ B ❑ C ❑ D

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AUTHOR DISCLAIMER INSTRUCTIONS COURSE CREDITS/COST The author(s) of this course has/have no commercial ties with the sponsors or the providers of the unrestricted educational All questions should have only one answer. Grading of this examination is done manually. Participants will receive All participants scoring at least 70% on the examination will receive a verification form verifying 4 CE credits. grant for this course. confirmation of passing by receipt of a verification form. Participants are urged to contact their state or local authority for continuing education requirements. SPONSOR/PROVIDER EDUCATIONAL DISCLAIMER RECORD KEEPING No manufacturer or third party has had any input into the development of course content. All content has been derived The opinions of efficacy or perceived value of any products or companies mentioned in this course and expressed PennWell maintains records of your successful completion of any exam. Please go to www.FireEngineeringUniversity.com to from references listed, and or the opinions of the instructors. Please direct all questions pertaining to PennWell or the herein are those of the author(s) of the course and do not necessarily reflect those of PennWell. see your continuing education credits report. administration of this course to Pete Prochilo, [email protected]. Completing a single continuing education course does not provide enough information to give the participant the COURSE EVALUATION and PARTICIPANT FEEDBACK feeling that s/he is an expert in the field related to the course topic. It is a combination of many educational courses and © 2009 by Fire Engineering University, a division of PennWell. We encourage participant feedback pertaining to all courses. Please be sure to complete the survey included with the course. clinical experience that allows the participant to develop skills and expertise. Please e-mail all questions to: Pete Prochilo, [email protected]. www.FireEngineeringUniversity.com www.FireEngineeringUniversity.com