How to Avoid Training Scars Continuing Education Course

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