What I learned about hiring Paramedics, with some tips for candidates.

Often I come across emergency services students looking for advice on how to succeed in the hiring process for their first job, since I have had the opportunity to sit across the table and conduct the interviews I thought I would share and give back to the profession with a few simple ideas to help make your interview go a little smoother. This is both specific, but also has some general pointers.

Before I get started, I would like to acknowledge that while looking for stock photos for this post the lack of women and non-caucasian interviewers became extremely apparent. Even the photos meant to be diverse demonstrated the power imbalance towards the minority interviewees. Which leaves me to explore the thought of how we can shift this power imbalance and make the interviewing process more welcoming and inclusive.

What should you expect. Certainly every employer will take their own approach to the hiring process and often there are hundreds or even thousands of candidates. If you reach an interview you have done well with your resume and screening criteria. The really great thing about a larger candidate pool is that it can be equalizing when an unbiased approach is taken to screening.

Resume and Credential Screening

Since most Canadian emergency services are government based or arms length contract to government there is an emphasis on using screening and scoring tools to maintain equity throughout the process. As each stage of the process progresses often candidates are reduced through the scoring process until reaching an interview. In some cases a multi-mini-interview (MMI) process may be used as part of the scoring rounds as well.

MMI’s are meant to be unbiased by having multiple short interviews where the individual interviewer has one consistent question to promote inter-rater consistency between candidates. It is also meant to reduce bias hoping that if one interviewer is biased then for example nine of ten will not be and it does not have a large impact on overall score.

Taking this one step further, I have personally run a completely blinded process in the screening phase. I had a Human Resources department person remove all identifying information by assigning candidate numbers and removing names, addresses, school names and anything that could identify ethnicity, community, and school. This helps to remove bias around socioeconomic status, ethnicity through names, and school preferences such as traditional community colleges over private institutions.

I have to admit, the staff hired preceding this hiring process in comparison to this particular hiring process was substantially different. There were only two caucasian males out of twelve hired in the later. As much as the thought of assigning numbers to candidates seemed offensive, it became obvious that designing a process to remove unconscious bias is the right approach.

My recommendation for resume writing is quite simple for a technical hiring such as entry to practice. Find the required credentials and preferences in the job posting or request the job description and place them all in order on the front page of your resume. The screener will likely use a rubric and assign points for meeting or partially meeting each criteria. Make it easy for them to find the job requirements.

You would be amazed at what counts as well. Often there are points for people going that extra step to stand out. Make sure you include all of your experiences; part-time jobs, volunteering, papers or articles you have written and extra courses you have gone out of the way to take to ensure that you stand out.

Written Tests

I’m not going to spend a lot of time on this topic. As a new graduate you are immersed in academic studies in the profession. There will be a cross section of areas covered. I would like to say don’t focus on protocols; focus on physiology, pathophysiology and evidence based treatment plans; but alas, we have not yet fully evolved and you are going to find geographically variants of written tests that expect you to make decisions within local medical directives and standing orders (protocols) that will be judged as right or wrong and require you to know indication, contraindications and your limits.

Watch for the subtleties, there are no trick questions, but keep in mind things like mathematics may give you multiple choice options that include common miscalculations.

Physical Testing

This has a long and winding history in Canada. The unfortunate element is that physical testing is an extremely time consuming and resource heavy phase in the process. As a result many organizations have contracted this out to offset the work and liability.

There have been many different approaches to this pre-service fitness testing. Many of which were or are irrelevant to the actual physical demands of the job.

Enter academic science. In recent years the Ottawa Paramedic Service partnered with researchers at Wilfred Laurier University to develop a validated fitness test for Paramedics. Similar in functionality using actual equipment similar to what had been established for fire services many years prior through York University.

My recommendations here are quite simple. Make good use of the equipment available to you in your education program and practice a lot with a variety of other students. Ideally at the beginning of your education program find out the testing requirements and work on functional fitness movementents that mimic the actual equipment to build strength with good form. Consider approachingng a kinesiologylogy program at a university to work with students there to help you with your form and fitness; Win-Win.

The Interview

This can be very intimidating. Often a panel of senior staff and Human Resources people sitting across from you ready to dole out questions.

It’s pointless for me to say relax, don’t be nervous. So, I will offer some solace. We all know how nervous you are, and we appreciate and understand what you are going through. Each person on the panel has been in your seat in one form or another, with it all on the line and we are empathetic, patient and understanding. We want to you to succeed!

I would like to sidebar here. My values very much include as much front-line staff participation in the success of the organization as possible. Including front-line staff in strategy meetings, program planning, and hiring which helps to build positive culture and re-enforce values and inclusiveness while also valuing the input and contributions of staff in building a positive organization. We need to progress to including clinicians on the interview panel. [Another article perhaps]

The interview will typically be structured as a series of questions that the panel interviewers will take turns asking, each candidate receives exactly the same questions and they are scored by having key points on a rubric that the interviewers are seeking to address throughout your answer.

Studying for an interview is not usually going to be helpful. However, doing some research on how to answer behavioural based questions would be beneficial. Here are the tips that will help you be successful:

You are likely learning to deliver clinical reports and updates using the SBAR format. (Situation, Background, Actions, Results) This has become a common approach in medicine, aviation, and emergency services. You don’t have to learn anything new for your interview. Use the SBAR+L(Learning).

I have often seen panels assist or coach candidates who struggle with these questions. (They aren’t supposed too) Here’s the trick… You don’t have to relate everything to your clinical placement or courses. We know you are new to the profession. We want to know about you and your experiences. Truth is, diversity of experience makes the organization better. Tell us about your varied experiences.

A quick tip: If you are currently in school, make sure you are doing things to get varied experiences. Volunteer, get out in the community, build relationships, truly help others, be more curious and learn.

Experiential questions are looking for you to share stories that address the issues outlined in the question. So, go back to school, volunteering, sports camp, band camp, family. The point of the question is to see that you can recognize behaviours and difficult situations, get an idea how you think and deal with difficulties; and if they didn’t go well, thats also alright, we want to know what you learned and changed to do better now when you work with us.

Tell your story using SBAR+L

Situation: What happened that is similar to the question

Background: Tell the story, de-identified circumstances that led to your involvement.

Actions: What did you do in this situation.

Results: What happened when you got involved and how did it solve the problem. (Or frankly not solve the problem or make it worse)

Learning: What did you learn form this situation, how would you do it differently now in your new role that you are being interviewed for.

Clinical Practical Testing

This is the broadest variable across the country and most challenging to describe. I have the privilege of knowing some great academic people who have put a lot of work into developing and validating what is called the Global Rating Scale (GBR) to evaluate clinical practice. This in my opinion is one of the best methods to approach the evaluation of the application of clinical abilities.

It is designed similar to MMI’s, multiple small clinical scenarios designed to assess specific clinical criteria, assessments, treatment plans, application of devices, decision making, etc. It is scored on a matrix that looks to understand thought process, competency, and safety to practice.

It is possible to fail at a scenario and still pass the overall GBR. It has inter-rater independence to help remove bias, and it grades the level of errors to allow for errors in the clinical practice that are recognized, wouldn’t be harmful or may be adverse. Then a global rating is derived across all scenarios.

The take home point with this approach is that you don’t have to be perfect. You can demonstrate broad depth of knowledge but still be week in an area needing improvement and not jeopardize your hiring process. To me this seems far superior than a scenario with a critical point that defines pass or fail. I came up through such a system and having your entire course or hiring process come down to one scenario and one error was pretty stressful.

I hope that I have contributed a little to your preparations for your upcoming recruitment process. I also hope that I have challenged the convention in a couple of areas of the hiring process. How are we going to be more open, inclusive and eliminate unconscious bias while being empathetic and valuing individuals throughout the process. Where can we include front-line staff participation more often in building our organizations for the better. Would love to hear people thoughts and feedback on all of the areas in this article.

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