Hard Times for Soft Skills revised from the NAEMSE Educator Update Summer 2014 

Are so-called “Soft Skills” such as critical thinking, leadership, professionalism, adaptability, and teamwork important for today’s emergency responder?

If so, then why aren’t we teaching them?

Crucial to everyday human interaction, Soft Skills consist of personality traits, communication skills and social abilities often closely associated with Emotional Intelligence and professionalism. Rising to prominence in the early 1990s, soft skills were identified by the Secretary of Labor’s “Secretary’s Commission on Achieving Necessary Skills” (SCANS) as critical to workplace productivity.¹ More recently, in 2008 a Job Outlook survey conducted by the National Association of Colleges and Employers (NACE) found that the top five characteristics looked for in new hires were soft skills: initiative, strong work ethic, interpersonal skills, ability to communicate, and perform as a team. Yet another poll by the Society for Human Resource Management found that soft skills such as critical thinking, leadership, professionalism, teamwork, and adaptability were important for experienced professionals.

Soft Skills is are especially critical in industries where the worker is in direct, face-to-face contact with the customer

While any employee to must possess industry specific Hard Skills (such the ability to force a door, splint, or proper lift an injured person) Soft Skills is are especially critical in industries where the worker is in direct, face-to-face contact with the customer, has to work independently in an unsupervised context or has to lead and coordinate coworkers.² Scenarios such as these are clearly integral to EMS work, especially in time or task critical situations. Despite the fact that Soft skills play an important role in the success of many professions, the 2007 report “Every Promise, Every Child: Turning Failure Into Action” indicated that a large percentage of students preparing to enter the workforce over the next 20 years are significantly lacking in their ability to apply soft skills in the workplace. This then begs the question of all educators: are we incorporating these critical skills as a core component of our educational programs or are we simply hoping that students pick it up as they go along?

Skills to Pay The Bills!

Evidence of the failure of our primary school system to teach and foster soft skills resulted in the development of the US Department of Labor document “Skills to Pay The Bills”, a new soft skills teaching curriculum targeting students aged 14 to 21.³ This program focuses on six soft skills specifically: communication, enthusiasm and attitude, teamwork, networking, problem solving and critical thinking, and professionalism. While this program is no doubt a good first step towards defining and teaching soft skills for a future workforce, it does not benefit current today’s EMS providers and students.

Educators dealing with students who have limited prior experience with the development and application of soft skills may find a comparable list of soft skills first proposed by Archna Sharma to be more applicable to emergency responders.⁴ This list includes written and oral communication, critical thinking and problem solving, teamwork, lifelong learning and information management, entrepreneurship and motivation, ethics and professionalism, and leadership.

Why then do they so often go by the wayside?

The skills on this list are undeniably important to the field delivery of Fire, EMS, and Rescue Services; why then do they so often go by the wayside when it comes to emergency services education? Six reasons come immediately to mind.

• These skills are often presumed to be acquired by students before they begin class.
• These skills are presumed to be somehow integrated into each lesson.
• These skills are presumed to be the responsibility of the examining body to test for as a requirement for certification / licensure.
• These skills are presumed to be the responsibility of the students’ employer to teach / test for if they are valued.
• Educators don’t know how to teach these skills.
• Educators fear liability associated with evaluating what they believe to be subjective performance criteria.

What can be done?

So what can be done to correct this problem? The good news is that healthcare educators need not reinvent the wheel. These skills can either be taught in stand alone soft skills specific programs, or they can be embedded into existing curricula. Both methods have their pros and cons.

While stand alone programs can offer clear and defined emphasis on written and oral communication, critical thinking and problem solving, teamwork, lifelong learning and information management, entrepreneurship and motivation, ethics and professionalism, and leadership, it can be difficult for educators to add additional educational modules for all of these skills in to existing EMS programs.

The logistics of embedding the teaching and evaluation of soft skills into existing curricula is often much easier than adding discrete soft skills modules and adds the benefit of contextual learning and integration of these skills into field EMS practices. The risk is that many educational programs place great emphasis on high risk/low-frequency emergency medical skills, while everyday skills such as report writing, safe driving, and soft skills can receive far less attention, class time, and practice.

Whether an educator chooses the standalone or embedded format, developing learning outcomes for soft skills hinges, as it does with any skills, on identifying the appropriate topics (in this case soft skills such as those in the list above), and identifying the desired performance criteria using SMART, ABCD or other objective setting format. These then provide the outline for teaching and testing soft skills in either their own standalone lessons or as integrated into other lessons an EMT, paramedic or other EMS education program. Once the performance criteria have been set, any number of teaching techniques can be used to meet these objectives based on the skills and preferences of the educators. Examples include fostering written and oral communication by having students write and present to the class on a selected EMS topic, or, alternately, evaluating the student’s ability to give a written and/or oral report during a simulated patient transfer at the end of the patient care scenario.

Because by their very nature soft skills can be difficult to define, educators must be careful to use clear criteria and to find a ranking system that enables them to provide students with the feedback they will need to develop and apply soft skills effectively in their practice. An example of such a system may include using an even number of ranking levels (leaving no “middle-of-the-road” option) such as: Unsatisfactory, Moderate, Good, and Excellent. Of course, ranking students in such a manner is only effective as part of a larger feedback mechanism that will help guide the students to improve their application of soft skills in the patient scenarios that they are likely to encounter as part of their work in emergency services.

“The public and employers… demand (responders) who are technically competent, socially conscious, and culturally sensitive.”

The EMS Education Agenda for the Future says “The public and employers demand that health care education produce graduates who are responsive to the needs of the patient, have excellent communication skills, and are able to adapt to changes in their responsibilities. They demand graduates who are technically competent, socially conscious, and culturally sensitive.”⁵ And yet what is commonly taught, practiced, and tested in the EMS Communication System section of the National EMS Education Standards are primarily communication system procedures and technology rather than effective oral, written, and interpersonal communications. ⁶

It has been argued that due to a lax communication and social skills, the need for the teaching of Soft Skills is greater with Millennials than with any previous generation. Whether or not this argument is valid, it is clear that the inclusion of Soft Skills in educational objectives and testing criteria is crucial for EMS providers’ ability to provide excellent patient care, succeed in leadership levels within their profession and to advance emergency medical services as a profession on par with other health care providers.⁷ For this to happen, fire and EMS educators must not allow Soft Skills critical to all calls to be pushed aside in favor of more easily tangible and “teachable” Hard Skills critical for only some calls.

1. Skills, U. S. D. O. L. S. C. O. A. N. Teaching the SCANS competencies. (1993).
2. Lazarus, A. Soften up: the importance of soft skills for job success. Physician Exec 39, 40–45 (2013).
3. Department of Labor. Skills to Pay the Bills. (2014). at <http://www.dol.gov/odep/topics/youth/softskills/softskills.pdf>
4. Sharma, A. Importance of Soft skills development in education. (2009). at <http://schoolofeducators.com/2009/02/importance-of-soft-skills-development-in-education/>
5. National Highway Traffic Safety Administration. EMS Agenda for the Future. (Washington, 1996).
6. American Academy of Pediatrics et al. Equipment for Ground Ambulances. Prehosp Emerg Care 18, 92–97 (2014).
7. Ray, J. D. & Overman, A. S. Hard facts about soft skills. Am J Nurs 114, 64–68 (2014).