Training FTOs
Training a field training officer is different from training an EMT. Clinical competence still matters, but the new work is helping somebody else learn.
I trained about 30 people at Royal Ambulance over my time as an FTO and supervisor. Here’s what I learned.
The Core Problem
Most FTOs were selected because they were excellent clinicians. That’s necessary but not sufficient. Being good at a job does not automatically make you good at explaining it to someone who isn’t.
One trap I saw was demonstrating without creating enough room for practice. Observation can be useful. It just does not show that the trainee can recognize the situation, reason through it, and perform when the FTO is not there.
The goal isn’t for your trainee to have watched you do the thing. It’s for your trainee to be able to do the thing when you’re not there.
That is the same identity shift a new supervisor faces in Stop Being the Answer. Your competence is still necessary. It simply stops being the product. The other person’s judgment is the product now.
Teaching FTOs to Teach
When I trained FTOs, or mentored them through training questions, the through-line was always the same: shift from demonstrating to developing.
One progression I used was see one, do one, teach one. It was a prompt for increasing independence, not a rule that every skill is safe to learn in three attempts.
1. See one. They watch. Once, maybe twice. Before you start, tell them what to pay attention to — not a running commentary during. Let them observe without narration cluttering it.
2. Do one. Trainee attempts. Before you hand it over, narrate your reasoning out loud — not the steps, the thinking. “I’m starting here because… I’m checking this because…” Most experienced providers have automated their reasoning. Making it explicit again takes practice. Then step back and let them work. Resist the urge to jump in.
3. Teach one. Ask them to walk somebody else through the reasoning. Teaching can reveal gaps that successful execution hides. It is useful evidence of understanding, not the only test of competence.
Debrief often enough that practice turns into learning. The depth should match the task and the risk; not every routine attempt needs a formal conversation. See The Debrief. “What were you working with when you made that decision? What would you pay attention to next time?”
Move through the progression as fast as the trainee can handle. The FTO’s job is to become unnecessary.
Common FTO Mistakes
Rescuing too early. The trainee pauses and the FTO steps in. Sometimes safety requires that. When it does not, a little room to think can be more useful than an immediate rescue. The skill is knowing which situation you are in.
Correcting in front of the patient. If immediate safety requires intervention, intervene. Otherwise, pull them aside afterward. The debrief is private. The call is not the time for a performance review.
Inconsistency. Different standards on different shifts, depending on how the FTO feels that day. Trainees notice immediately and it destroys trust. Consistent doesn’t mean rigid — it means your trainees know what to expect from you.
Skipping the “why.” Teaching steps without teaching reasoning can produce a trainee who performs in familiar scenarios and struggles when the shape changes. Teach the “why.” EMS is too unpredictable for rote execution alone.
A completion record can show that the trainee received the material. It cannot, by itself, show that the trainee can recognize the situation, adapt, and perform under pressure. I am still trying to find better ways to make that difference visible without turning development into another pile of checkboxes.
The Hygiene Problem (And All the Other Uncomfortable Ones)
New FTOs ask about this more than almost anything else. “My trainee doesn’t use deodorant. How do I handle it?”
Directly. Privately. Kindly. Quickly.
The longer you wait, the harder it gets, and the more it affects the partnership. These conversations feel enormous beforehand and are usually over in three minutes. The formula: private setting, specific observation, no editorializing, clear expectation, move on.
The basic approach carried into many uncomfortable FTO conversations: private setting, specific observation, clear expectation, and room for the other person to respond. Some situations require more process than others. Direct does not have to mean abrupt.
What Makes a Good FTO, Honestly
Clinical competence — yes, required.
Patience — more than you think you have.
Genuine investment in the trainee’s success — not their performance on your watch, their success in the career. Those are different things.
The ability to remember what it was like to not know something. This gets harder the more experienced you become. Fight to hold onto it.
Related
- The Debrief — the most important FTO skill
- Leadership Philosophy — the mindset underneath all of this
- Hard Conversations — the uncomfortable stuff FTOs face
- Stop Being the Answer — resisting the urge to make your expertise the center of the learning
The Provider Development Reviews and FTO Selection Guide are the practical companions to this note.