Training FTOs
Training a field training officer is different from training an EMT. You’re not teaching clinical skills — you’re teaching someone how to teach. That’s a harder thing to do, and almost nobody does it deliberately.
I trained 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.
The trap new FTOs fall into: they demonstrate instead of develop. They show the trainee how to do the skill, the trainee watches, and everyone moves on. No learning has actually occurred. What’s occurred is observation.
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.
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.
Practical framework — see one, do one, teach one:
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. They can walk someone else through it. That’s the real test. Not whether they can execute — whether they understand it well enough to explain the why. If they can’t teach it, they don’t own it yet.
Debrief after every attempt. Not a list of corrections — use the Socratic method. 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, the FTO steps in. Natural instinct, wrong move. Productive struggle is where learning happens. Let them sit in it a little longer than feels comfortable.
Correcting in front of the patient. Never. Pull them aside. 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 the steps without teaching the reasoning produces a trainee who can perform in familiar scenarios and falls apart in novel ones. Always teach the “why.” EMS is too unpredictable for rote execution.
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 same framework applies to almost every uncomfortable FTO conversation. Don’t build up to it, don’t over-explain, don’t apologize for having the conversation. Have it and be done with it.
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
Take this further
Three tools go with this chapter: 04: Provider Development Review (monthly coaching log with See/Do/Teach progression tracking) and Tool 08: FTO Selection Guide (behavioral interview questions for selecting FTO candidates). All three are in the EMS Supervisor Field Guide, free with your email on Gumroad.