Do you remember learning how to drive? Who taught you how to use the brakes, accelerator, clutch (remember those?), steering wheel and turn signals?For those of you from California, turn signals are something that many people find useful to communicate their driving action before they take it.But I digress.For me, it was thelady across the streetwhotaught me to drive,because my parents were too nervous to do it themselves.

She would take me to a big parking lot on Sundays when the store was closed and there was nothingin the lot forme to run into. Her green mustang had a stick shift. It didnt take long for me to even out the lurching to a smooth start and stop.

Soon,we were driving around the neighborhood. When I think back on that experience,and when you think back on yours,its something that we know we experienced; ithappened in the past. Neuroscientists call that explicit memory. It lives primarily in the hippocampus part ofthebrain.

On the other hand,I drove to the airport this morningto catchmy flight to New York. Its memory that allowed me to start and drive my Prius, properly using the turn signals from my home to the Santa Barbara airport.Its memory that allows you to drive your car too, but I suspect that you dont think of it as remembering how much pressure on the accelerator it takes to make your cargo.

You just know how todo it;you just drive. This type of memory is called implicit memory. It probably lives somewhere in the frontal lobes of your neo-cortex.

When it comes to building a new skill,like driving a car, playing the guitar, assessing a patient or negotiating a contract,there are some other aspects of neuroscience that are interesting.Here are some of theneuroscience principles that help learning:

Youll remember things better when youre well rested.Yes, that meansthatholdingoverexhausted crews to attendthemandatory CE session is unlikely to result in any actual learning.

Good quality sleep enhances the integration of what youve learned into your memory.This is the sleep that happens after learning. A gooddeep and restful 7-9 hours of sleepwithin 30 hours of learning something helps integrate it into long-term memory.

Youll learn more if you put the informationinto practice soon after or while youre learning.Our 8-year-old son remembers math better after hes used it to calculate how many more weeks ofallowancehe will need to buy his next dream Lego set.

That old saying, To teach is to learn twice is true. If you teach someone what youve learned,youll remember it much better.When Im reading something particularly exciting or listening to a great presentation, Ill open a new slide deck andtake noteson what Im going to share in my next class, presentation or article. It helps me pay attention at a much deeper level,knowing that Im going to teach what Im learning.

Your retention increases dramatically when you are re-exposed to what youre learning five or six times with a bit ofspaceinbetweeneachexposure.This is known as the spacing effect and its the anecdote to forgetting. In the late 19thCentury,German psychologistHermann Ebbinghauscreated whats commonly known as the Forgetting Curve. Heperformeda series of memory experiments, first on himself and then with others. He found then when youre exposed to new information once, youll forget 80% of it within a few days. If you revisit it the next day, youll only forget 60%. And if you actively revisit it five times over a couple of weeks,you can retain over 90%.

If you look at this list and compare it to the primary andcontinuing educationwe provide folks in our profession,weve really missed the boatin EMS.When it comes toteachingimportant leadership and clinical competencies like relationship building, trust building, empathy, compassion,self-defense,differential diagnosis of abdominal pain or reading a12-lead EKG,wetend to put tired people in a room for a two- or three-day workshop. Then we lecture at them for hours on end,often withslides designed to tranquilize a rhinoceros. Andthenwe wonder why people are still having problems with conflict even after the conflict management workshop.

Its time for us to apply the principles of neuroscience, memory and optimal learning tothe waywe teach our teammates and how we learn ourselves.It would be great to have learning systems that build implicit knowledge for the things thatreally make a difference for whatour teams do every day.

[Rom Duckworth sharedhis top tips, ideas and resources for improving initial and ongoing EMS educationat EMS World Expo. Read:Dozens of tips for EMS educators and training officers]

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Knowledge retention: the link between sleep and EMS training - EMS1.com