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Blog Post: Classroom Medicine

Tod Schimelpfenig — Mon, 07 May 2012 22:52:00 GMT

I recently sat through a wilderness medicine class by a well-meaning instructor who, despite decent credentials, had never cared for anyone in the wilderness. This is just after reading a poorly crafted wilderness medicine text. Instead of listening to the talk I made a list of things that drive me nuts in wilderness medicine education.

At the top of the list is classroom medicine. These are tools, techniques and advice that work in a clean, controlled world and fail in the reality of the field. Years ago we taught, I taught, not to apply warmth to a severely hypothermic patient because they were in "a stable metabolic icebox." Then I knelt next to my first severely hypothermic patient and the shallowness of this advice was clear. I had no illusions I would warm this patient in the field, but not applying heat to stabilize his temperature made no sense. I read advice to keep frozen feet frozen all night by keeping the foot outside a sleeping bag. This fell to the axe of reality when I stared at my own frozen foot in a tent on a cold winter's night. We used to think tourniquets implied amputation and that open chest wounds need to be sealed with three-sided dressings to allow air to escape. This classroom advice did not survive the test of the battlefield. If your skepticism meter is pegging over words of dubious wisdom, ask the instructor if he has ever done this to a real patient. You'll be surprised how often the honest answer is no.

High on my list are inaccurate statements of frequency. If I believed all the tales of drama I hear from someone who heard from someone who heard, I would not leave home without an auto- injector of epinephrine in a hip holster, locked and loaded. If I believed the NOLS incident data history, solid enough to generate multiple medical papers, I can argue that anaphylaxis is rare in the wilderness. But I won't make that argument. A snapshot is not the entire picture. Data is often a matter of context. We don't know the true incidence of anaphylaxis, or many other ailments, in the outdoors. Statements of frequency need to be viewed with healthy skepticism.

In the same vein I recently read that the risk of a lawsuit from reducing a dislocation in the field is high. Based on what cases or data? I've heard outdoor experts say that the most common injury on NOLS courses is a laceration from slicing cheese. The real answer, sprains and strains, is easily accessible in the published literature. When you see or hear numbers, ask for the source, and ask for the conflicting evidence. If the educator is worth his salt he will tell you the breadth of science on this question and why he choose to believe this particular study. Consider any unreferenced number to be junk.

I'm also skeptical of resumes, credentials and endorsements. Resumes can be exercises in creative writing, exaggerating or underselling experience. Credentials often tell us of educational accomplishments, not experience. Endorsements might be earned, but they can also be purchased-- a source of income for an organization willing to sell their name. These badges don't tell us whether the person has ever seen a patient, seen a patient in the wilderness, spent much time in the wilderness or whether they have ever had to make a real decision in the field.

In my upper echelon of molar grinders are statements of absolutes. These often reveal inexperience, not expertise, and as William Osler MD said "are made at the expense of a clean conscience." There isn't an “accepted” splint. There are splints that are crafted based on available resources and splinting principles. There is no single evacuation plan. There is only what we create based on sound plans, sound assessments and sound judgments. There are many lists of classic signs and symptoms, there is rarely a classic patient.

Last, but not least, is the phrase "our curriculum is evidence-based." This is an intriguing statement since quality evidence in first aid is rare, and in wilderness first aid it is almost non-existent. I prefer to say "evidence-informed." It acknowledges that our choices are a blend of science, experience and opinion.

Am I a curmudgeon? Probably. Am I innocent of these sins? Probably not. But I am aware. I'm trying to be virtuous and I do have the good fortune of being surrounded by colleagues who enjoy calling me to task when I slip.

Take care

Tod Schimelpfenig

Curriculum Director

NOLS Wilderness Medicine Institute

May 2012

Blog Post: Do you inform pre-orientation students that they must follow college policies while traveling off-campus?

Brent Bell — Thu, 03 May 2012 14:45:00 GMT

Another listserve I monitor (National Orientation Directors Association) has started a discussion regarding policies. How are students informed that they are expected to follow college policies while on a pre-orientation trip away from campus? Although this is not confusing to most program directors, it may be confusing to participants?

I wonder about student led programs that perceive a bit of distance from the administration, is it clear that college policies apply during trips in the summer?

I am hoping to hear how others inform students and if their are any stories to learn from. It is one detail that you may want to include with your paperwork distributed to incoming students.

Brent

Wiki: Outdoor Orientation - Wiki

Anonymous — Tue, 01 May 2012 01:04:00 GMT

Wiki Page: test 2

Brent Bell — Mon, 30 Apr 2012 21:04:00 GMT

This is test 2

Wiki Page: Test 1

Brent Bell — Mon, 30 Apr 2012 21:03:00 GMT

Test 1

I am adding to this test.

Wiki Page: Research Resources for Outdoor Orientation Programs

Outdoor Ed — Mon, 30 Apr 2012 20:57:00 GMT

This Wiki is dedicated to expanding research into the effects of outdoor orientation programs

File: NOLS: Using Leadership Skills In Everyday Life

Outdoor Ed — Tue, 24 Apr 2012 03:48:00 GMT

Janeen Hutchins, Field Staffing Director, and John Kanengieter, Director for Leadership, discuss how the NOLS leadership skills learned in the backcountry transfer to the front country.

Forum Post: Challenge Course/Adventure-Based Counseling program NAICS code?

BradBarron — Thu, 19 Apr 2012 04:16:00 GMT

Evening OutdoorEd denizens,

I am getting ready to file some LLC papers to start a ABC/group development/experiential ed. business. Our local Small Business and Technology Development center provides a ton of free market research, but I need a good NAICS number in order to effectively look any of it up to see who local competitors or clients may be as well as to look at industry trends, etc., etc.

This is the number your accountant puts somewhere on your tax forms to identify what industry you are in. Anyone have some feedback on what they chose and why? Right now in some preliminary stuff my consultant sent, I am seeing everything from golf courses to cheer-leading gyms. Not really helpful...

Thanks!

Forum Post: Has anyone used citizen science app for i-phone with students?

Nathantaxel — Wed, 18 Apr 2012 19:26:00 GMT

I am considering investing in a set of i-phone to use with my student groups and I was wondering if anyone had experience with any of the nature and education apps like SciSpy or inaturalist in the outdoor education context? Thanks for your help!

Nathan Taxel
Outdoor Education Coordinator
Cleveland Museum of Natural History

File: Adaptive Climbing Clinic at Brooklyn Boulders

Outdoor Ed — Mon, 16 Apr 2012 03:41:00 GMT

Professional amputee climbing athlete Ronnie Dickson joined the Brooklyn Boulders climbing community for an afternoon Adaptive Climbing Clinic.

Blog Post: Introducing The Curriculum Project

Rick Curtis — Sun, 15 Apr 2012 04:18:00 GMT

I just got back from this spring's OOPS Conference (Outdoor Orientation Symposium) hosted as the Association for Experiential Education AEE new England Regional Conference). OOPS is an annual event that brings together student leaders and program directors and staff from college outdoor orienation programs.

Brent Bell, Professor from the University of New Hampshire and the leading researcher on outdoor orientation programs again served as conference convener. Brent's opening presentation was on his ongoing research project - The Neighborhood Project - the goal of which is to identify adn track the various outdoor orientation programs in North America to understand the range of programs and to ascertain what are the key elements that make programs successful and, as a corollary, what factors cause programs to fail/be discontinued.

During the discussion period of Brent's talk and throughout the other presentations during the day, one factor emerged as the key reason for program success - CURRICULUM. Good curriculum is what creates, builds and maintains successful programs.

Based on the understanding, those of us in the outdoor orientation field are coming together to create a corollary to The Neighborhood Project that we are calling The Curriculum Project.

The goal of The Curriculum Project is to gather curriculum and successful practices from all of the existing outdoor orientation programs on the OutdoorEd.com Outdoor Orientation Community site so that all of us can benefit from the individual expertise of our peer programs. It's simple to do. Go to the Files Tab and upload files you want to share.

For specific guidelines on the types of files we can take, see the general Submissions Information page.

Start Posting Now. Strong Curriculum means Strong Programs

File: Leader Trainer Manual - Princeton University Outdoor Action Program

Rick Curtis — Sun, 15 Apr 2012 03:23:00 GMT

This is the operational manual for Leader Trainers in the Outdoor Action Program at Princeton University. It provides the philosophical and programmatic guidelines for our Leader Training Program and specifically focuses on the 6-day Leader Training Trip.

File: What LOW Avalanche danger looks like

Outdoor Ed — Mon, 09 Apr 2012 03:57:00 GMT

Doug Chabot, director of the Gallatin National Forest Avalanche Center, describes the stable snow conditions in Cooke City. Describing a LOW danger has been frustratingly rare this season. Understanding stable snowpack is as important as understanding what unstable/dangerous snowpack looks like.

Blog Post: The Outdoor & Adventure Orientation Program Census 2012

Rick Curtis — Mon, 09 Apr 2012 02:24:00 GMT

Dear orientation program representative,

The following survey collects information on adventure orientation programs, such as outdoor orientation, camp-based, service, academic, and arts based orientation programs. The term adventure orientation is defined in a recent paper (Vlamis, Bell, & Gass 2011) as an orientation using novel experiences and challenges combined with reflective activities to meet the goals of student orientation.

The first census of such programs was completed in 2006 with a 98% participation rate. This census updates the 2006 study and will be used to verify adventure orientation program trends and complete an accurate account of adventure orientation program practices. This survey will help form a deeper understanding of the 200+ programs in the USA and Canada. This survey focuses on program features and operation; it does not ask for information about individuals. All information will be used in aggregate. The research will not be reported in a manner to identify individual program practices.

This survey is comprehensive. It will take most people 20-30 minutes to complete up to a maximum of 57 questions (where the total number will depend on the response path taken). We understand that directors of adventure-based orientation programs are busy people, and we appreciate your time responding to this research. If you would prefer to take the survey by phone instead, please email the researchers (emails are listed below).

If you have any questions about the survey, please contact us. We (the research team) appreciate your participation. The cooperation of the "neighborhood" is an outstanding feature of adventure orientation programs.

https://docs.google.com/spreadsheet/viewform?formkey=dFhITkN1Vjl3ODFTR0pvNU5hcDlVUmc6MQ#gid=0

Sincerely,

Dr. Brent Bell
UNH Outdoor Education
bbell@unh.edu

David Starbuck, Ph.D. ABD
UNH Outdoor Education
David.Starbuck@gordon.edu

Patricia Chan
Graduate student in outdoor education at UNH
patriciagchan@gmail.com

File: Chris Sharma: Letting Go // Inside Game Episode 1

Outdoor Ed — Mon, 02 Apr 2012 02:19:00 GMT

Chris Sharma and Prana Mindful Living Ambassador Mark Coleman talk about the ‘inside game’ of climbing – how our thoughts can either hinder our performance or enhance our experience. The universal idea of letting go and focusing on the present moment allows us to more fully enjoy our passionate pursuits and our lives… of course this is easier said that done.

Blog Post: Ibuprofen and Altitude Illness

Tod Schimelpfenig — Mon, 26 Mar 2012 16:42:00 GMT

I've been receiving emails about the recent online publication of a study in the Annals of Emergency Medicine titled “Ibuprofen Prevents Altitude Illness: A Randomized Controlled Trial for Prevention of Altitude Illness With Nonsteroidal Anti-inflammatories.” the study was highlighted by several of the health blogs and newspapers.

Eighty-six study participants took either ibuprofen 600 mg or placebo three times a day, beginning 6 hours prior to ascent from 4,100 feet (1,240 meters) to 12, 570 feet (3,810 m) in the White Mountains of California. The study looked at the incidence and severity of acute mountain sickness (AMS) as measured by the Lake Louise Questionnaire AMS score.

The ideal way to prevent AMS is to ascend slowly and acclimatize. Some folks don't want to do this, others may not be able to do it, and some folks still need assistance from medications. The standard has been acetazolamide (Diamox) which is well studied and received an endorsement in the recent WMS Consensus Guidelines for Prevention and Treatment of Altitude Illness.

Acetazolamide (Diamox) works by stimulating breathing, which facilitates acclimatization. We don't know how ibuprofen, an anti-inflammatory medication, works in AMS treatment. It might dampen an inflammatory component to AMS. This remains an active area of research.

In the recent study 69% of the people taking placebo and 43% of the ibuprofen group developed AMS. The severity of the AMS score was less in the ibuprofen group, but it did not meet the predetermined level of significance the authors hoped for.

Ibuprofen is appealing because it is non-prescription and readily available. Both medications have their side effects - pick your poison. This study suggest ibuprofen might work faster than acetazolamide, which should be started the day prior to ascent.

I don't think this study knocks acetazolamide (Diamox) from the altitude medication podium. I'm always skeptical of the latest and greatest drug for altitude illness. They come and they go. We need to see this work replicated, controlled for ascent profile, dehydration and other causes of headache and compared head-to-head with acetazolamide.

In the meantime , given no contraindications or adverse side effects,it is reasonable to use Ibuprofen as a non-prescription medication for prevention of AMS symptoms. If you have a history of AMS talk with your doctor about your choice of medication. Acetazolamide, with it's proven effect on acclimatization, and it's ability to smooth out erratic breathing during sleep,might be a better choice for you.

File: Climbing as Therapy with Whitney Boland

Outdoor Ed — Mon, 26 Mar 2012 03:16:00 GMT

In this video Whitney Boland talks about her life in Chattanooga, her relationship with a chronic disease called Ankylosing Spondylitis (AS) as well as her relationship to climbing. For many people climbing is a form of therapy for Whitney that has taken on a whole new meaning.

Whitney Boland has been on the Sterling Rope team for years, she originally joined in 2005. In addition to Climbing she loves to travel and is an accomplished writer. She has been published in Rock and Ice magazine and numerous other print and on-line publications such as Women’s Health, Aspen magazine, Climbing magazine and Rocky Mountain Sports just to name a few.

Blog Post: New Book: Outdoor Program Administration: Principles and Practices

Rick Curtis — Mon, 19 Mar 2012 02:42:00 GMT

A new book has just come out from Human Kinetics Publishing from the Association of Outdoor Recreation and Education (AORE) that adds to the growing list of text books that focus on outdoor education and is a great reference title for any professional's library. The editors, Mat Epeldring and Geoff Harrison have brought together experts from across the industry to explain administering outdoor programs from the inside out. Available from Amazon.com and Human Kinetics.

[Full disclosure - the authors included a graphic on risk management and decision making from one of my lectures. I did not receive any compensation for the use of my material.]

About the Author:

The Association of Outdoor Recreation and Education (AORE) provides opportunities for professionals and students in the field of outdoor recreation and education. AORE’s mission is to exchange information; promote the preservation and conservation of the natural environment; and address issues common to college, university, community, military, and other not-for-profit outdoor recreation and education programs.

Geoff Harrison, MS, has been working in the field of health and recreation for over 20 years and has been fostering student and staff development at Boise State University since 1998. Geoff serves as the associate director of education and recreation at Boise State University, where he oversees multiple programs and service areas, department partnerships, and initiatives. He also serves as an adjunct faculty for the department of kinesiology. Prior to his work at Boise State, Geoff worked in the fields of publishing, event promotion, and domestic and international adventure travel.

Geoff has served the Association of Outdoor Recreation and Education as a committee chair, board member, conference host, and interim national director. In 2010, Geoff was the recipient of the Association of Outdoor Recreation and Education’s Jim Rennie Leadership Award.

Mat Erpelding, MA, has been working in the field of physical education and outdoor leadership for over 15 years. Currently, he teaches at the College of Western Idaho in the physical education department and at Boise State University in the leadership studies minor. Additionally, Mat guides mountain climbers and teaches courses for the American Alpine Institute and teaches wilderness medicine courses for the Wilderness Medicine Training Center. Before making the transition to outdoor education, Mat worked as a developmental therapist and in the mental health industry.

Mat is a past president of the Association of Outdoor Recreation and Education and served on committees and the board of directors and as a conference host. In 2006, Mat was the recipient of the Association of Outdoor Recreation and Education’s Jim Rennie Leadership Award, and in 2010 he received the Instructor of the Year Award from the Wilderness Education Association.

Mat and Geoff co-own Experiential Adventures LLC. They provide training and consulting services to organizations that foster leadership development, help organizations manage change, develop positive organizational cultures that promote success, and build professionalism in outdoor programs through trainings and certifications.

From the Publisher:

Outdoor recreation programming is a growing and diverse field that requires administrators to be ready to work in complex and multidisciplinary environments. Outdoor Program Administration: Principles and Practices will help both seasoned and new administrators—as well as students and emerging professionals—flourish in various settings, including university, military, government, commercial, and nonprofit organizations.

You’ll learn the best contemporary administrative strategies and practices from veteran professionals from the Association of Outdoor Recreation and Education (AORE). The AORE authors provide extensive coverage of all aspects of administrative duties and responsibilities from a diverse organizational setting.

Outdoor Program Administration: Principles and Practices guides you in developing and sustaining programs in outdoor recreation settings across public, private, and nonprofit sectors. You will reap the benefits of the experience shared by the AORE authors, who also provide questions and critical thinking exercises that will enhance the materials and deepen your understanding.

This reference explores all the issues pertinent to being a successful outdoor program administrator. The book has four sections: Outdoor Program Foundations, Program Design and Implementation, Staffing Considerations, and Facilities and Programs. Topics you’ll delve into include

designing and developing programs;
risk management and legal considerations;
budgeting and financial operations;
marketing and land access (permits);
environmental stewardship;
staff recruitment, supervision, training, and assessment; and
management of indoor climbing walls and challenge courses.

Outdoor Program Administration: Principles and Practices presents material that will help you improve your administrative skills and enhance the programs you oversee. As such, it’s an essential book for your professional library.

Contents

Preface

Part I. Outdoor Program Foundations

Chapter 1. The Outdoor Program Administrator
Geoff Harrison, MS, and Mat Erpelding, MA
Outdoor Program Administration Defined
Outdoor Program Administrator Defined
Skill Sets for Outdoor Program Administrators
Administrative Competence
Acquiring Skills
Professional Maintenance
Administrative Challenges
Summary

Chapter 2. History of Outdoor Recreation in the United States: An Outdoor Program Administrator’s Perspective
Steven P. Guthrie, PhD, Bryan J. Cavins, EdD, and Jerome Gabriel, MEd
The Beginnings of Environmentalism and Outdoor Recreation: 1825 to 1880
The Beginnings of a Profession: 1880 to 1920
National Environmental Consciousness and Outdoor Recreation Evolves: 1920s to 1960s
Adventure Programming Emerges: 1960s to 1990
Outdoor Adventure Programming Today (1990 to Present)
Summary

Chapter 3. Dimensions of Outdoor Recreation Programs
Todd Bauch, MEd, and Steve Hutton, MA
Three Service Sectors of Outdoor Recreation Programs
Common Programmatic Types
Common Facilities or Resources of Outdoor Programs
Outdoor Program Administrative Structures and Models
Summary

Chapter 4. The Future of Outdoor Program Administration
Laurlyn K. Harmon, PhD, and Susan L. Johnson, MS
Evolving Participant Characteristics
Staffing
Professionalization of the Field: Standards, Certifications, Accreditation
Youth and the Outdoors
Technology and the Outdoors
Sustainability
Collaborations and Partnerships
Outcome Assessment
Summary

Part II. Program Design and Implementation

Chapter 5. Administrative Risk Management
Mat Erpelding, MA, and Geoff Harrison, MS
Terms and Definitions of Risk Management
Creating a Comprehensive Risk-Management Plan
Summary

Chapter 6. Designing and Developing Outdoor Recreation and Education Programs
Todd Miner, EdD, and Heidi Erpelding-Welch, MS
Vision
Mission Statement
Strategic Plan
Sustainability
Dealing With Change: Evolve to Survive and Thrive
Summary

Chapter 7. Legal Considerations in Outdoor Recreation
Brent Wilson, JD, and Tracey Knutson, JD
Negligence
Legal Definition (Elements) of Negligence
Negligence and Related Theories of Liability
Defenses Against Negligence
Role of Insurance in Legal Liability Matters
Summary

Chapter 8. Budgeting and Financial Operations of Outdoor Programs
Tim J. Moore, MS, and Geoff Harrison, MS
Budget Components
Budget-Development Strategies
Forecasting Expenses and Revenue
Summary

Chapter 9. Marketing Outdoor Programs
Geoff Harrison, MS, and John McIntosh, PhD
Marketing Basics
Identifying the Market
Marketing Mix
Developing a Marketing Plan
Branding
Marketing Methods
Summary

Chapter 10. Access and Permitting for Use of Public Lands
Rachel M. Peters, MA
Outdoor Programs on Public Lands
Permitting Defined
Management Agencies and Regulations
Permitting Tips
Summary

Chapter 11. Environmental Stewardship
Whitney Ward, PhD, and Will Hobbs, PhD
History of Environmental Stewardship in the United States
Major Impacts of Recreation Today
Applied Environmental Stewardship
Integration of Environmental Stewardship and Recreation
Summary

Chapter 12. Developing Policies, Procedures, and Guidelines for Outdoor Programs
Mat Erpelding, MA, Curt Howell, MA, and Brien Sheedy, MA
Characteristics of Quality Policy, Procedure, and Guideline Documents
Considerations Specific to Developing Policies and Procedures
Developing Administrative Policies and Procedures
Developing Field Policies and Procedures
Summary

Part III. Staffing Considerations

Chapter 13. Staff Recruitment and Supervision
Jeff Turner, PhD, and Leigh Jackson-Magennis, MEd
Human Resource Planning
Staff Selection
Staff Supervision
Summary

Chapter 14. Staff Training
Bruce Saxman, MA, and Tom Stuessy, PhD
Needs Assessment
Staff-Training Progression
Mentoring
Staff-Training Assessment
Mechanisms for Training Assessment and Evaluation of Staff
Staff-Training Designs: Integrated Training Model
Activity-Specific Training
Staff Appraisal
Summary

Chapter 15. Staff Assessment
Jenny Kafsky, PhD, and Mark Wagstaff, EdD
The Basics and Purpose of Staff Assessment
An Effective Environment for Assessment
Assessment Criteria
Assessment Tools
An Effective Assessment System
Summary

Part IV. Facilities and Programs

Chapter 16. Rental Operations
Rob Jones, MS
Planning
Purchasing
Rental Center Operations
Summary

Chapter 17. Indoor Climbing Walls
John Bicknell, MA, and Guy deBrun, MS
History of Artificial Climbing Walls
Climbing Wall Facilities and Construction
Climbing Wall Activities
Climbing Wall Management
Summary

Chapter 18. Challenge Course Management
Christina Carter Thompson, MS, and Adam Bondeson, BA
Challenge Terms
History
Challenge Course Program Design and Outcomes
Primary Influences on Challenge Programming
Challenge Course Facilities
Designing and Choosing a Course
Bidding Process
Building Process
The Challenge Course Administrator
Organizational Support and Resources
Summary

Chapter 19. Land-Based Programming
Curt Howell, MA
Incident Prevention and Incident Response
Cost Analyses
Determining Learning Outcomes
Risk Management
Backpacking
Climbing
Caving Programs
Mountaineering
Ski Programs
Cycling
Summary

Chapter 20. Water-Based Programming
Chris Stec, BS, and Geoff Harrison, MS
Incident Prevention and Incident Response: Needs Assessment
Water-Based Programming: Flat Water
Water-Based Programming: Moving-Water and Whitewater Venues
Water-Based Programming: Open Water
Summary

Chapter 21. Special Events Programming
Brent Anslinger, BS, and Amy Anslinger, BS
Special Event Options
Risk Management for Special Events and Competitions
Assessing and Planning for Your Event
Staffing
Managing the Event
Developing Timelines for Successful Events
Putting the Planning Into Motion
Summary

References and Resources
Index
About the Editors
About the Contributors

Audiences

Reference for outdoor program professionals in university, military, nonprofit, and other settings and for outdoor professional employers. Text for college and university students.

File: How to sharpen and maintain your ice screws

Outdoor Ed — Tue, 28 Feb 2012 04:22:00 GMT

Advice about how to sharpen and maintain your ice screws.
http://www.petzl.com

File: Reinhold Messner Speaks at 2012 Winter Outdoor Retailer

Outdoor Ed — Tue, 28 Feb 2012 04:19:00 GMT

Famed alpinist Reinhold Messner spoke at The American Alpine Club's reception at this year's (2012) WInter Outdoor Retailer.