Expedition Medicine Course – Partnerships In Action

Nick HancockChris GallagherDavid Brown

 

Outdoor education, by its very nature, seeks to promote the virtues of self reliance of the individual and the group. To do this the outdoor education specialist deliberately takes his/her clients away from the security and support of society and exposes his/her client to more risk than would be allowed in a classroom environment. The balance of perceived risk to actual risk has to be carefully judged and managed, but must in order to be treated seriously by our clients, the two elements of risk must be somewhat similar.

As a result the outdoor educator runs a chance of precipitating an incident that requires immediate decisive action to contain the incident, prevent further harm to his/her clients and possibly evacuate the clients, potentially with no help whatsoever from outside sources.

Many outdoor educators will go their whole career with no serious incidents to deal with, but the consequences of failing to deal with a serious incident in a timely and professional manner could have far reaching consequences for everyone involved.

The outdoor educator might well be drawn to the field because he/she believes that he/she has an innate ability to deal with critical incidents without the assistance of other professionals like the police, ambulance service, fire service etc.

Regardless of whether the outdoor educator does have the necessary knowledge and skills to deal with an incident, performance at a high level of leadership whilst under a high level of stress, might not be forthcoming, especially for the lucky outdoor educator who has not had the misfortune to have had to deal with a serious incident previously.

How then, do we gain the skills, knowledge and confidence to deal with a serious incident?

It is well known that the most effective learning occurs when the learner is towards the edge of their comfort zone, and indeed the outdoor educator uses this knowledge to gain the maximum learning for his/her client. It stands to reason then that any training in serious incident management will have to be pitched at a different level for different clients depending on their comfort in outdoor environments and their prior experiences. Training should also be conducted in as remote an environment as is practicably possible, as realistic as possible and also on a realistic timescale.

The traditional medium for training outdoor educators is via Remote First and Wilderness First Aid courses. These courses typically run over five days or so and are often run in only slightly remote locations. This can lead to clients wishing to leave courses in the evening to return home and as a result time is limited, scenarios are often short lived and rarely run throughout the night. It would be advantageous to us all, if incidents only occurred during the hours of daylight, when we were fully rested, when it wasn’t raining and when we knew exactly where all our stuff was. The real world isn’t like that so we had better make sure our training reflects the confusion, fear, complexity and unpleasantness of real incidents as closely as possible.

To this end The University of Tasmania in partnership with The Australian Antarctic Division and The Hutchins School has been running Expedition Medicine Courses for several years, in midwinter, at remote locations in Tasmania. Expedition Medicine runs for eight days, usually at Arm River Field Centre, just outside Cradle Mountain Lake St Clair National Park Tasmania. The course builds on the Accident Management Plan common to RAFA & WFA, but aims to create learning through well planned, well acted, complex, multi-layered scenarios, that utilise the natural features of the local terrain and weather to simulate incidents that are often based on true events. Although nominally a First Aid Course, Expedition Medicine might be more aptly though of as a Critical Incident Management course, even though effective patient medical, and other, care is a priority.

The course aims to bring together a broad mix of participants and to use the varied skills and knowledge within the group to form an effective team that responds to incidents. Participants have been outdoor teachers, paramedics, outdoor guides, nurses, military, doctors, medical students and many others. Having a broad range of participants reflects the reality of group make up in the real world, and importantly greatly increases the amount of teaching that occurs on the course, as it is then not only the instructors that do all the teaching.

Scenarios sometimes begin on dark at the end of a full day learning new skills and attending lectures. Responses have been known to run until the early hours of the morning, in constant heavy rain, with moderately long approaches carrying heavy rescue gear in addition to personal overnight camping gear. River crossing has been facilitated via tyrolean rope traverses, including the evacuation of a stretchered patient. Rafting, abseiling, caving and  snowholeing have all featured in scenarios, building on participants practical skills as well as making events more realistic and complex. Tiredness is a feature of the course and instructors take great care to ensure it si at manageable levels to minimise the risk of harm to participants and themselves, but only through having responded to acritical incident in adverse self care and environmental conditions cane an Outdoor Educator hope to be able to perform efficiently during a real incident.


Biographies:

Dave Brown

Dave is an Intensive Care Flight Paramedic and has 18 years of paramedic experience in three Australian states. He is also a Wilderness Rescue Paramedic and as such forms part of the Tasmanian Helicopter Rescue crew. He has been instructing wilderness first aid courses for over ten years and is a key facilitator of the Expedition Medicine Course conducted by the University of Tasmania.

Nick Hancock

Nick is a multi-pitch guide, instructor trainer, and assessor with the TCIA. He is a prolific climber and instructor having pioneered some of the hardest routes in Tasmania as well as climbing and guiding extensively in Europe and the USA. Nick is a key facilitator of the Expedition Medicine Course conducted by the University of Tasmania.

Chris Gallagher

Chris has worked for 18 years as a Field Training Officer with the Australian Antarctic Division; he trains expeditioners in leadership, teamwork, risk management, polar first aid, search and rescue, alpine and survival skills. He also works as a wilderness first aid instructor and facilitates the Expedition Medicine Course for the School of Medicine at the University of Tasmania.

Boat Building Workshop- A practical hands on experience to explore the process of building simple canoes.

Mr Tim Whelan1

1The Friends School

Tim will have a number of boats at varying stages of completion available for viewing.  Participants will assist with the build of a canoe in this 90 minute workshop.  Participants will be given a booklet with plans, equipment lists, risk assessments and tips/ tricks to enable them to deliver their own program.


Biography:

Tim has been involved in Outdoor Education for 20 years.  He is keenly interested in the development of programs that lead to life long passion for the outdoors.  Programs delivered include climbing, sea kayaking, bushwalking, cycle touring, ultralight walking, winter skills and white water kayaking. Tim has worked with students building canvas-skinned canoes at the last two Australian Wooden Boat Festivals.  This led Tim to develop a five day program for students to build plywood canoes, learn to paddle and then adventure in them.

Using Practical Risk Management to Create Training Pathways for Program Leaders

Mr Rob Stillwell1, Mr Jonathan Bannister2

1Scotch College Adelaide, 2Scotch College Adelaide

Creating safe learning environments where adventurous learning can occur is a challenge. Documented risk mitigation through identifying hazards and matching them with processes, skills and experience is critical in today’s litigious society. This is particularly true where programs demand skills from leaders beyond those taught and assessed through readily available qualifications. This presentation discusses a South Australian private school’s project to leverage 50 years of program experience to populate a modern risk management framework and ensure safety and learning outcomes are achieved during its unique expedition program to an offshore Island.

Over a 12-month period the project team developed a highly focused and structured approach to hazard identification and risk management. Critically, this process captured lessons learnt since the program started in 1966. Concurrently, a framework to store all risk mitigation activities was developed with the overarching principles of being lean, practical in the field and never duplicating information. In this structure, critical skill sets for leaders could be identified and training pathways developed, closing the loop between hazards and processes and skills. These training pathways make it possible to safely use non-specialist teaching staff to support activities on program. The new structure was implemented in November 2016; feedback from school staff and external instructors was overwhelmingly positive. The structure made program leaders feel more prepared and less exposed. While intensive to develop, the framework is thorough, lean, practical and ready for continuous improvement. This approach could be adopted to other outdoor education programs in schools or commercial environments.


Biographies:

Rob Stillwell, Head of Outdoor Education, Scotch College, Adelaide. Rob is passionate about holistic education and using the outdoors to learn about sustainability, resilience building, leadership and group development. After cutting his teeth as a freelance instructor, Rob completed a Masters of Teaching in 2010 and has spearheaded Scotch’s OE program since 2014. An outdoor enthusiast at heart, Rob also recognises the importance of professionalism and responsibilities as a leader. This characteristic has facilitated the industry leading approach to risk management at Scotch College. When not at work Rob is searching the uninhabited coastlines of South Australia for waves.

Jonathan Bannister is an Old scholar, engineer, entrepreneur, occasional OE instructor and outdoor enthusiast. Jonathan is a firm believer in the skills learnt through outdoor education and their application in other areas of life. Drawing on professional experience gained working as a Mechanical Engineer and running two businesses, Jonno has continued to support Scotch College’s OE program to ensure it continues to add value to students lives, like it did to his. A strong background in offshore and dinghy sailing, as well as personal climbing and kayaking adventures, the combination of professional career blended with outdoor activities provide a unique perspective on risk.

Behavioural Safety

Mr Graham Pringle1

1Youth Flourish Outdoors Ltd

Students who fit poorly into classrooms seem to perform better in the outdoors. However, when they arrive at camp their behaviours are often challenging and escalate beyond those experienced at school. The experience can become one of survival and constant boundary enforcement. Less dramatic but often psychologically worse are those students who shut down and withdraw during activities.

What goes wrong?

It is a tale of two competing brain based responses that leave little choice to be exercised by the student. They do not choose to be disruptive. This workshop will describe the theories about teenage responses to childhood adversity. The brain based systems at play when these students arrive in the outdoors will be summarised.

Strategies for harnessing the brains quite predictable responses to new outdoor experiences will be workshopped. Participants will divide into activity specific group to analyse their group leading procedures. Each group will plan to cater for these student’s needs while also creating excellent outdoor learning activities for their class peers.


Biography:

Graham has experience in Residential and Foster Care, Outdoor Education, Adventure Based Youth Work and Adult Training. He leads the youth Flourish Outdoors program team. Graham has spent 13 years pursuing adventure as therapy for adolescents and is now researching the field through a Master in Philosophy degree at Griffith University. He enjoys training adults in adventure therapy and designing programs that stop young people from acquiring mental illness. Having worked outdoors with young people since 1985 he has also studied widely and holds an Masters of Arts (Outdoor Education), Graduate Diploma in Social Science (Psychology) and a Graduate Diploma in Education. Graham has recently finished writing a book for youth workers who wish to take young people on therapeutic programs and plans to write also for adventure workers and adventure therapy planners. He and his wife Janelle (also a carer, youth worker and assistant in nursing) live at Mapleton in Qld and enjoy using their camper trailer on trips away. His favourite outdoor pursuits are bushwalking, canoeing and photography.

Safety and Risk Management – Lessons learnt

Mr Aaron Pittaway1

1World Challenge

An earthquake in Nepal…. Political unrest throughout Thailand… A suspected spinal in the jungle in Laos… A scorpion sting in a remote village in Tanzania… A horse bite in the Himalayas… World Challenge Asia Pacific have 120 teams on the ground in over 40 developing world countries. Keeping students safe is our number 1 priority as well as giving peace of mind to their parents, guardians and principles while their sons, daughters and students are in our care is paramount to our organization. Safety and risk mitigation for each expedition starts long before students step on the plane and is a cyclical process. Our dedicated Operations Centre, with bespoke technology and systems keeps teams & their loved ones informed 24/7 & responds proactively to events on the ground. In this industry, lessons learnt and best practices in safety and risk mitigation should be shared for all too continuously learn from.


Biography:

Aaron has been in field of education for 15 years. He has taught in Australia, England and the USA up to the level of an Assistant Principal. He has also worked as a learning and development consultant for a global environmental, health and safety company. He now brings this diverse experience to World Challenge as the National Sales Manager.

A Mental Health Action Plan within Wilderness First Aid

Mr Adam Kershaw1

1Survive First Aid

As a Wilderness First Aid provider Survive has recently introduced a new session within our courses to address the importance of mental health in the outdoors, and how to appropriately respond to anyone who has had a traumatic event or a emotional mental health episode. After speaking with industry operators the importance of training in Mental Health First Aid within the outdoors seems as important as training for wounds, burns, fractures etc. As such we have started to introduce teaching M.A.N.E.R.S which is a psychological first aid model developed by Ambulance Victoria. The model helps provide an action plan for either coping with a traumatic event or for helping someone who is having an emotional mental health episode.

More info can be fund here https://www.youtube.com/watch?v=BScY-ojApA8&feature=em-share_video_user


Biography:

Adam is an experienced expedition leader that has lead expeditions within Australia, New Zealand, South East Asia, South America, Asia and Central Asia for over 15 years. Originally from southern Africa he worked in Australia as the ‘Operations Manager’ of a large overseas expedition company for seven years, he was responsible for the safety and training of all participants and leaders prior to their month long expeditions.

He is an Advanced Emergency Medical Technician (AEMT) and the CEO of Survive First Aid, an Australian based Registered Training Organisation (RTO) which specialises in Wilderness and Remote Area medical training and is an Advanced Wilderness Life Support Trainer.

He is married with two children and loves adventure travel, is an avid skier, mountain biker and former white water rafting guide who would really like to be a better surfer!

Vu Deja for risk assessment: Exploring an old problem through a new lens

Ms Clare Dallat1,2

1The University Of The Sunshine Coast,

2Risk Resolve

Failure to identify and adequately manage foreseeable risks associated with the task of determining participant characteristics in the program design and planning phase of an outdoor program can lead to the creation of 150 further, emergent risks.   This is just one significant finding from a program of PhD research that focused on the development and testing of a risk assessment method which could identify and analyse risks associated with the design, planning and conduct of outdoor programs. The method, called NET-HARMS, is theoretically underpinned by the now widely accepted view in safety science, that accidents are caused by multiple, interacting factors located throughout the system of work, and not solely by the actions or decisions of the people closest to the accident scene, e.g., an instructor’s ‘poor decision’, a student’s ‘carelessness’, or the high river level.  Clare will demonstrate how NET-HARMS differs from current risk assessment methods in highlighting how it can identify and assess risks involved in the design, planning, delivery and review stages of a program, as opposed to risk associated with the delivery stage only. Workshop participants will then have the opportunity to have a go and trial the method with their own programs in mind.


Biography:

Clare Dallat is an experienced outdoor educator with over twenty years practicing both in the field, and in administrating programs. For thirteen years, Clare held the position of Director of Risk Management at The Outdoor Education Group (www.oeg.edu.au), a large not-for-profit organisation that provides multi-day outdoor education experiences for approximately 40,000 participants annually. She now leads Risk Resolve, a risk and crisis management consultancy service. Through this work, Clare has supported many organisations, including schools, universities, and local government to assist them develop and improve their risk and crisis management systems. She has responded to, in both a field and leadership capacity, to critical incidents and has expert witness and court experience. Clare holds an MSc. in Risk, Crisis and Disaster Management from the University of Leicester, UK, and is currently a PhD researcher with the Centre for Human Factors and Sociotechnical Systems at the University of the Sunshine Coast, Queensland, Australia (www.hf-sts.com).

Incidents are more than just a number: Lessons from 3 years of UPLOADS

Dr Amanda Clacy1, Professor Paul Salmon1

1University Of The Sunshine Coast

The UPLOADS project has been collecting incident report data since 2014, and has provided a summary of 2030 incidents from across Australia. Through the combined efforts of researchers and practitioners working together, we now have national incidence rates for led outdoor activities and are beginning to see trends in the contributory factors which lead to injuries, illnesses, and near miss incidents in the Australian outdoors.

Incidents are much more than a number. Behind each incident are people and stories.  In this session delegates will be presented with a summary of the first 3 years of data, including the common contributing factors to incidents in the led outdoors. Rather than progressing down the well-travelled road of blame or criticism aimed at the people and objects directly involved with an incident, the UPLOADS project aims to facilitate a culture of learning from incidents. The systems approach used in the incident reporting and analysis of the UPLOADS data encourages practitioners to view incidents in a new light – namely, by looking for the interaction of contributing factors across the whole led outdoor system, rather than just at the sharp end.

By aiming to better understand the multiple influencing factors that contribute to led outdoor incidents, system level changes can be supported. Delegates at any stage of their journey will find something interesting and valuable in this session, whether they are just learning their trade, responsible for designing and delivering programs, or involved with safety and risk management operations

 

Safety regulation: perception, intention, and practice.

Mr Tony Carden1

University Of The Sunshine Coast

The experience and wisdom of practitioners have informed the development of various systems that seek to regulate safety in led outdoor activities. These systems include adventure activity standards, education department guidelines, operator licensing, instructor registration, and camp and activity accreditation. Interviews with field staff, supervisors and managers across a range of outdoor activity provider types in Victoria revealed a wide range of understanding of these regulatory mechanisms and how they relate to practice. In turn, these understandings were found to be at variance with the stated aims, advice and requirements of the regulatory systems. Furthermore, incongruity was found between the requirements of different regulatory instruments for the same activities. Has reductionist thinking limited the effectiveness and efficiency of attempts to regulate and manage safety in the outdoors? Would a more integrated approach be better? Is a more holistic approach possible? This presentation will explore how the analysis of accumulated wisdom from within and without the led outdoor activity sector can inform the improvement of safety regulation into the future.


Biography:

Tony Carden began working in led outdoor activities in 1993. Starting as an assistant in youth-at-risk and corporate outdoor training programs, he went on to work as a commercial raft guide and free-lance group leader. In 1997, Tony started work at the Outdoor Education Group. Following a decade working at OEG as a School Manager, Group Leader, Course Coordinator, river trip leader and finally Director of Schools, Tony left OEG in 2008 to take up the role of Executive Officer at the Victorian Outdoor Education Association. In 2015, Tony was admitted as a postgraduate student at the Centre for Human Factors and Sociotechnical Systems at the University of the Sunshine Coast, where he is now working toward his Ph.D. by conducting research on the application of systems theory to the regulation of safety in led outdoor activities.

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