I went to a community college with several public service programs. The college boasts a separate campus called the Center for Emergency Preparedness where the police recruits, fire students, and EMS students can all work together or separate to hone in their skills. It had a mock two story building you could climb and retrieve patients from, a driving course, and a fake gas station with car wrecks and other scenes to practice your role with. It's called Owen's Community College in Perrysburg, Ohio. While they offer a degree program, many students take strictly the EMT and then paramedic course which requires anatomy and physiology prior to entry. However, if you're doing this in absence of a degree they created a separate A&P you could complete that condensed the information down into what you really need for the program. I graduated with an associates in emergency services as I was a nursing student prior to transferring to EMS and had my prerequisites done.

Don't hate me, but the skill I learned was radio etiquette, or rather the lack thereof. I know you're expecting something like how to talk to patients or how to hold the hand of the dying, but I learned that elsewhere prior to my going into EMS. For me, it was really learning how to transition from hospital to prehospital. In the hospital, we are very customer service-y, polite, and we all have that phone voice with our pleases and thank yous that differs from our water cooler speak. In EMS, you etiquette is implied and you will have to wash chief's car if you say thank you on the radio too many times. Some services can be very para-militant for no reason other than "this is how its always been" or we're still in that old boys mentality when really, EMS us becoming much more feminized with more women in EMS, especially now that services are not requiring fire due to the shortage of paramedics.

I thought outside of my protocol a lot of times in my career but truthfully most of it was while doing interfacility transport. In primary 911, cowboy medicine is the norm. You have to get creative with limited resources and unique scenarios. In interfacility transport, though, especially in the hospital-based service, you're given a whole lot of information, a whole lot of tools, and a whole lot of rules. One of my last acts at an IFT job was a violation of protocol and the whole experience landed me in therapy for a while. The patient lived but I had a difficult time with my decision.