Roles, Responsibilities and Professional Boundaries

Lesson 1.1

The role of the CFAR tutor

A CFAR tutor does far more than pass on information.  You are responsible for making sure that every person who completes the course can act safely and confidently when someone collapses, bleeds or stops breathing in front of them.  In many communities your learners may be the only help available for some time, so the standard you set in the classroom becomes the standard of care in the street, the market and the home.

The training cycle

Most teacher education programmes describe the tutor’s work as a cycle of five stages.  Each stage carries its own responsibilities.

1. Identifying needs. Finding out who your learners are, what they already know and what might prevent them from learning.
2. Planning. Preparing sessions, resources and a safe venue, and arranging equipment in good time.
3. Delivering. Teaching the approved content clearly, accurately and inclusively.
4. Assessing. Checking learning throughout and making fair decisions about competence.
5. Evaluating. Reviewing what went well and what should change, using feedback from learners and colleagues.

The cycle does not stop at the end of a course.  What you learn from evaluating one course becomes the starting point for identifying needs on the next.

The tutor as a role model

Learners copy what they see.  If a tutor arrives late, skips the safety check at the start of a scenario or cleans a manikin carelessly, learners will conclude that these things do not matter.  Punctuality, a calm manner, respect for every learner and consistent attention to safety are all part of the content of the course, even though they are never written in the syllabus.

Lesson 1.2

Law, policy and your own country

The CFAR course is delivered in many countries, and the law that applies to first responders and to training differs from one country to another.  This course therefore does not give you a single summary of the law.  Instead, it asks you to find out what applies where you teach.

Work through the areas below and record what you find.  This forms part of your evidence for the Unit 1 assessment.

• The legal position of lay responders. Is there any law or official guidance that protects a member of the public who gives first aid in good faith?  What do people in your community believe about this, and is that belief accurate?
• Health and safety. What duties do you and the host organisation have to keep learners safe during training?
• Safeguarding. What are the requirements for protecting children and vulnerable adults, and who should you report a concern to?
• Data protection. How must you store learners’ personal details and assessment records?
• Equality and inclusion. What law or policy protects learners from discrimination?
• Programme policies. What policies does the CFAR programme itself require you to follow, for example on complaints, appeals and conduct?
• Emergency arrangements. What is the correct number to call for help in the area where you will teach, and how quickly is help likely to arrive?

Lesson 1.3

Boundaries: teaching, not treating

Many CFAR tutors are experienced clinicians.  This brings great credibility, but it also brings a risk.  When learners ask questions, it is tempting to answer from your own clinical experience and to add techniques, medicines or advice that are not part of the course.

The boundary is clear.  The tutor teaches the approved course content and nothing beyond it. There are three reasons for this.

1. Safety. The course has been designed for lay responders with a defined level of training.  A technique that is safe in the hands of a nurse or paramedic may be dangerous in the hands of someone who has had a few days of training.
2. Consistency. If different tutors teach different methods, learners become confused and the credibility of the whole programme suffers.
3. Accountability. The programme can only stand behind the content it has approved.

When a learner asks something outside the course

Acknowledge the question, explain that it falls outside what the course covers and, where appropriate, refer it to the programme’s clinical lead.  You might say: “That is a good question, and it is outside what this course covers.  I will pass it to our clinical lead and come back to you.”

The same principle applies to personal medical questions.  A learner who asks about their own health or that of a relative should be directed to an appropriate health service, not given an opinion during the course.

Lesson 1.4

A safe and supportive learning environment

Ground rules and psychological safety

Learners practise skills in front of others, make mistakes in scenarios and talk about frightening situations.  They will only do this fully if they feel safe.  Agreeing ground rules together at the start of the course helps.  Typical ground rules cover respect, confidentiality, phones, punctuality, the right to step out of a scenario and the use of a safety word that stops any activity immediately.

Ground rules work best when learners suggest them in their own words.  Write them up, refer to them during the course and model them yourself.

Distressing content

Some learners will have witnessed sudden death, serious injury or the loss of someone close to them.  Emergency care training can bring these memories back without warning.  At the start of the course, explain that some content may be upsetting and that learners may step out at any time without explanation.  Watch for signs of distress, check on anyone who leaves the room and know where to refer a learner who needs further support.

Safeguarding

If a learner discloses abuse or you become concerned that a child or vulnerable adult is at risk, follow the safeguarding procedure you identified in the previous lesson.  Listen, do not promise confidentiality, record what was said in the learner’s own words and report it to the named person without delay.

Physical safety and infection prevention

• Check the venue for hazards before learners arrive, including floor space for practical work and exits.
• Clean manikins between users in line with the manufacturer’s guidance and use single use face shields or lungs where required.
• Teach and model safe moving and handling during practical work.
• In hot conditions, schedule practical work for the cooler parts of the day, provide drinking water and allow rest breaks.

Lesson 1.5

Working with others

A CFAR tutor rarely works alone.  Courses depend on partnerships, and good relationships make courses easier to organise and more useful to the community.

• Programme leads set standards, approve content and manage quality assurance.
• Clinical leads answer clinical questions and approve any changes to content.
• Co tutors and interpreters share delivery and must be briefed so that everyone teaches consistently.
• Community leaders, faith groups, transport associations and employers often host or sponsor courses, recruit learners and support responders after training.
• Local health facilities receive the casualties that responders help, and can advise on local arrangements.

Points of referral

Part of your role is knowing when a learner’s need lies beyond what you can provide and where to send them.  Examples include learning or language support, emotional support after a distressing disclosure, safeguarding concerns, complaints about the course and personal health questions.  Keep a list of referral points for each area where you teach.