Stone Mountain Affinity Group Medic Training

Grace Keller and Dave Pike taught an Affinity Group Medic (AGM) training in Atlanta as part of the convergence against the Klan in November 2016. Hopefully these reflections [written one week later] will contribute to the larger conversation about trainings.

Dave and Noah recently taught AGM trainings in Baltimore, I think, and might have a different philosophy on these trainings; this is Grace's take.

Purpose

The purpose of an AGM training, as I see it, is to promote the assembly of affinity groups. I would wager that self-organization into affinity groups does more to improve health and political power than any other intervention we can make.

The way the training promotes self-organization is by promoting a circumscribed goal. The AGM doesn't attend to the health of strangers; only the health of friends. In order to be useful in an AGM role, she has to assemble an affinity group.

I believe that, unlike street medics, AGM is not a basic scope of practice. It is just a role. I teach that the only requirements to be an AGM are the desire and the consent of the group. The AGM training may make one a better AGM, but is not a prerequisite for the role.

In an action, an affinity group has a goal. That goal might be to cut a fence, block a road, provide safer space, do clinical support, carry water, do media, be marshals, spiral dance, scout, drop a banner, make lots of noise, cook and serve food, do childcare, do jail support, drive the getaway car, or whatever. The AGM's job is to help them achieve that goal without injury or illness. It is a before, during, and after role.

Learning Objectives

During a human barometer, people arrange themselves from "strongly agree" to "strongly disagree" in response to the statement "People come to me for help." This identifies natural AGMs, and leads to good conversations, especially between the agreers and the disagreers, about things like referrals and healthy boundaries.

I see the core of the AGM role to be SAMPLE and confidentiality. When I taught an AGM training in Ferguson, we spent a lot of time on confidentiality. Unfortunately we breezed by it in Atlanta. This is in contrast to what I see as the core of the street medic role: initial assessment and consent. The difference: AGMs care for friends; street medics care for strangers.

SAMPLE helps the AGM start health conversations, build trust, and assess risks faced by group members before the action. If the medic knows group members' allergies, medications, and past pertinent medical history in advance, she can better assist when group members are trying to balance personal needs with group actions.

Training agenda

The agenda for the 6-hour training:

  • 2 hour health and safety (open to anyone)
  • Affinity groups lecture, SAMPLE practice, and confidentiality discussion
  • Scene assessment and communicating about a scene practice sessions and debriefs
  • First aid lectures, demonstrations, and practice sessions (no initial assessment)
  • Lecture and discussion on local referral options.

Evaluation

During the post-training evaluation, students said they liked:

  • PEARL buddy check-in
  • SAMPLE
  • HALTS and "What did you do to take care of yourself today?"/"What do you need to do?"
  • Local resources: alternative to 911 mental health crisis line, peer support warmline, others.

I don't have the eval notes in front of me, but I remember people saying they had concrete situations in which they could immediately apply those assessments and resources.

We discussed how AGMs are prepared for acute first-aid, while recovery is a prolonged process. Some students wanted to improve their skillset for supporting post-action/post-crisis recovery.

Four final comments:

  1. We should have integrated SAMPLE more deeply into scene assessment (give people cards with AMPs of their fictional affinity group before going outside for the exercise), first aid, and referral options. As it was we taught SAMPLE then never referred back to it.

  2. Street medic trainings (because of the centrality of consent) provide lots of opportunity for practicing communication. AGMs don't need that much practice, but could use some. It should be adapted to mimic communication with someone the AGM knows.

  3. We taught privacy circle but didn't emphasize how intensely a crowd mobs a casualty---wanting to help, protect, or just curious. I remembered this crowd behavior when a person with a breathing difficulty was mobbed by a crowd, including two street medics who didn't recognize that a nurse was already on scene. The paramedics arrived promptly with oxygen, but that poor person needed space.

  4. Scenarios adapted for caring for known friends instead of randos would be great.