Development of a tool to monitor paramedic clinical placements : A case study of innovation overcoming tradition

Introduction This paper discusses a trial of the use of CompTracker© – an online platform used to link the student, preceptor and academic in a time sensitive manner during student clinical placement – within a cohort of 330 first and second year paramedic students studying at an Australian university. CompTracker© allows for preceptors to identify and assess clinical competencies, and for the student to reflect after each case is completed on placement. The tool was initially piloted, and then remodeled on several attempts to improve its overall functionality and relevance for the placement learning experience. The study aims to educate and inform other health disciplines that may have an interest in using online tools for competency tracking and education in diverse workplaces. Methods Multiple surveys were conducted over a 3-year period, using both Likert 5-point scales and open-ended questions, to evaluate 330 first and second year students’ and 261 preceptors’ experiences. Results Of the 54 student responses, 92% felt the tool was useful and 67% felt it was easy to use. Within the preceptor results, 63 ± 2% preferred CompTracker© over traditional paper-based methods. Conclusion CompTracker© can be used to support students and preceptors in clinical placement. The flexibility of this online tool makes it adaptable to most clinical workplaces, and should be considered in any workplace that requires the use of competency-based clinical assessment and used in place of traditional paper-based portfolios

Measured and perceived handover effectiveness among nurse, paramedic and medical students

Objective: This study aimed to measure the effectiveness of student handovers in simulation and examine perceptions of handover effectiveness.Methods: A mixed-methods crossover study involving interprofessional teams of nursing students (NS), paramedic students (PS) and medical students (MS). Students participated in two medical clinical simulations, which involved handovers, completion of self-reflection questionnaires (SRQ) and pre-post simulation questionnaires: Readiness for Interprofessional Learning Scale (RIPLS) and Attitudes Towards Health Care Teams Scale (ATHCT).Results: 18 handovers were observed. Outbound simulation (n=9): 61% of all data items were transferred by the MS, 60% by NS, and 63% by PS. Inbound simulation (n=9): 80% of all data items were transferred by PS, 64% by NS and 50% by MS. Information handed over was most variable when broken down into categories. Data most likely to be handed over were patient demographics, clinical impression and treatment. Least likely to be handed over were additional background and response to treatment. The RIPLS questionnaire showed significant differences between student groups and a change in score between pre-post questionnaires, with NS and PS scoring higher than MS: 6.33 ± 3.51, 4.71 ± 4.37 and -2.67 ± 2.3, respectively (p < 0.05). No differences were noted between the pre- and post-ATHCT questionnaire. Comparison of actual and perceived data transferred showed the percentage of non-clinical data actually transferred to be higher than students’ perceived (p < 0.05).Conclusion: In simulation, a significant amount of critical patient information was lost in subsequent handovers. The greatest loss of data occurred from additional background information and response to treatment. There was also an imbalance between students’ perceptions of, and actual, data transferred. Our results indicate that students require increased opportunities for handover practice and clarification on what constitutes an accurate handover. Amalgamation of current handover tools to a single tool that can be used in pre-hospital and hospital environments may be beneficial.Article submitted: 8/11/2018Article accepted: 6/12/2018Publish date: 17/12/201

Paramedic student clinical performance during high-fidelity simulation after a physically demanding occupational task : A pilot randomized crossover trial

Introduction Paramedic duties include assessing, treating, and maneuvering patients in physically challenging environments. Whether clinical skills and patient care are affected by these occupational demands is unknown. High-fidelity simulation affords the opportunity to study this in a controlled setting. Methods Using a randomized crossover design, 11 regional paramedicine students and graduates (mean ± SD age = 23 ± 2 years) completed two, 20-minute high-fidelity simulations that included cardiopulmonary resuscitation (CPR) immediately after either an acute bout of occupational physical activity (OPA) or a rest period (REST). Heart rate, respiratory rate, and mean arterial pressure were measured throughout. Clinical performance was scored using the Global Rating Score and a patient care record. Measures of CPR efficacy were recorded in the manikin. Results There were no significant differences in Global Rating Score (P = 0.07, ES = 0.03) or CPR efficacy between conditions. Patient care record accuracy was higher after the OPA versus REST simulations (mean ± SD = 61.8 ± 12.6% vs. 55.5 ± 12.0%, P = 0.03, ES = 0.5). Mean heart rate was higher during OPA simulations versus REST simulations (121 ± 14 vs. 84 ± 9 beats per minute, P < 0.01, ES = 3.1), as was mean respiratory rate (19 ± 3 vs. 16 ± 3 breaths per minute, P < 0.01, ES = 1.0). Mean arterial pressure was higher for OPA versus REST at simulation start (105 ± 11.3 vs. 95.8 ± 11.8 mm Hg, P = 0.01, Effect Size = 0.8), although not different after simulation. Conclusions Paramedicine students including recent graduates performed as well, or better, in a simulated clinical scenario immediately after occupation-specific acute physical exertion compared with a REST, despite higher physiological exertion. Whether this is the case for more experienced but potentially less physically fit paramedics in the workforce warrants investigation