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Clinical competencies in paramedic students

David Lim, Stephen Bartlett, Peter Horrocks, Courtenay Grant-Wakefield, Jodie Kelly, Vivienne Tippett
BACKGROUND: Paramedic education has evolved in recent times from vocational post-employment to tertiary pre-employment supplemented by clinical placement. Simulation is advocated as a means of transferring learned skills to clinical practice. Sole reliance of simulation learning using mannequin-based models may not be sufficient to prepare students for variance in human anatomy. In 2012, we trialled the use of fresh frozen human cadavers to supplement undergraduate paramedic procedural skill training...
2014: BMC Medical Education
Franziska Trede, Celina McEwen, Amanda Kenny, Peter O'Meara
OBJECTIVES: We present our findings from a scoping review that sought to identify what is known about nursing and paramedic clinical supervisors' experiences of their supervision practices in rural settings. Our interest in these two groups is based on the central role that nurses and paramedics play in rural health care. DESIGN: Scoping reviews support identification of a broad range of literature, including all types of study designs. We adopted Arksey and O'Malley's five-stage approach: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising and reporting results...
May 2014: Nurse Education Today
Fenton O'Leary, Margaret Allwood, Kathryn McGarvey, Julie Howse, Karyn Fahy
AIM: A key competency for all health-care workers (HCWs) who care for children is the ability to respond to a child in respiratory or cardiorespiratory arrest. However, evidence suggests that medical and nursing staff may not have the knowledge and clinical skills to respond to these emergencies. The aim of this project was to create a standardised, evidence-based, paediatric life support course that would be available free to all HCWs in New South Wales (NSW), including NSW Ambulance...
May 2014: Journal of Paediatrics and Child Health
Michael T Hilton, Jestin N Carlson, Stephanie Chan, Paul E Phrampus
BACKGROUND: Stylet use during endotracheal intubation (ETI) is variable across medical specialty and geographic location; however, few objective data exist regarding the impact of stylet use on ETI performance. OBJECTIVE: We evaluated the impact of stylet use on the time required to perform ETI in cases of simulated difficult airways in novice and experienced providers. METHODS: We performed a prospective, randomized observational study of experienced (attending anesthesiologists and emergency physicians) vs inexperienced airway providers (emergency medical technician, paramedic and medical students) comparing the use of stylet vs no stylet in random order using a simulated difficult airway...
March 2013: American Journal of Emergency Medicine
Walter Tavares, Sylvain Boet, Rob Theriault, Tony Mallette, Kevin W Eva
OBJECTIVE: The aim of this study was to develop and critically appraise a global rating scale (GRS) for the assessment of individual paramedic clinical competence at the entry-to-practice level. METHODS: The development phase of this study involved task analysis by experts, contributions from a focus group, and a modified Delphi process using a national expert panel to establish evidence of content validity. The critical appraisal phase had two raters apply the GRS, developed in the first phase, to a series of sample performances from three groups: novice paramedic students (group 1), paramedic students at the entry-to-practice level (group 2), and experienced paramedics (group 3)...
January 2013: Prehospital Emergency Care
Erin L Simon, Paul J Lecat, Nairmeen A Haller, Carolyn J Williams, Scott W Martin, John A Carney, John A Pakiela
BACKGROUND: The Ventriloscope® (Lecat's SimplySim, Tallmadge, OH) is a modified stethoscope used as a simulation training device for auscultation. OBJECTIVE: To test the effectiveness of the Ventriloscope as a training device in teaching heart and lung auscultatory findings to paramedic students. METHODS: A prospective, single-hospital study conducted in a paramedic-teaching program. The standard teaching group learned heart and lung sounds via audiocassette recordings and lecture, whereas the intervention group utilized the modified stethoscope in conjunction with patient volunteers...
December 2012: Journal of Emergency Medicine
Donna Venezia, Andrew Wackett, Alexander Remedios, Victor Tarsia
BACKGROUND: Few studies have evaluated the impact of the upright position on the success of oral-tracheal intubation. Yet, for patients with airway difficulties (i.e, active intraoral bleeding or morbidly obese), the upright position may both benefit the patient and facilitate intubation. OBJECTIVES: We compared the success rates of subjects performing standard intubation to a modified version of the sitting face-to-face oral-tracheal intubation technique on a simulation model...
December 2012: Journal of Emergency Medicine
Eleanor Riesen, Michelle Morley, Debra Clendinneng, Susan Ogilvie, Mary Ann Murray
Interprofessional simulation interventions, especially when face-to-face, involve considerable resources and require that all participants convene in a single location at a specific time. Scheduling multiple people across different programs is an important barrier to implementing interprofessional education interventions. This study explored a novel way to overcome the challenges associated with scheduling interprofessional learning experiences through the use of simulations in a virtual environment (Web.Alive™) where learners interact as avatars...
July 2012: Journal of Interprofessional Care
Donnamay Brown, Craig Zimitat
BACKGROUND: Undergraduate students' in several Australian medical courses undertake short placements with Paramedics to increase their awareness of biopsychosocial factors affecting health, provide opportunities to apply knowledge and clinical skills in health contexts and to develop inter-professional knowledge. AIM: The purpose of this study was to provide the first report of medical students experiences on Paramedic placements, by identifying the opportunities and range of clinical activities they experienced, and to seek feedback to improve placements...
2012: Medical Teacher
Michael S Mitchell, Marjorie Lee White, William D King, Henry E Wang
INTRODUCTION: Pediatric endotracheal intubation (ETI) is difficult and can have serious adverse events when performed by paramedics in the prehospital setting. Paramedics may use the King Laryngeal Tube airway (KLT) in difficult adult airways, but only limited data describe their application in pediatric patients. OBJECTIVE: To compare paramedic airway insertion speed and complications between KLT and ETI in a simulated model of pediatric respiratory arrest. METHODS: This prospective, randomized trial included paramedics and senior paramedic students with limited prior KLT experience...
April 2012: Prehospital Emergency Care
Melisa Martin, Michael W Hubble, Marianne Hollis, Michael E Richards
INTRODUCTION: Prior to graduation, paramedic students must be assessed for terminal competency and preparedness for national credentialing examinations. Although the procedures for determining competency vary, many academic programs use a practical and/or oral examination, often scored using skill sheets, for evaluating psychomotor skills. However, even with validated testing instruments, the interevaluator reliability of this process is unknown. Objective. We sought to estimate the interevaluator reliability of a subset of paramedic skills as commonly applied in terminal competency testing...
April 2012: Prehospital Emergency Care
Caroline MacKenzie
There is a large body of evidence to suggest that use of the Ottowa knee rules (OKR) (Stiell et al 1995) can ensure a consistent level of care for patients with acute knee injuries and that the OKR are a useful tool for autonomous practitioners. However, there is also evidence that in using the OKR, nurses tend to overestimate the extent of knee injuries. This article draws on a case study of a man who had sustained a knee injury while being tackled in a football match. During the consultation, the author, who was the duty student paramedic practitioner, and the author's mentor, who was the duty senior nurse practitioner, disagreed about the need for an X-ray of the patient's knee...
November 2011: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Annmarie Ruston, Abdol Tavabie
OBJECTIVES: To report the extent to which the placement of paramedic practitioner students (PPSs) in accredited general practice (GP) training practices supported their development as autonomous, patient-centred practitioners and fostered interprofessional learning. DESIGN: A case study method was used. Sources of data included semi-structured telephone interviews (eight PPSs, eight GP trainers), an online end of placement survey and placement and assessment documentation...
2011: Quality in Primary Care
Marc Nagels
The purpose of the study is to show that the analysis of the activity is a factor of construction of the collective self-efficacy of the trainers of five training institutes in nursing care (IFSI). As a collective system of beliefs on the capacity of the group to attain its goals, self-efficacy finds its foundations in the sociocognitive theory which articulates, within a mutual triadic causality, the personal, behavioral and environmental factors of the human agentivity. The personal determiners (self-efficacy, cognitive organization of the activity) are put in connection with the behavioral (production of the performance) and environmental (attribution of skill, professional tasks and standards) factors...
March 2011: Recherche en Soins Infirmiers
Young-Min Kim, Hyung-Goo Kang, Ji-Hoon Kim, Hyun-Soo Chung, Hyeon-Woo Yim, Seung-Hee Jeong
OBJECTIVES: To evaluate whether chest compressions affect the time taken for intubation (TTI) using the Macintosh laryngoscope and two portable video laryngoscopes (VLs) (GlideScope Ranger and Airway Scope) when used by novice prehospital caregivers, and to compare the TTIs and rates of successful intubation among the three laryngoscopes with and without chest compressions in a manikin model. METHODS: This was a pilot randomized crossover study. Twenty paramedic students and paramedics who had no clinical experience with tracheal intubation and had never used any of two VLs participated in the study...
January 2011: Prehospital Emergency Care
Waylan Wong, Suraj Kedarisetty, Nathan Delson, Dale Glaser, Jennifer Moitoza, Daniel P Davis, Randolph H Hastings
BACKGROUND: A problem with learning endotracheal intubation on airway mannequins is poor transfer of direct laryngoscopy skills from model to patient. We developed an airway model with adjustable anatomic features and investigated whether practicing on a model with frequent adjustments improved laryngoscopy skills transfer. METHODS: Fifty-one paramedic students and 18 medical students with minimal previous experience practiced laryngoscopy 25 times with either the novel model with static features, the novel model with variable features, or a Laerdal Adult Intubation mannequin...
October 2011: Anesthesia and Analgesia
Orhan Cinar, Erdem Cevik, Ali Osman Yildirim, Mehmet Yasar, Erden Kilic, Bilgin Comert
The aim of this study was to determine whether GlideScope video laryngoscope (GVL) and intubating laryngeal mask airway (i-LMA) improve the intubation success rate and could be easily learned and performed by paramedic students when compared with the direct laryngoscopic (DL) method. The study was designed as a prospective randomized crossover trial that included 121 paramedic students. All participants were asked to intubate each Ambu Airway Management Trainer manikins after the lecture and demonstration. Successful intubation was defined as the passage of the tube through the vocal cord within 60 s...
April 2011: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Robert F Sapp, Jane H Brice, J Brent Myers, Paul Hinchey
INTRODUCTION: Large-scale events may overwhelm the capacity of even the most advanced emergency medical systems. When patient volume outweighs the number of available emergency medical services (EMS) providers, a mass-casualty incident may require the aid of non-medical volunteers. These individuals may be utilized to perform field disaster triage, lessening the burden on EMS personnel. OBJECTIVE: The purpose of this study was to evaluate the accuracy of triage decisions made by newly enrolled first-year medical students after receiving a brief educational intervention...
May 2010: Prehospital and Disaster Medicine
Felix Walcher, Thomas Kirschning, Michael P Müller, Christian Byhahn, Mario Stier, Miriam Rüsseler, Franziska Brenner, Jörg Braun, Ingo Marzi, Raoul Breitkreutz
OBJECTIVES: To establish a training course for Prehospital Focused Abdominal Sonography for Trauma (P-FAST) and to evaluate the accuracy of the participants after the course and at the trauma scene. METHODS: A training programme was developed to provide medical staff with the skills needed to perform P-FAST. In order to evaluate the accuracy of P-FAST performed by the students, nine participants (five emergency doctors and four paramedics) were followed during their course and in practice after the course...
May 2010: Emergency Medicine Journal: EMJ
R Buyl, M Nyssen
OBJECTIVES: EBP (evidence-based practice) is becoming the standard paradigm in modern healthcare. Therefore different healthcare providers have the need for easily accessible evidence-based information. The Internet creates new opportunities to fill the gaps in education that are experienced by healthcare workers. Contributing to solutions and filling in the needs in the above-mentioned scope, the University of Brussels initiated a European project called MedSkills in 2004. METHODS: MedSkills' main goal was to create a copyright-free reference work containing valuable evidence-based information on medical skills for all levels of healthcare professionals (paramedics, nurses and physicians, teachers of medical skills and students)...
2010: Methods of Information in Medicine
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