An investigation into the clinical practicum experience of als paramedic students and their preparedness for professional practice

Abstract

Clinical practicum remains an integral part of training and a vital component of the emergency medical care curriculum that takes place in a realistic and complex emergency care environment. Clinical practicum should provide students with the opportunity to combine cognitive, psychomotor and affective skills to develop competencies to prepare the qualifying practitioner for demands of pre-hospital emergency care in the real world. The aim of this study was to explore the multidimensional aspects of the clinical practicum experience of ALS paramedic students in the Western Cape through the lens of a qualitative research design. The study involved exploring the experience of paramedic students in the clinical practice placement. In addition, the views of paramedic graduates were also explored, to ascertain whether the placement experience adequately prepared them for practice. An analysis of the clinical practice documents utilised in the training of ALS paramedic students was conducted with particular reference to identify correlations with relevant literature. In addition, it was necessary to identify how clinical practice manifested itself, not only in what students and graduates express but also how it was coordinated and conveyed in a professional work related context, against the backdrop of the work integrated learning framework. Using a case study design, focus group interviews were conducted with final year EMC students from CPUT and CCA students from the Western Cape CEC. This was followed with one on one interview with paramedic graduates. Further to this, clinical practice documents were analysed to triangulate the data. This study revealed that the clinical practice learning objectives for paramedic students were not adequately achieved and paramedic graduates felt ill prepared for independent practice. These discrepancies were attributed to the complex issues both in theory and practice. The study provided a number of recommendations for improving the clinical training experience, such that paramedic graduates who enter the complex and challenging world of EMC are better prepared.

Undergraduate paramedicine students' experiences of feedback during clinical placement on‐road: A scoping review

“…One adopted a mixed methods approach (Wongtongkam & Brewster, 2017) and two utilized qualitative methodology (Lane, 2014; Moodley, 2016). Two studies were published peer reviewed studies conducted in Australia (Lane, 2014; Wongtongkam & Brewster, 2017) with one study being an unpublished master's thesis conducted in South Africa (Moodley, 2016). All three studies explored various aspects of the clinical placement experience for paramedicine students.…”

“…Concerningly, in a study from South Africa some paramedicine students reported when they did something incorrectly, the paramedic would “scream and shout at [them] and make [them] feel worthless and then they [would] ignore [them] the whole day” (Moodley, 2016, p. 96). Additionally, at times feedback was personal and destructive in nature and lacked structure (Moodley, 2016). Students reported qualified paramedics were unable to provide constructive feedback when students displayed poor attitude or clinical skills.…”

“…Students reported qualified paramedics were unable to provide constructive feedback when students displayed poor attitude or clinical skills. At times positive feedback was given regardless of how the student performed rather than providing feedback addressing the student's deficiencies and how to improve (Moodley, 2016).…”

“…A further concern regarding the feedback process surrounds the timing and amount of feedback provided to students by qualified paramedics. The timing of feedback was often rushed and provided at the end of the shift, preventing and limiting a student's opportunity to improve their performance (Moodley, 2016). Furthermore, the written feedback provided to students was often limited to a few lines, with minimal information to enable the student to improve (Moodley, 2016).…”

“…The qualified paramedics working alongside students during clinical placement are referred to by a variety of terms within both international and Australian literature. These are the “crew” (Devenish, 2014), “paramedic educator” (Lane, 2014; O'Meara et al, 2014), “paramedic mentor” (Wilson, 2013), “preceptor” (Maria et al, 2019; Wongtongkam & Brewster, 2017), “mentor” (Lane, 2014; Moodley, 2016), and “clinical instructor” (Moodley, 2016; O'Meara et al, 2014). Despite the varying terms, these roles are held by paramedics with qualifications enabling them to fulfill the role of a qualified paramedic, regardless of the jurisdiction in which they work.…”