Masters Degrees (Office of the Dean: Health Sciences)
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Browsing Masters Degrees (Office of the Dean: Health Sciences) by Author "Campbell, Roderick Grant"
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Item Open Access Integrated clinical simulation assessment criteria for emergency care education programmes in South Africa(University of the Free State, 2015-07) Campbell, Roderick Grant; Labuschagne, M. J.; Bezuidenhout, J.English: An in-depth study was done into integrated clinical simulation with a view to identifying assessment criteria and case types in order to employ integrated clinical simulation as an instrument for summative assessment of learners by ALS emergency-care-education programmes in South Africa. Clinical simulation is mandated by the Health Professions Council of South Africa, Professional Board for Emergency Care (HPCSA: PBEC), for use by emergency-care-education programmes as a summative assessment instrument. The Higher Education Quality Committee (HEQC) calls for integrated assessment as a suitable test of applied competence reflecting the key purpose of a qualification. The South African Qualifications Authority (SAQA), using the outcomes-based education and training paradigm, provides a clear definition of “assessment criteria” and “integrated assessment” for employment when assessment of applied competence occurs (SAQA 2001:11, 21). These definitions were used to frame and focus the study. This study sought to bridge the gap created by the absence of guidelines by PBEC for assessment criteria and case types or scenarios for use with integrated clinical simulation summative assessment. In this study the elements of assessment criteria, as defined by SAQA, relevant to integrated clinical simulation were explored. In tandem with assessment criteria, case types or scenarios appropriate to integrated clinical simulation were extrapolated. This study is situated in the field of Health Professions Education and focused on the profession of Emergency Medical Care. The research methods comprised analysis of documents that contextualise the mandate and use of clinical simulation for assessment by emergency-care-education programmes in South Africa. A review of scholarship provided a conceptual framework for understanding healthcare simulation as an educational methodology and valid assessment instrument for assessing applied competence in an authentic situation. A conceptual understanding of the prerequisites for using healthcare simulation that ensures an authentic situation for meaningful student engagement was discoursed. Perspectives from literature that address assessment criteria and case types relevant to ALS paramedic practice were discovered. An embedded, single-case study design was employed and focus-group interviews were used as the method of data collection for the empirical phase of the study. Data from focus-group interviews with experienced ALS paramedics was analysed and interpreted in conjunction with scholarly viewpoints and experience of the researcher to examine integrated clinical simulation as a summative assessment instrument, which was the main unit of analysis, and the subunits, namely, assessment criteria and case types. From the analysis of focus-group discussions, seven themes informing the research questions were deliberated. The first theme addressed the integrated clinical simulation as an assessment instrument. The second theme spoke to the context and conditions of ALS paramedic practice that are relevant to the integrated clinical simulation. Theme three through to theme six tackled the knowledge framework together with the physical, cognitive, affective and the social-professional dimensions of ALS paramedic practice that are relevant to the integrated clinical simulation. Finally, theme seven engaged case types and scenarios for integrated clinical simulation as a summative assessment instrument. The lack of fidelity of the integrated clinical simulation perceived by focus-group participants, together with its historical use as a summative assessment instrument challenges the application of integrated clinical simulation as an authentic assessment. Using a single, once-off integrated clinical simulation to assess competence in ALS paramedic practice is contested by the range of life-threatening emergencies possible across medical disciplines. In order for the integrated clinical simulation to assess competence it must cover the range of medical disciplines, incorporate the dimensions of ALS paramedic practice, reflect the conditions, complexity and range of life-threatening emergencies presented to ALS paramedics in South Africa and elicit the appropriate response modes required in practice. Although no specific case types were identified for use in the integrated clinical simulation, characteristics of case types were identified and they provide a matrix for case-type selection. These characteristics refer to the categories of medical and trauma conditions, with a focus on life-threatening emergencies across the range of medical disciplines. The action-response mode of the ALS paramedic and life-support interventions required are determined by the nature of the presenting life-threatening emergency within the scope of practice prescribed by the PBEC. The context and conditions of ALS paramedic practice must also be represented if true competence is to be assessed. This study informs a conceptual framework of healthcare simulation for use by emergency-care-education programmes in South Africa. The study serves to frame the breadth, depth and scope of assessment criteria applicable to integrated clinical simulation for use as a summative assessment instrument. Finally, this study provides a conceptual matrix for case type and case design for clinical simulation in emergency care.