Integrated clinical simulation assessment criteria for emergency care education programmes in South Africa
| dc.contributor.advisor | Labuschagne, M. J. | |
| dc.contributor.advisor | Bezuidenhout, J. | |
| dc.contributor.author | Campbell, Roderick Grant | |
| dc.date.accessioned | 2018-01-19T10:04:46Z | |
| dc.date.available | 2018-01-19T10:04:46Z | |
| dc.date.issued | 2015-07 | |
| dc.description.abstract | 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. | en_ZA |
| dc.description.abstract | Afrikaans: ‘n Vasgebakende diepte-gevallestudie oor geïntegreerde kliniese simulasie is uitgevoer om assesseringskriteria en gevaltipes te identifiseer ten einde geïntegreerde kliniese simulasie as instrument vir summatiewe assessering van leerders in gevorderde-lewenssteun noodsorg- opvoedkundige programme in Suid-Afrika toe te pas. Kliniese simulasie word deur die Raad vir Gesondheidsprofessies van Suid-Afrika, Professionele Raad vir Noodsorg (GBRSA: PRNSP) voorgeskryf as ‘n summatiewe assesseringsinstrument vir opvoedkundige programme in noodsorg. Die Raad op Hoër Onderwys Hoër Onderwys Gehalteversekering Komitee (RHO HOG) beskou geïntegreerde assessering as ‘n geskikte toets vir toegepaste vaardigheid wat die hoofdoel van 'n kwalifikasie weerspieël. Aan die hand van die uitkomsgebaseerde opvoedings- en opleidingsparadigma verskaf die Suid-Afrikaanse Kwalifikasie Outoriteit (SAKO) ‘n duidelike definisie van “assesseringskriteria” en “geïntegreerde assessering” vir indiensneming wanneer assessering van toegepaste vaardighede plaasvind (SAQA 2001:11, 21). Hierdie definisies is gebruik om die studie van ‘n raamwerk en fokuspunt te voorsien. Hierdie studie het gepoog om die gaping te oorbrug wat geskep is deur die afwesigheid van riglyne deur PBEC rakende assesseringskriteria en gevaltipes of scenario’s, wat vir geïntegreerde kliniese simulasie vir summatiewe assessering gebruik kan word. In hierdie studie is die elemente van assesseringskriteria, soos deur SAQA gedefinieer en relevant tot geïntegreerde kliniese simulasie, ondersoek. Tesame met assesseringskriteria, is gevaltipes of scenario’s relevant tot geïntegreerde kliniese simulasie geëkstrapoleer. Hierdie studie is geleë in die veld van Gesondheidsorgonderwys, in die besonder die professie van Nood- Mediese Sorg. Die navorsingsmetodes het behels ontleding van dokumente wat die opdrag rakende en gebruik van kliniese simulasie vir assessering by noodsorg onderwysprogramme in Suid-Afrika in konteks plaas. ‘n Oorsig van vakgeleerdheid het ‘n konseptuele raamwerk verskaf om ‘n begrip te ontwikkel van gesondheidsorg-simulasie as ‘n opvoedkundige metodologie, en as 'n geldige assesseringsinstrument wat toegepaste vaardigheid in ‘n egte situasie assesseer. ‘n Konseptuele begrip van die voorvereistes vir die gebruik van gesondheidsorg-simulasie wat 'n egte situasie vir betekenisvolle studentebetrokkenheid verseker, is bespreek. Perspektiewe uit literatuur wat assesseringskriteria en gevaltipes aanspreek wat van toepassing is op gevorderde lewenssteun paramediese praktyk, is ontdek. ‘n Vasgebakende diepte-gevallestudie en fokusgroeponderhoude is gebruik om data te versamel vir die empiriese fase van die studie. Data verkry uit fokusgroeponderhoude met ervare gevorderde-lewenssteun-paramedici is ontleed en geïnterpreteer met inagneming van die navorser se vakkundige standpunte en ervaring, ten einde geïntegreerde kliniese simulasie as instrument vir summatiewe assessering te ondersoek. Die hoofeenheid van ontleding was die summatiewe assesseringsinstrument, en die ondergeskikte eenhede was assesseringskriteria en gevaltipes. Sewe temas wat die navorsingsvrae inlig en wat uit die ontleding van die fokusgroepbesprekings ontstaan het, is ondersoek. Die eerste tema het gehandel oor geïntegreerde kliniese simulasie as ‘n assesseringsinstrument. Die tweede tema het verwys na die konteks en toestande van gevorderde lewenssteun paramediese praktyk wat van toepassing is op geïntegreerde kliniese simulasie. Temas drie tot ses het aandag geskenk aan die kennisraamwerk, tesame met die fisieke, kognitiewe, affektiewe en sosiaal-professionele dimensies van gevorderde lewenssteun paramediese praktyk wat relevant is vir geïntegreerde kliniese simulasie. Laastens is in tema sewe aandag geskenk aan gevaltipes en scenario’s vir geïntegreerde kliniese simulasie as ‘n summatiewe assesseringsinstrument. Die gebrek aan egtheid van die geïntegreerde kliniese simulasie wat deur fokusgroepdeelnemers waargeneem is, tesame met die historiese gebruik van simulasie as ‘n summatiewe assesseringsinstrument, kan in die pad staan van die toepassing van geïntegreerde kliniese simulasie as ‘n egte assessering. Die gebruik van ‘n enkele, eenmalige geïntegreerde kliniese simulasie om vaardigheid in gevorderde lewenssteun paramediese praktyk te assesseer, word bevraagteken deur die verskeidenheid lewensgevaarlike noodgevalle wat oor mediese dissiplinies moontlik is. Indien die geïntegreerde kliniese simulasie vaardigheid moet assesseer, moet dit die verskeidenheid mediese dissiplines dek, dit moet oor al die dimensies van gevorderde lewenssteun paramediese praktyk handel, dit moet die toestande, kompleksiteit en verskeidenheid lewensgevaarlike noodgevalle waarmee gevorderde lewenssteun paramedici in Suid-Afrika gekonfronteer word, weerspieël, en dit moet toepaslike reaksiewyses wat deur die praktyk vereis word, ontlok. Hoewel geen spesifieke gevaltipes wat in geïntegreerde kliniese simulasie aangewend kan word, geïdentifiseer is nie, is eienskappe van gevaltipies geïdentifiseer, en hulle verskaf 'n matriks vir die keuse van gevaltipes. Hierdie eienskappe verwys na kategorieë van mediese en traumatoestande, met die klem op lewensgevaarlike noodgevalle oor al die mediese dissiplines. Die tipe aksie-respons van die gevorderde-lewenssteun-paramedikus en die lewenssteuningryping wat vereis word, word bepaal deur die aard van die lewensgevaarlike noodgeval binne die omvang van die praktyk wat deur die PRNSP voorgeskryf word, voorkom. Indien vaardigheid geassesseer moet word, moet die konteks en toestande van die gevorderde lewensteun paramediese praktyk ook verteenwoordig word. Hierdie studie is die basis van ‘n konseptuele raamwerk vir gesondheidsorgsimulasie wat in noodsorg- opvoedkundige programme in Suid-Afrika gebruik kan word. Die studie dien as ‘n raamwerk vir die breedte, diepte en omvang van assesseringskriteria wat toepaslik is vir geïntegreerde kliniese simulasie as 'n summatiewe assesseringsinstrument. Laastens verskaf die studie 'n konseptuele matrys vir gevaltipes en gevalontwerp vir kliniese simulasie in noodsorg. | af |
| dc.description.sponsorship | Health and Wellness SETA (HWSETA) | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11660/7642 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Integrated assessment | en_ZA |
| dc.subject | Summative assessment | en_ZA |
| dc.subject | Assessment criteria | en_ZA |
| dc.subject | Case types or scenarios | en_ZA |
| dc.subject | Healthcare simulation | en_ZA |
| dc.subject | Simulation fidelity | en_ZA |
| dc.subject | Focus-group interview | en_ZA |
| dc.subject | Single | en_ZA |
| dc.subject | Embedded case study | en_ZA |
| dc.subject | Dissertation (M.HPE. (Health Professions Education))--University of the Free State, 2015 | en_ZA |
| dc.title | Integrated clinical simulation assessment criteria for emergency care education programmes in South Africa | en_ZA |
| dc.type | Dissertation | en_ZA |