Opportunities and Challenges Associated with The Paramedic Evidence-Based Education Project - Essay Example

Opportunities and Challenges Associated with PEEP Report in Terms of Paramedic Clinical Practice. By Opportunities and challenges associated with PEEP report in terms of paramedic clinical practice. INTRODUCTION Paramedics continue to develop from their historical roles of delivering first aid and transportation of patients to hospital, towards a greater emphasis on decision-making, treatment and referral. According to the current medicine legislation these paramedics they are able to administer various medications after making critical and clinical decisions independently as part of their professional practice for urgent and needed treatment of the sick and the injured people (DH, 2010). However, practitioners should ensure that they continue to develop new knowledge and gather enough evidence to support these practices in order to control the new patient experiences. Reports later emerged that community paramedics were treating more patients at home, thereby providing primary care out of hour’s services, responding more efficiently and effectively to non-urgent 999 calls and reducing more visits to accidents and emergencies, there was need to advance education and teaching of paramedics to create a workforce that could provide a greater range of mobile urgent care with further suggestions that the education and training should focus on clinical decision making. The Paramedic Evidence-Based Education Project (PEEP) was commissioned in August 2013 to address this issue of delivery of paramedic teaching. It was accepted that paramedics were well known by the general population and equipping them with urgent care skills will be very beneficial to the wider community. This report provided the following recommendations: There should be a national wide agreed approach to the commissioning and funding of the training with students accessing bursaries. Pre-registration education should be in alignment with other non-medical professions leading to an all graduate profession. Enhancement of clinical skills and clinical decision making developed through the College of Paramedics. The paramedic profession has made rapid progression since its inception. The paramedic profession was registered as an occupation in the year 2000 when paramedics were required to register with the Council for Professions, an organization that is known as the Health Professions Council (HPC) (Donaghy, 2008). In the earlier times, horse-drawn carts and carriers were being used to carry and treat the sick and ambulances were later developed and they were used during the First and the Second World Wars (Claggs and Blaber, 2008). In the 1960s the drivers of the ambulances had roles to carry the sick and injured from home to hospital. However, little or no training was provided to these drivers and what was required from them was good driving skills and to be strong. After some time it was evident that basic emergency care like first aid could be provided by ambulance drivers. However, even with this information, equipping ambulance drivers with knowledge remained negligible and they only relied on delivery of the training instead of an educational approach needed to make them understand the topic better (CoP 2008). The training given to the drivers focused more on transportation based mostly on learning through routine and repetition without full comprehension of topic leading to inflexibility where the ambulance drivers were not able to address new demands of the service. It was suggested that the paramedics should provide a wider range of emergency and unscheduled care and should offer interventions to assist patients to remain at home and not require admission to hospital (DH, 2005). Paramedics should be prepared educationally for their role within a higher education setting using a curriculum guided by the College of Paramedics and developed and delivered in partnerships with paramedic NHS Trusts (Darzi, 2008). The paramedics practicing in the twenty-first century have knowledge and skills that are quite unrecognizable from the transporting function of the early ambulance driver. The evolving roles of the paramedics are reflected in the key changes in the College of Paramedics curriculum for paramedic registrants (CoP, 2008) that notes that the paramedic should be skilled in: Making appropriate referrals, Providing increased patient assessment, undertaking enhanced history taking, enhancing clinical decision making and critical thinking and appreciating research and understanding research methodology. These skills and abilities cannot be learnt through routines and repetition but rather by having a critical understanding of the knowledge base of the paramedic profession, including learning from and in practice and using skills of reflection to aid this process of continuous learning (Rolfe et al., 2010). This transition has followed the expansion of paramedic clinical capability and responsibility, presenting the student paramedics with more opportunities to apply their own professional judgment and experience to make clinical decisions to best suit the patients’ needs and to accept, explain and justify these decisions when challenged and with an advantage of preceptorship, they will be able to take the leadership role in care delivery within a team. Having the ability to critically review evidence, arguments and assumptions, the student paramedics will be in a position to advise patients and care teams on health care issues, health promotion and injury prevention, and be able to make sound clinical decisions and develop care plans with a greater degree of independence. The role of paramedics was to just provide basic first aid and transport patients to hospitals (Ball and Al-shaqsi, 2015), but recently there has been expansion in countries such as the United Kingdom (Cooke, 2006) United States, Canada and Australia (Kruperman, 2010). By training student paramedics these countries have realized several benefits; clinical decision making by the practitioners that can save lives of the patients (Cooper et al., 2009), reduction of ambulance transportation since they attend to patients at home (Brown et al, 2009), addressing the shortage of health workers (Raven et al, 2006) and offering more convenient and timely treatment to patients (Cooke, 2006). Paramedic training also presents opportunities to the students in training; first the student is able to gain diverse skills and knowledge through working alongside senior paramedics but also other healthcare professionals. The students have the opportunity to acquire clinical skills, but also develop non-clinical skills, such as problem-solving, clinical reasoning, critical thinking, professional responsibility, joint effort, and the capability to be self-governing but mutual practitioners (Henning et al., 2008 & Ross &Cameron, 2007). A UK study found that undergraduate paramedics felt their communication and interpersonal skills required further development and that they often felt ill-equipped to engage constructively and confidently with patients (Donaghy, 2010). Harrison and Fopma-Loy (2010) discussed a mounting frustration with student nurses displaying a ‘disconnection’ from patients overlooking the human being they are caring for. Throughout history, teaching and learning have been central to the progression of society (Tokuhama-Espinosa, 2011). Paramedic students are able to acquire skills that enable them to serve the community together with other paramedics or independently. The students get to feel that patient care has been improved and get to express increased job satisfaction and development of their skills (Machen et al., 2009). During their teaching, students should profit from having good and strong peer groups in order to get a chance of development and even if the College of Paramedics acknowledges that forming such groups can be difficult, it is a great opportunity for many students to learn and to grow (CoP, 2008). Peer learning presents a good opportunity to revise their own skills which could have become a little rusty for instance skills learnt in their first and second year in the university and helps clarify knowledge, especially where there have been changes in clinical procedure since their studies in cases where some standards and procedures are revised. Practice placements being an integral of the program, enables the amalgamation of theory into practice, thus continuing the development of clinical skills. The students are able to integrate theoretical teaching with clinical education placement in a variety of settings which include; community health centers, rehabilitation centers, emergency ambulance, non-emergency ambulance and hospital ward departments. These settings are critical for paramedics as many have limited scope due to timetabling constraints, healthcare organizations which are not in a position to meet clinical placements demands (Boyle M, 2007) competition with other allied health care professionals(Johnstone B,2006) and reduced exposure to critical ill patients (Boyle and Smith,2008). Paramedic students are faced with several challenges during training. Some students may be excluded from first hand patient management by already experienced paramedics who may feel that they are not qualified enough or who are anxious for the safety of the patients. In some cases, students are left at the ambulance stations or have to move to other crews and this can lead to lack of confidence by the students during learning, clinical placements and when dealing with people in real life situations after training. Clinical educators may not always be available to students during their clinical placements. This will therefore limit the opportunities for these students to learn many skills and put them into practice. Another challenging issue is where already qualified paramedics discourage these students that they will not be able to perform physical roles this leads to some students losing interest to learn and to practice the already acquired knowledge and skills since generally paramedicine is considered a very challenging job. According to Ham and ORourke (2006) there are situations where nursing students feel uneasy when they are treated badly their clinical educators. Negative experiences of students have unconstructive effects on learning and also have an effect on where students seek future employment (Courtney et al, 2002). In dealing with these problems, (Reid & Dwyer, 2005) propose that better preparation for the clinical instructors should be considered by the ambulance service administration, especially where students are known to be anxious about their placements and exposure to their potential employment organization. Conclusion Paramedic students should be presented in environments where they can learn and utilize their acquired skills in order to encourage them. The training program should include a feedback program where the students get a chance to state the challenges and opportunities they got during their training. 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