Despite the plethora of training programs, community
initiatives, and advances to simulation fidelity and technologies,
patient survival rates from cardiac arrest remain at less than
ten percent. Extensive reporting of the rapid decay in clinician
competency occurring soon after certification, broadly
implicates the sustainability of current learning conventions
within nursing, medicine and paramedicine. Ranging from
civilian basic 1st aid initiatives, through to the most advanced
clinician resuscitation credentialing, training programs typically
share several pedagogical principles.
Resuscitation education is approached as a specialised discreet
curriculum. Program delivery is intensive over short periods.
Learning is centered on student memorisation and recital of
an algorithm. High stakes certification of competency is a
performed exclusively by assessors and is terminal event of the
program. Many of these features are at odds with contemporary
evidence aligned with achieving deeper, authentic learning
which is sustained for the longer term.
This study reports on an alternative learning design which
reflects evidence on clinical competence, sustainable assessment,
authentic learning, and the Ottawa good assessment criteria.
Classroom simulations were based on real paramedic
resuscitation cases, and assessment was expanded to reflect
holistic professional expectations. Traditional credentialing was
replaced by a longitudinal programmatic assessment design
where competency decisions could reflect trends. Outcomes also
considered student metacognition, which was reported through
student led evaluations.
Methods. Paramedic undergraduates were tested at five intervals
spaced a fortnight apart using simulated cases based on real
events. Assessment design reflected the holistic professional
expectations of the profession and a work based entrustment
scale grading philosophy. Students and assessors were also
surveyed in relation to their experiences and perceptions of the
Ottawa good assessment criteria.
Results. 84 participants achieved a mean score of 57% at the first
testing interval, which witnessed a mean 9% total score increase
across the span of 5 tests. An 18% reduction in borderline or
below scores was witnessed across the same 5 tests. Post hoc
Tukey pairwise comparisons showed no significant differences
between the scores awarded by the assessors. The accuracy of
student critical appraisals of their performance remained above
91% across the five tests. Qualitative participant responses
showed high levels of broad agreement regarding each of the
Ottawa good assessment criteria.
Conclusion. An iterative program of authentic resuscitation
assessment offers improved decision making about the
students’ capabilities for future real-world practice. The
approach is associated with significant and continued
improvements to mean competency standards across the
period of the program and applies principles which are
consistent with educational best practice and sustainable
learning for the longer term.
|Number of pages
|Published - 27 Sept 2022
|Higher Education Research Group Adelaide (HERGA) Conference 2022: Rethinking and Reshaping Higher Education - Adelaide University, Adelaide, Australia
Duration: 27 Sept 2022 → 27 Sept 2022
|Higher Education Research Group Adelaide (HERGA) Conference 2022
|27/09/22 → 27/09/22