Improving simulation through student assessment partnerships

Improving simulation through student assessment partnerships
Practical simulations and mock scenarios are commonplace components of paramedic education and training. While there have been advances to simulation fidelity, the underlying theoretical approaches to student learning and assessment have changed little. The established practice requires students to demonstrate skills and reasoning before an observer, who then critiques and scores student performance in line with a pre-determined rubric. Check-box style grading requires assessors to penalise student errors, encouraging students to execute faultlessly. Meanwhile, academic frustration often is linked to students exhibiting grade seeking behaviours such as challenging results, attempting to conceal mistakes, as well as difficulties with receiving critical feedback.
While credentialing rubrics typically require an observer to apply their judgement to observed student performance, without a rich discourse these do not provide insight to the depth of student understanding, rationales, or the student’s own evaluation of their performance. There is irony that a process used to develop the critical thinking, reflective practice, and self-regulation skills required of future paramedics, routinely excludes the learner from making decisions about their own work.
The student-tutor consensus approach (STCA) is an alternative method of assessment based on observed on-road practices of paramedic debriefing following a case. It requires the student and assessor to first independently evaluate practical performance using broad, flexible criteria. The 2 parties then come together in a rich discussion regarding the event. Marks are awarded to the student each time their judgement is in consensus with that of their paramedic tutor. Student’s ability to identify errors or omissions is rewarded (instead of being associated with a penalty), and students have a major partnership role in determining their own grades during high stakes assessments.
Over a number of years, we have been expanding the use of STCA approaches across undergraduate paramedic education, post-graduate nursing, and medicine. Recently the STCA method was introduced and evaluated with a beginning paramedic student cohort, with no prior paramedic training or experience.
Methods: Paramedic students commencing undergraduate paramedic practice studies were invited to complete an anonymous paper-based questionnaire regarding their learning experiences following undergoing a semester of practical learning using STCA.
Results: 88 participant responses were obtained. 98% indicated broad agreement for recognised importance of paramedic self-assessment skills, 84% broad agreement that STCA was an effective learning method, 83% felt they had obtained skills for future use.
Conclusion: Beginning students readily embraced the STCA approach and were able to effectively demonstrate critical thinking and reflective practice skills.