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Oct 22, 2018Article Details
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Perspectives of advanced life support paramedics on clinical simulation for summative assessment in South Africa: Is it time for change?
Abstract
Background. The Professional Board for Emergency Care (PBEC), the statutory body regulating the quality of emergency care education programmes in South Africa, has mandated these programmes to use integrated clinical simulation as an instrument for authentic assessment. In support of the validity of this instrument, actions by students during simulation are assumed to replicate what they would do in similar circumstances in practice.
Objectives. To present and discuss perspectives of advanced life support (ALS) paramedics on the use of integrated clinical simulation as a summative assessment instrument, offer a critique of assumptions regarding the use of this assessment instrument, and recommend improvements for its use.
Methods. A qualitative, single, embedded case study design was used to address assessment criteria and case types for integrated clinical simulation as a summative assessment instrument. Qualitative data were collected by means of focus group interviews. Perspectives of ALS paramedics emerged from the results of this study.
Results. Participants agreed that integrated clinical simulation was an appropriate assessment instrument if assessment principles were adhered to. Accurate replication of the contextual elements of emergency care practice was perceived as central for eliciting authentic responses associated with ALS paramedic practice. The conditions, context and range of life-threatening conditions across medical disciplines challenged the idea that a single, once-off assessment event could be a valid reflection of competence.
Conclusion. To elicit authentic responses, the design of integrated clinical simulation events for summative assessment should include relevant clinical, environmental and social-professional elements of ALS paramedic practice. More than one assessment should be done, and should address the range and complexity of medical and trauma emergencies, thereby assessing the true competence of ALS paramedic students. Assessors should acquire the requisite skills to assess simulation effectively.
