JRCALC App
The Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines are often referred to as the prehospital ‘Bible’. They have been the ‘go to’ guidelines for all UK NHS Ambulance services since 2019, although were first created in the early 2000s, with three annual updates produced since 2013. For those that were in practice in the late noughties, you will recall carrying around a well-weathered JRCALC pocketbook which would be pulled out prior to administration of medications or to check an algorithm. The application (app) is essentially the full guidelines accessed through a reasonably easy-to-use app.
There is clearly a challenge to include such a significant amount of information in an app; at times, it can be difficult to search specific guidance and there can be conflicting information depending on which page you are accessing. However, having used the app since its inception, there has been significant improvement in its usability. It can now also be accessed via a web page on a laptop or as a standalone app accessed on a phone or tablet.
So, the question is, is it any good? With a wealth of contributors to the information contained in the guidelines, including the College of Paramedics, the Association of Ambulance Chief Executives (AACE) and the National Ambulance Service Medical Directors (NASMeD), it is no surprise that the short answer is yes.
However, I must acknowledge that there are no real alternatives to compare it to. If you want an evidence-based prehospital guideline, this is the only real option. The risk that comes with no competition is that the product becomes stagnant as there is nothing to drive improvement. Additionally, given they receive no central or government funding and rely solely on good will from contributors, this has the potential to delay updates.
I am pleased to say though that this does not seem to be the case. The beauty of the app is that you no longer have to wait for the release of updated versions. They are constant and on a rolling basis; this gives the user assurance that when you open the app, you are accessing the latest guidance. The other plus point is that the guidelines are available offline so if you find yourself in a mobile black spot, you can still open and use the app.
There are a few points that cause a little frustration. The search function is not as slick as it could be; I guess we are all used to the efficiency of ‘Google’ and JRCALC is simply not as good. This is fine if you have time to look for a specific drug or guideline; however, if you need something in a hurry, it can delay you at times. I have no doubt however that this app will continue to improve over the coming years and remain the primary source of information for the practising clinician.
ParaPass App
There are several online continuing professional development (CPD) options available to clinicians wanting to engage with an online learning platform. Having a competitive market for CPD does mean that the producers need to be constantly raising their game to come up with new and innovative ways to keep people engaged. ParaPass is relatively easy to navigate.
Three Key Takeaways
There are five sections the user can click on at the bottom of the screen, starting with your personal ‘dashboard’; this summarises the recent topics which you have been accessing and allows you to continue where you left off. There are sections for quizzes, a case studies/Standby section, which hosts both short and longer case studies, a section which can provide access to full books should you wish to purchase them and, finally, a results page.
The authors are listed alongside the case studies and a short biography is provided. The quizzes cover topics such as tracheostomy, choking and panic attacks, which were the first three listed for me. Once you select your topic, you are presented with around 10 questions, which can be a mixture of multiple-choice questions (MCQ) or a short-written paragraph. The MCQs are scored automatically, whereas the short-written answers have to be self-marked. You are presented with the correct answer, and you can choose if your written answer warrants you to hit the ‘correct’ button.
The app is available on both mobile devices and on a web-based platform, although it feels like this is an app you would be more likely to access on the go when you have a spare 5 minutes. There is a plethora of topics to access; however, the quizzes are short and some are fairly basic. The standby CPD section provides more in-depth learning and explores wider themes related to the topic. I particularly like ‘sex differences in ACS presentation and care outcomes—the ways of a woman's heart’. There are 10 expandable sub-headings, allowing you to learn about such areas as anatomy and physiology, the scale of the problem, as well as some very interesting evidence around unconscious bias.
The more I explored ParaPass, the more I was drawn to the Standby CPD section. It just felt like I was learning more content around a topic, whereas with MCQs, you either know the answer or you don't—guessing an answer does not demonstrate learning.
