The University of Worcester is a growing university and its geographical location attracts students from many areas. Under the umbrella of the Institute of Health and Social Care is the prehospital unscheduled and emergency care team. It is this team that has been running direct entry paramedic foundation degree programmes since 2007. In addition to this, it also offers ambulance technician to paramedic conversion courses leading to Health Professions Council (HPC) registration as a paramedic.
‘By providing mentorship for the students, it encourages them to critically analyze incidents and recieve rapid feedback on their progression’
Paramedics who are already HPC registered can enhance their continual professional development by enrolling on the diploma in higher education paramedic studies. The course team is made up of registered paramedics and nursing staff. This multi-disciplinary approach engenders a holistic view of the patient's care and provides students with a comprehensive educational experience.
Direct entry student paramedic
Entry requirements for this course are currently 120 UCAS tariff points and a minimum of six to twelve months recent adult care experience. National vocational level 3 qualifications are no longer accepted for this course as it is felt that they are not robust enough for the programme of study. Recent adult care experience is considered an essential prerequisite to the course as not only does this provide a good foundation from which to work, it also helps develop key transferable skills such as communication, problem solving, manual handling and interpersonal skills.
There is no C1 driving licence requirement to commence the course but candidates are advised to possess a provisional C1 licence. This is to ensure they meet the health requirements laid down by the driver vehicle licensing agency and will be able to undertake the C1 course when necessary. Enhanced criminal records bureau checks and occupational health screening are also carried out before any student enters clinical practice.
Approach to teaching
The university has an innovative and student-centred approach to the teaching and success of this two-year course and offers patient contact from as early as the third week. Placements are welcomed by students at this early stage. One student commented ‘Going out on placement was better than I thought it would be. I thoroughly enjoyed this.’ Practice placements are then continuous over the four semesters alternating between one and two shifts per week.
Students need to achieve 750 hours of clinical practice in each year. During this time they are supervized by a university trained mentor and are supernumerary. This allows the students to develop at their own pace but still within a realistic timeframe to achieve the learning outcomes.
By providing mentorship for the students, it encourages them to critically analyze incidents and receive rapid feedback on their progression. The rapid practical placements also reduces skill decay. Students have commented that they feel rapid patient access helps them to assimilate the knowledge gained at university with the practicalities of patient contact. These experiences and observations are then developed during classroom sessions, making any discussion student-centred and providing motivation for the students to learn more.
Placements are carried out in a variety of locations from rural villages to inner-city areas so students are exposed to a wide variety of cases.This variation means that students are required to use different skill sets; perhaps one day providing crucial life saving care to a patient on a 30 minute journey to hospital, then another having only ten minutes in which to take a history and provide the appropriate care before arriving at hospital. Skills practiced while on shift are recorded in a workbook and signed by a mentor. This book then provides evidence of the student's practical experiences and forms part of their portfolio which will be an ongoing process throughout their career.
Students are placed with named mentors who monitor their progress and alert the university of any students they have concerns about or are doing exceptionally well. This is very much a three way process between students, mentors and the university. When concerns are raised, students may need specialist advice from the university's student services. If the concern is of a practice related nature, then the lecturer practitioner may become involved and extra support would be provided in order to help the student develop weaker areas.
Mentors generally work on an ambulance or responder car and the student works as part of a two or three person team. This team development and close working relationship promotes learning and helps students to feel valued. One student commented that ‘mentors are supportive and motivated me as a student to reach my goal.’
Students also undertake observed scenarios that provide an opportunity to demonstrate skills in a simulated environment. This allows lecturers to assess individual student's skills and where necessary provide constructive feedback to the students and mentors.
Quality assurance
The course is validated by the Health Professions Council and conforms to the College of Paramedics curriculum guidance and competency framework document (British Paramedic Association 2008). A range of systems are in place to ensure quality is maintained and improved these include Quality Assurance Agency and Local Strategic Health Authority auditing, and internal quality auditing
Modules
The course is run in a modular format and subjects include anatomy and physiology, personal and professional development, care loss death and bereavement, evidence and research, paediatrics, pharmacology and work based learning. Initially, students gain hands on practice in core skills such as manual handling and communication skills. As they progress through the course, more emphasis is placed on them to make clinical decisions relating to the patient's care with the aim that they become autonomous practitioners by the end of the second year of study.
Clinical placements are arranged for students in a variety of care settings including operating theatres, cardiology, accident and emergency and palliative care, as well as ambulance shifts. These opportunities are a valued part of the course, allowing students to gain insight into other areas of health care, and perform practical skills such as cannulation and endotracheal intubation. To quote one student ‘I have loved being on shift and have met some amazing people.’
To support the students learning, all lecture presentations, handouts, research and useful links to relevant web sites are posted on an electronic program known as blackboard. Students have access to this information simply by logging on to a computer with internet access. This system allows students to refresh their memory of the sessions that have been taught and provides areas of research that may be followed up. Some sessions are made available to students prior to the sessions and this has been very useful for students who are dyslexic by giving more time to assimilate information before receiving the taught session.
Assessment methods
Assessment methods are varied but include the more traditional examination style question paper as well as essay writing, practical OSCE assessments, development of posters promoting such things as care of vulnerable individuals and creating new clinical guidelines using evidence based practice. This variety of assessment styles help students contextualise theory with paramedic practice. Students are actively encouraged to promote their profession by publishing work and completing professional portfolios.
Communication is a very important aspect of this course and email accounts are set up so students can communicate with each other and university staff. A personal tutor is allocated to each student at the beginning of the course and these tutors are a dedicated point of contact with the university for students who may be experiencing personal or academic issues. Students are of course at liberty to talk to any tutor if they feel it is appropriate.
Students are encouraged to learn for themselves with lecturers facilitating the learning rather than actually providing lists of facts that need to be memorized. Some students find this approach a little disconcerting at first but with study skill sessions embedded throughout the modules, this concern seems to dissipate as the course progresses.
Technician to paramedic
This course allows IHCD ambulance technicians to progress and achieve HPC paramedic registration. It may be possible for IHCD qualified ambulance technicians working outside the West Midlands region to apply for this course, however arrangements would need to be made for practice placements. Students study broadly the same subjects as the direct entry candidates but over a 32 week time frame.
The course requires candidates to gain 120 points at level 4 and 120 points at level 5 for successful completion. Using the accreditation prior experience and learning (APEL) system, the ambulance technician qualification is awarded 60 credits at level 4 and the remaining level 4 and 5 credits are achieved by successful completion of the course.
Practice placements are structured differently to the direct entry students in that students need to achieve 600 to 650 hours in practice and the placements are in blocks, the remaining 100 hours are in simulated environments thus making up a total of 750 hours. The first 150 hours of the placements will be in the company of a named mentor.
During the first block, the student works as part of a crew. The second block would be supernumerary and would include theatre placements. The third block is supernumerary or part of a crew depending on the needs of the student. At all times students work with a registered paramedic. Between each practice block are theory modules that enhance the students knowledge and understanding of their chosen profession.
Diploma in higher education paramedic studies
This course would appeal to qualified paramedics who wish to develop and enhance their education to diploma level. The course is designated a level 5 academic qualification which would help prepare successful students for degree level study. The requirements for this course are that the candidate should hold an IHCD paramedic certificate.
Students have a maximum of five years to complete the course. This gives flexibility to students who may be working shifts or have other commitments during the day and also allows for unexpected periods of sickness. The university believes that it is essential for the students to be supported during their studies and by providing some of the sessions online this reduces the requirement to attend the university. However none of the modules are exclusively on line and group lectures, student centred learning and project work are also built into the program.
The delivery of the course is flexible as it fits into the current foundation degree program, allowing paramedics to learn alongside other students. This affords the students the opportunity to meet paramedics on an equal footing and paramedics can become more attuned to the student's academic and practical needs.
There are 12 to 15 taught sessions per module and there are six modules that make up the course. Three of the modules are mandatory and these are mentorship, academic skills and research. The optional modules include care across the lifespan, principles of trauma care, diabetes, effective care for vulnerable people, vascular disease, clinical health assessment and clinical leadership in paramedic practice.
The courses outlined above help to provide students with a rewarding experience and become an autonomous paramedic who is equipped with the knowledge and skills to work in a relatively new profession. However this is linked into other health care professions to provide seamless transition of patient care from prehospital to primary care and other appropriate medical and social services.
Conclusion
The University of Worcester is a progressive and innovative university that offers a variety of courses to suit both current and prospective paramedics. Students are supported to achieve their potential in a variety of ways including early patient contact, mentor support, clinical placements and a multi disciplinary team of lecturers.
The curriculum is constantly evolving to take account of changes in practice and refects the developments in contemporary research. The university provides excellent facilities for study for both pre-registration and post registration students and prides itself on preparing graduates with the necessary skills and knowledge to meet the rigors and challenges of the modern prehospital arena.