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BSc(Hons) Paramedic Science

Practice Education Handbook

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Contents Introduction 3 Practice education experience 3 Practice support 7 Making the most of practice placement experience 9 Uniform policy 12 Whilst in practice 13 What do I do if I see something that worries me in practice 15 Appendix Section Appendix 1 Definitions 16 Appendix 2 Course content 17 Appendix 3 Course modules and hours 18 Appendix 4 Non ambulance example guide 19 Appendix 5 Course overview 20 Appendix 6 Capability Framework explained. 21 Appendix 7 Years1-3 Capability chart 23 Appendix 8 Skills Matrix explained 32 Appendix 9 Cause for Concern Flow Chart 33

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Introduction Practice education is a fundamental competent of your BSc Paramedic Science programme. Together the Practice Education Handbook (PEH) and Practice Assessment Document (PAD) contain information relating to the practice education component of your programme. Both documents support each other; they contain a lot of important information related to your practice education and should be read carefully and referred to throughout your 3 year course. The PEH is a reference document which contains information about how practice is organised and regulated. It also provides guidance to help develop reflective learning skills and contains a glossary of terms, in Appendix 1 Practice Education Experience Practice education experience will occur in partnership with South Western Ambulance Foundation NHS Trust (SWASFT) and in other NHS trusts and private, voluntary & independent settings. These placements are designed to increase student exposure to practice experiences and to facilitate student reflection on practice. Undertaking Student reflection will help demonstrate how your student experiences within these visits have helped development in relation to the relevant placement learning outcomes. Students will be allocated the required placements throughout the programme to provide a range of practice learning experiences relevant to achieve the required learning outcomes. Throughout the practice learning experience students will be encouraged to explore and challenge existing knowledge and experience in relation to paramedic practice and to develop their own practice learning from this. In each practice placement students will be expected to engage with the capability framework and the skills matrix as applicable to the current placement. Students will need to plan their capability development in negotiation with their Practice Educator (PEd) and with reference to the specific learning opportunities available within each placement. This is important so that students can demonstrate they are achieving not only skills development but also demonstrate they are achieving the capabilities through the use of reflective practice. The practice education experience is a valuable component of the Paramedic programme where students can learn to be professional practitioners. It is important that the student always acts in a professional manner and fulfil their professional responsibilities. It is therefore essential that you read fully the regulations set by the Health Care and Professions Council (HCPC) Guidance on conduct and ethics for students available at https://www.hcpc-uk.org/education/learners/while-i-am-studying/guidance-on-conduct-and-ethics/ The standards of proficiency for paramedics available at https://www.hcpc-uk.org/standards/standards-of-proficiency/paramedics/ Standards of conduct, performance and ethics available at https://www.hcpc-uk.org/standards/standards-of-conduct-performance-and-ethics/

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In addition to professional regulation and guidance the following University of Gloucestershire guidance will need to be read in full and adhered to whilst in practice placement settings

FITNESS TO PRACTISE PROCEDURES available at https://www.glos.ac.uk/docs/download/Key/fitness-to-practise-procedures.pdf

STUDENT CODE OF CONDUCT available at https://www.glos.ac.uk/docs/download/Equality/code-of-conduct.pdf

STUDENT CHARTER available at https://www.glos.ac.uk/docs/download/Equality/student-charter-2019-20.pdf

SUBSTANCE MISUSE POLICY (STUDENTS) available at https://www.glos.ac.uk/docs/download/Key/substance-abuse-policy.pdf

All placement experience is quality assured through processes which meet placement partner and University Quality Assurance requirements. These processes are supported by the Practice Placement Team. There are agreed contractual arrangements between the Health Education England, Gloucester Health, SWASFT and the University of Gloucestershire. Contravention of these processes by students is neither possible nor allowed, and any contravention will be regarded as unprofessional conduct and may significantly affect a student’s progress on the programme. Paramedic Science Practice Education Learning The paramedic programme is designed to integrate practice experience and learning with theory modules. To achieve this the practice placements are organised in a variety of settings. You are expected to use your experiences in practice to enhance your understanding of the theory modules and to be able to demonstrate the ability to identify and apply the theory underpinning practice. This integration of theory and practice modules is paramount throughout the programme and is achieved by: Working closely with our partners to ensure the programme content is relevant and reflects current practice Involving practice colleagues in teaching and assessing practical skills University staff – Practice Education Lead (Keith Bromwich). Practice Placement Team (Jan Bailes) The learning outcomes from theory modules relating directly to the aims and objectives of practice Using knowledge, skills and attitudes gained in practice as a basis for theory learning in future modules As a student you are required to undertake a range of placement visits that will equip you with a “taster experience” that you can learn and reflect upon. This will help inform and develop your own practice The following are some examples of the areas you may be placed: (this is list is for guidance only and actual placements may vary)

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● Paramedic services ● NHS and private hospitals ● Paediatric care ● Emergency departments/admissions units ● Critical care areas ● Nursing and residential care homes (including dementia care specialists) ● GP practices/walk-in centers/specialist practitioners ● Fundamental care areas You will be expected to attend all placements in all allocated placement visits. You need to be prepared to travel, sometimes at a distance, to your placement allocations and will be required to work days, nights, weekends and bank holidays. The placement team will inform you of all practice placements via the ARC resource. How are placements organised Practice education is structured around practice modules and is intended to develop your clinical and professional practice capabilities and competence. Placement locations are determined by the Placement management team and SWASFT. Both consider travel distance and student living arrangements in their allocation process. However, these are dependent upon placement provider healthcare student placement capacity and you may be likely to be required to travel further afield for some experiences. Some of the specialist practice education placements may not seem relevant at first but it is important to remember that these short experiences of wider health care services will help you to practice in a multi-dimensional and inter-disciplinary environment. Placements have been guided by the national and regional data regarding the top ten calls for paramedics and are intended to increase your exposure to specific clinical conditions and available services. All specialist practice education placements have specific learning outcomes and guidance to aid you and the staff supporting you in practice. During practice education placements, you will be expected to engage with the capability framework and learner outcomes applicable to each of the placement areas. Moreover, you will need to plan your capability and competency achievement in negotiation with key personnel, including your practice educator and practice lead for paramedics. All assessment of your practice is recorded in the PAD. As placement quality and capacity is governed by strict policies and procedures aimed at ensuring equity, parity and insurance cover among students, no student is authorised or permitted to seek out placement opportunities themselves. Should an experience be offered it must be discussed with the placement management team and the paramedic placement lead in t he first instance before accepting such offers. There are jointly agreed principles which govern placement allocation as well as agreed contractual arrangements between placement providers and the University, to which the placement management team has to adhere. Contravention of these processes by individual students is not possible or permitted and any contravention will be regarded as unprofessional behaviour.

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Notification of placements will be made within 4 weeks of placement start. It should be noted in some circumstances this 4 week notice period may not be able to be adhered to. In these circumstances the placement management team will keep students notified. Non ambulance placement dates will be notified via the ARC system. Student responsibilities before going into practice placements Before a student paramedic is permitted to enter a placement, they are required to meet the following criteria and complete the following: Disclosure and Barring Service (DBS) enhanced clearance for child and adult workforce Occupational Health clearance A specified mandatory training programme (which meets the requirements of the National Skills for Health Framework for mandatory training). Failure to comply will result in you not being allowed into the practice placement setting.

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Practice Support Student Support in Practice You will be supported in practice by your Practice Placement Module tutor (PS4003, PS5003 and PS 6003), Paramedic Practice Lead (Keith Bromwich),Practice Placement Manager, (Jan Bailes), Practice Educator (at your Ambulance Station), Paramedics and Nicola Shepard SWASFT Education Lead. Additionally you can access any of the paramedic programme team at any stage of your development. Further support is available fro the University of Gloucestershire HELPZONE team. Practice Educator Support. The Practice Educator (PEd) provide support and guidance towards achieving practice outcomes to successfully complete associated modules. In conjunction with the student and academic staff they ensure that areas of development or non-achievement are identified with appropriate measures implemented to support progress. The PEd will liaise with the Paramedic practice Leader regarding the progress of the student. It is essential that all PEds are familiar with the Health & Care Professionals Councils (HCPC) Standards of Conduct, Performances and Ethics (2018), and practice assessment requirement of the programme (in the Practice Assessment Document (PAD)). All students are allocated a PEd who works in partnership with SWASFT teams, NHS trusts and other settings. The PEd are able to assess the students’ capabilities and competency to practice formatively and summative assessments. Other Paramedics and allied staff can assess in a formative manner and record this in the PAD At the start of Your Practice Placement All student paramedics are allocated a PEd in SWASFT placement setting. At the start of practice placement they will ensure: Orientation of the student to the placement on the first day Help by identifying, planning and developing learning opportunities Establishing an effective, collaborative working and learning relationship with the student, based on mutual trust and respect Helping the student to work as a team member, and with other professionals Helping to identify learning needs relating to practice learning outcomes, capabilities and skills, and working with the student to complete the initial, mid-year and end of year review sections of the PAD Assessing practice learning, which includes: coordinating and providing constructive feedback to the student and to the education team negotiating clear future objectives; and assisting in identifying learning required to enable achievement of competence. assisting the student in developing action plans to achieve capabilities and competence providing confirmation of achievement of capabilities and competence

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prior to each placement visit, assisting to identify capabilities related to the forthcoming visit. Receiving student written evidence of learning from each placement visit assisting the student to reflect upon experiences from practice.

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Making the most of the practice placement experience During the practice placement, you should make the most of the opportunities available to you in order to develop into a well-rounded clinician. This can be achieved by:

Be enthusiastic about learning opportunities and show a willingness to learn: You will get a much better response if you can demonstrate your enthusiasm rather than being withdrawn and reticent. You may feel very nervous and lack confidence, but be aware of your body language and the impression you are giving.

Be proactive in seeking out experiences for your level of practice: Ask your PEd if you can observe or participate in different experiences. Arrive prepared to each shift and have an idea of what you want to achieve or do during that time. Take the initiative in planning your learning experiences.

Identify things to do when your PEd is busy: What can you do without supervision? Spend some time with other members of the team and learn about their roles. Read appropriate material available to you within the placement setting or bring your own revision. Take the opportunity to talk to patients and try to imagine what it is like from their perspective.

Use your observation skills: Observe your PEd and other members of staff. How do they communicate? How do they make decisions? How do they perform certain skills or procedures? How do they approach patients and their families? Prepare for the times when you can sit down and talk with your PEd Keep a notepad to jot down things you want to ask about. Keep a reflective diary so that you can remember the details of events when you come to talk about them with your Ped Develop your reflective practice: Use your reflective diary to reflect upon events and describe what happened. What were you thinking? What theory were you using? What was the outcome? How effective were you? Were there any other factors involved? Be prepared to work as a team member: Sometimes this will be to meet your own learning objectives but sometimes you will be asked to work with others who require additional help. Teamwork is a vital component for healthcare work and you will be able to learn a lot from participating as a member of the team. Know when to ask for help and seek support: Your PEd will expect you to ask lots of questions and to acknowledge your own limitations. Self- reflection will help you recognise these. Keep a record of your own progress: Note how your confidence and capabilities and competence are developing. Return to the action plan you set at the beginning of the placement and record your progress. Self- assess your level of competence using the capability and skills frameworks. This will ensure you are prepared for any meeting with your PEd about your progress.

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Reflective learning Reflection goes beyond just gaining knowledge, and assists in: exploring the foundations of that knowledge strengthening understanding increasing awareness of the values and attitudes that influence it. It is important to remember that reflection is a dynamic process. It is not about being passive, staying where you are and looking back, (although time to be still may be an important part of it) but an active engagement with knowledge and experience. So, by reflecting, you are able to construct new and deeper understanding and to articulate knowledge in a more meaningful way. The process of reflection will often mean that theoretical learning is challenged by reality of experience, where such things as diversity, value, resource constraints and conflicts pose questions and dilemmas. Reflection may not always give you easy answers, but it will help you take those tensions seriously. This is especially important for professional practitioners as it enables them to begin to make sense of practice experience without ignoring the fact that there are always, beneath the practice, values, assumptions, beliefs and personal perspectives that influence both the practice itself and the way that practice is experienced. Reflection requires an approach which is: Curious - there has to be a willingness to ask questions, to want to find out. Honest - you need to be honest with yourself and this includes being honest about doubts and uncertainty or lack of knowledge. Learning can't take place if you pretend to know what you don't understand. Open - to absorb what is happening. Patient (not jumping to conclusions) - just as there are no simple answers, there are no instant answers either and your ideas and understanding may well change over time. Tolerant of the diversity of ideas - not everyone will think the way you do, not everyone interprets or understands the world in the way you do.

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There are a number of reflective models that may assist in the development of reflective skills: Within the PAD we Use Rolfe et al (2001) and Gibbs (1988) models to help guide you

To be reflective you also need to be critical and analyse your practice. Critical analysis can be used for both academic and practical work experiences. Analysis involves the separation of a whole from its component parts. To analyse something is to undertake a detailed examination of the structure and ask questions about it in order to more fully understand their nature and how the parts relate to and influence each other. The term critical introduces another element involving the identification of the strengths and the weaknesses. This involves several activities. Identifying and illuminating existing knowledge of relevance to the subject. Exploring feelings about the situation and the influence of these. Identifying and challenging assumptions. Imagining and challenging assumptions. Synthesis-integrating new knowledge,feelings,attitudes. Evaluation-the ability to make judgment about the value of something.

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Student Paramedic Uniform Policy As a student paramedic you will be expected to wear a uniform when in practice settings and during simulation and skill sessions within the University It is important that the uniform worn is correct and complies with relevant Health and Safety requirements and that you do comply with these. You are not allowed to wear any other non University issued uniform as doing so may impact no Health and safety requirements and insurance requirements. You are also representing your University and your future profession and as such any uniform worn should be clean and presented in a professional manner at all times We will supply the following uniform items Reflective waterproof jacket Class 3 1 Polo Shirts 2 Soft Shell jacket 1 Trousers 2 Safety Boots HS3 standard 1 pair The reflective jacket and Soft Shell jacket will be returned to the course. Failure to do so will result in a charge for these items being applied to you. Additional Cost You will need to purchase at cost to yourself :- Any additional / replacement Polo shirts Trousers Boots Jackets (must be University approved) Student leisure tops (Jacket/sweatshirt NOT to be worn in practice ) Belts (black) The uniform will clearly identify you as a Student Paramedic from the University of Gloucestershire. As such you will be easily identifiable. Your uniform should be clean and ironed to provide a professional appearance When traveling to or from a placement setting it is important that you either cover your uniform with a coat (for example) or change into civilian clothes at the end of your working day. You must not wear the uniform to do your shopping in or go to the local public house. Maintaining your personal hygiene is important. Please ensure that you shower daily and deodorants are used. You may wish to carry a spare deodorant with you daily whilst on practice settings Uniform should be laundered as per the manufactures guidelines on a regular basis at the end of your working day. The only exception is the reflective jacket. With the reflective jacket please adhere to the washing guidance on the label inside the jacket. Appearance Hair neat and tied up off the collar Single stud ear / nose rings – usually one set worn only. Neutral lipstick colour Finger Nails short and clean Neutral nail varnish colour Shoes cleaned and polish applied regularly

Remember you are representing yourself, the University and your chosen profession.

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Whilst in Practice Recording Practice Hours You are required to record your practice hours on the documentation provided in the PAD. In some circumstances in addition to recording hours in your PAD you will be required to also record them on ARC This means that each time you attend practice education you will need a verifiable record of your activities which a registrant or practice educator has approved and authenticated as accurate. It is important to note that only the official recording of verified hours constitutes proof of your participation in practice education. Should it be deemed that you did not participate in the hours required it may mean that you are unable to proceed with your studies or graduate. Minutes are to be rounded up/down to the nearest 30 minutes. Any attempts made to claim hours which were not worked could constitute fraud and may be subject to investigation as a professional behaviour issue. Completion of these records is your responsibility and you will need to obtain the signature of the registrant with whom you have worked (paramedic/nurse/Clinical Mentor/placement visit facilitator) for each shift of work. Reporting Absence from Placement As a student professional practitioner, you are required to be able to manage your sickness according to professional expectations. It is not acceptable for students not to attend scheduled shifts. This not only contravenes Standards of Conduct: Fitness to Practice but also causes the loss of learning opportunities for others as well as causing significant disruption to supervising practitioners. If you are unable to attend the practice area due to sickness (even if only for one day) then you must email: practiceabsence@glos.ac.uk Please ensure the following information is included within your notification of absence. Name: Student number: Cohort: Reason for absence: Expected date of return: Current placement and mentor contact details if applicable: Please also include your practice placement module leader and When on ambulance SWASFT placement you must also email ROC.Students@SWAST.nhs.uk and your Practice Educator. Please note that this is in addition to practice absence When on NON ambulance practice you must contact your non ambulance placement provider and practice absence

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Returning to Practice Employment best practice recommends a return to practice discussion following periods of sickness so that employees are provided with appropriate support mechanisms. Once you identify that you are fit for duty, you must inform For Ambulance practice - ROC.Students@SWAST.nhs.uk and practiceabsence@glos.ac.uk email address. For non ambulance placement please use practiceabsence@glos.ac.uk and your placement provider at that time. For both ambulance or non ambulance placements please also include the module leader for practice placement Unauthorised absence from practice All unauthorised absence will be considered unprofessional conduct. In cases of unauthorised absence, the supervisor on duty in the practice area will document this and notify Practice placement management team, Paramedic placement link and any other appropriate member of the paramedic teaching team at the University. In the case of unauthorised absences from SWASFT placements their education team, PEd and the Operational Officer may also be informed. Students must not take holidays during allocated placement time. If students take holiday or any other form of unauthorised absence during placement times, students risk not meeting the practice and module assessment criteria, and this may affect your progression. Absence also limits the hours that are available to meet the programme requirements. Unauthorised absences such as holidays are not acceptable as mitigating circumstances and therefore extensions will not be granted.

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What do I do if I see something that worries me in practice? Freedom to Speak Up As a prequalifying student on a professional practice programme you have a professional duty to put the interests of the people you care for first and to act to protect them if you feel they may be at risk. Therefore, if you witness an incident that is detrimental to patient care/treatment, you have an obligation to safeguard the patient. You also may need to raise concerns about other issues, including bullying and harassment on placement. We recognise that it might not be easy for you to raise concerns about this type of issue, but this professional duty is becoming increasingly important for all professional health and social care programmes. You will be actively supported in raising any such concerns It is important that concerns are raised effectively and in a timely way so that safeguarding and other issues of concern can be addressed to protect the vulnerable. You will need to raise your concerns through the local placement provider policy, including adhering to the identified timescales. The location and access to the local policy should be part of your induction to a placement. If you have not been shown this you may find the local policy on their intranet or you can ask for a copy. If you are unable to access the local placement policy this should not prevent you from raising your concern, especially if the issue is serious and people are at significant risk (you can be provided with the local policy at a later stage). If you have any difficulties contact Practice Placement Management team , Paramedic Placement lead, PACL, ASL. You are advised to seek support at the earliest opportunity in the interest of public protection, and to see through any process to its conclusion. If there is an immediate risk of harm, it is important that you report your concerns without delay to an appropriate person. If you are worried about reporting your concerns (including making a formal statement), please seek support from your academic team immediately. The process will be dealt with confidentially, and only shared with other identified appropriate personnel. However, you will not be able to remain anonymous within this process, because your details will be required for an effective investigation to take place. In some cases it may be appropriate to change your placement to aid any investigation, and to protect your confidentiality. You will be offered support throughout this process from the University

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Appendix Section Appendix 1 Hub A large ambulance station where crews are deployed, ambulances cleaned and restocked. Often contain training resources and OO is based here Operational Manager (OO) person responsible for the day to day management of an ambulance hub. They will provide operational support at difficult situations as well as undertake investigations and support at the hub level PAD Practice Assessment Document to be completed each year. Used to demonstrate learning in practice, recording of practice hours and overall development to meet the requirements of practice education modules PS4003, PS5003 and PS6003 Practice Educator (PEd) These can be any HCPC registered paramedic, NMC registered practitioner, GMC registered Doctor or any senior care or support staff that have responsibility to supervise students in practice. They are responsible to support you and help you develop. Practice Placement Management team Responsible to establish and maintain practice placement links for University Health Care students. Will over see setting up and monitoring or quality at practice placements. Paramedic manager is Jan Bailes.

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Appendix 2 - Course Content

YEAR 1 YEAR 2 YEAR 3

PS4001: Foundations of Paramedic Practice 30 PS4002: Evidence Based Practice 1 15 PS4003: Practice Education 1 30 PS4004: Foundations of Anatomy and Physiology to Support Clinical Practice 30 PS4006: Skills and Simulation 1 15

PS5001: Pathophysiology for Paramedic Practice 15 PS5002: Evidence Based Practice 2 15 PS5003: Practice Education 2 30 PS5004: Applied Pharmacology 15 PS5005: Emergency Mental Health 15 PS5006: Skills and Simulation 2 30

PS6001: Leading and Managing Service 15 PS6002: Facilitating Learning in the Workplace 15 PS6003: Practice Education 3 30 PS6004: Driving Change in Practice 30 PS6005: Management of Trauma 15 PS6006: Management of Minor Illness 15

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Appendix 3 -Practice Placement Modules require an approximate number of hours to be achieved

Module Broad themes Hours Ambulance

Hours Non Ambulance

Hours Simulation

PS4003 Fundamental skills of care and communication Leading and managing self

350 200 55

PS5003 Paramedic practice Leading and managing care

450 200 65

PS6003 Leadership and management leading and managing service

450 200 65

(see Appendix 5 - Course Overview for more details)

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Appendix 4

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Appendix 5 - Course Overview Year 1 (Level 4) – Leading and Managing Self: From day 1 you will begin to see yourself as a leader, driving your own development with the support of academic and practice staff. You will understand how to achieve and develop your ambition through exposure to paramedic role models. Through profiling your strengths, weaknesses and interests alongside your academic study, 360 feedback and reflective practice, year 1 will develop essential care knowledge and skills, understand evidence based practice and tools to self-manage. By the end of the year you should be able to: 1. Apply knowledge gained about professional and personal development for health and well-being, to identify strategies for personal resilience 2. Identify the skills,attitudes and conduct for therapeutic engagement in person centred care to all those in their care 3. Recognise how the normal structure and function of the human body works 4. Explain, through an understanding of research appreciation, the importance of evidence-based care 5. Apply theoretical knowledge to the practice setting at the level of a first-year paramedic student Year 2 (Level 5) – Leading and Managing Care: The focus of year 2 will be on expanding and applying your leadership skills to lead and effectively manage the care of patients. You will continue to receive support from your practice educators, to develop knowledge of essential care pathways and leadership and management of care. By the end of second year you should be able to: 1. Recognise how the normal structure and function of the human body reacts to external influences and a range of illnesses and disease processes 2. Outline the physical and emotional needs of a person from a holistic perspective across the lifespan, including those living with common mental health problems 3. Demonstrate a critical understanding of the pharmacologically and non- pharmacological interventions in prehospital care. 4. Apply theoretical knowledge to the practice setting at the level of a second-year paramedic student During second year and third year you will be exposed to a number of different practice settings, including non-ambulance settings. Each student experience may include a different range of practice education placements but the same outcomes will be achievable. In extraordinary circumstances changes to placement allocations can be made but only when absolutely necessary. The practice education strategy and practice assessment documents have more detail regarding this.

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Year 3 (Level 6) – Leading and Managing Service: Year 3 will be a fundamental programme of consolidation for the students: strengthening your ability to lead a team, building resilience and driving service innovation. It will provide opportunity to strengthen practice knowledge in an area of interest. There will also be opportunities to demonstrate sophisticated application of the evidence base, role model to junior colleagues, supervising, coaching and leading others. By the end of third year you should be able to: 1. Compare and contrast the delivery of paramedic care services from an organisational, legal and policy context 2. Have a critical understanding of workplace learning and assessment in paramedic practice 3. Reflect on challenges in the workplace and critically examine leadership and management skills to generate change 4. Generate a potential service improvement and evaluation report, through critical review of literature 5. Apply theoretical knowledge to the practice setting at the level of a qualified paramedic

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Appendix 6 Capability Framework explained. The University of Gloucestershire has based the assessment of practice on the concepts developed by Dr Andy Freeman-May (2012). This work discussed areas of capability aligned to the professional responsibility of paramedics and the requirements of the Health and Care Professionals Council (HCPC) Standards of Proficiency for Paramedics (2018). In essence, the capability framework operationalises the HCPC Standards of Proficiency and allows for the analysis of student performance as they progress to seek competency in those standards. The capabilities, developed by Dr Freeman-May (2012) seek to describe the components of paramedic practice that can and should be assessed. Rather than a simple list of skills, they are designed to capture the essence of what it required to deliver competent and professional paramedic care. Capabilities tend to be seen as infrastructure to achieve an outcome. For students paramedics the outcome is to achieve Standards of Proficiency for HCPC registration A student paramedic with a capability has a potential to acquire a specific ability or skill that will be helpful in a task. The learned skill or ability adds to a person's knowledge bank or skill set and thus competence. However, achieving capabilities also increase the functions of a person which can lead to them being more productive. In time and with continuous practice, capabilities can develop into worthwhile competencies. Capable people are more than competent, they are creative, know how to learn, have a high level of self-efficacy, can use competencies in novel as well as familiar situations and work well in teams. They also they are more likely to be able to deal effectively with the turbulent environment in which they live by possessing this “all round” capacity. (Hase.S and Davis.L 1999). This approach can help build resilience which is important in modern day paramedic practice. Capabilities serve as the starting point of being able to do something and gradually becoming more adept in performing the task and this approach best describes student paramedic development across their 3 year course in their journey to become competent. Competence relates to a state or quality of an individual’s work. A person and their work can be evaluated as competent if the performance is considered satisfactory but not outstanding. Using Dr Freeman-May’s capability framework (2012) affords the student paramedic a developmental pathway to becoming a competent paramedic building on basic requirements towards becoming adept in performing tasks required to be a registered paramedic Each PAD for years 1,2 and 3 has levels of capability increasing in complexity for practice educators and students alike to assess and progress towards competency. When assessing students practice educators need to take note of the expectations of the level of attainment for each year of the PAD, and the guidance on the skills required for the students at each level .

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Capabilities assessed

Year 3 final sign off process and successful application to the HCPC paramedic register confirms competency has been met

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Appendix 7 Capability Framework Years 1,2,3 Chart- Use this to help guide and identify student learning needs for each year alongside the PAD

Capability Year 1 Year 2 Year 3 Information Gathering

This includes information gathering from all sources, including observation of the patient and scene. History taking and the ability to ascertain information from observations are key to this capability By the end of the first-year students should be able to: • Take a basic medical and social history from a patient • Conduct a primary and secondary survey, including basic observations • Demonstrate an understating of key, life threatening signs Achievement Areas Pre-hospital ambulance

This includes information gathering from all sources, including observation of the patient and scene. History taking and the ability to ascertain information from observations are key to this capability By the end of second year students should be able to: • Take a medical and social history from a patient • Demonstrate an understanding of the context of that history and what it means for the patient’s presenting condition • Take observations relevant to the presenting condition • Demonstrate an understating of the meaning of those observations and history Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres NHS 111 potential? (adult/Paediatric and Maternity areas)

This includes information gathering from all sources, including observation of the patient and scene. History taking and the ability to ascertain information from observations are key to this capability By the end of third year students should be able to • Demonstrate the ability to take relevant history without prompting • Demonstrate the ability to select and conduct the appropriate assessment Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres GP Practice Clinical support desk

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Managing People and Situations

The active management of scenes, resources and people is an important part of paramedic practice. This involves the effective task orientated organisation as well as dealing with often conflicting priorities during a paramedic intervention. Team work and leadership play a role in this capability. At the end of first year students should be able to: • Demonstrate the ability to communicate effectively with service users and colleagues • Organise their own workspace appropriately • Demonstrate an appropriate level of leadership Achievement Areas Pre Hospital Ambulance

The active management of scenes, resources and people is an important part of paramedic practice. This involves the effective task orientated organisation as well as dealing with often conflicting priorities during a paramedic intervention. Team work and leadership play a role in this capability. At the end of second year students should be able to: • Demonstrate the ability to actively manage basic scenes for the benefit of the service user • Demonstrate the ability to recognise and prioritise resources • Demonstrate the ability to communicate and work as a team Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres supported by paramedic (Adult/Paediatric and Maternity areas)

The active management of scenes, resources and people is an important part of paramedic practice. This involves the effective task orientated organisation as well as dealing with often conflicting priorities during a paramedic intervention. Team work and leadership play a role in this capability. At the end of third year students should be able to: • Demonstrate the ability to actively scenes for the benefit of the service user • Demonstrate the ability to recognise, organise and prioritise resources • Demonstrate the ability to communicate and work as a team or lead that team where appropriate Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres (adult/Paediatric and Maternity areas)

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Treating the Patient

Basic treatments such as positioning, oxygenation and pain management as well as airway management need to be considered in this capability. The ap-propriate use of equipment, such as airway adjuncts, as well as medication should be in line with accepted guidelines. At the end of first year students should be able to: • Demonstrate and understanding of basic treatments • Deliver basic treatments under supervision • Manage basic life support and recognise critical treatment needs Achievement Areas Pre Hospital Ambulance

Basic treatments such as positioning, oxygenation and pain management as well as airway management need to be considered in this capability. The appropriate use of equipment, such as airway adjuncts, as well as medication should be in line with accepted guidelines. At the end of second year students should be able to: • Demonstrate an understanding of paramedic treatment options • Deliver paramedic treatment under supervision • Manage advanced life support and react to critical changes in patient condition Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres under paramedic supervision (Adult/Paediatric and Maternity areas)

Basic treatments such as positioning, oxygenation and pain management as well as airway management need to be considered in this capability. The appropriate use of equipment, such as airway adjuncts, as well as medication should be in line with accepted guidelines. At the end of third year students should be able to: • Demonstrate an understanding of treatment options and referral pathways • Deliver high quality care without prompting • Lead basic and advanced life support as well as resuscitation Achievement Areas Pre Hospital Ambulance (RRV/ACP)

HART

Critical care Teams / HEMS car etc

Hospital ED/Minor illness or Injury setting Walk in Centres NHS 111 potential/call desks (adult/Paediatric and Maternity areas)

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Communicating Communicating with patients, team members, other professionals and members of the public is an essential capability for paramedics. This naturally feeds into nearly every aspect of professional practice and should be considered a core component. Communication cannot naturally be considered in isolation, so the contextualisation of appropriate verbal and non-verbal communication is important. Students at all levels should be able to: • Communicate effectively with service users from a variety of backgrounds • Contextualise verbal and non-verbal communication appropriately • Show empathy in communication Achievement Areas Pre Hospital Ambulance Schools/care homes / day centres/ EOC call takers

Communicating with patients, team members, other professionals and members of the public is an essential capability for paramedics. This naturally feeds into nearly every aspect of professional practice and should be considered a core component. Communication cannot naturally be considered in isolation, so the contextualisation of appropriate verbal and non-verbal communication is important. Students at all levels should be able to: • Communicate effectively with service users from a variety of backgrounds • Contextualise verbal and non-verbal communication appropriately • Show empathy in communication Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres NHS 111 potential (adult/Paediatric and Maternity areas)

Communicating with patients, team members, other professionals and members of the public is an essential capability for paramedics. This naturally feeds into nearly every aspect of professional practice and should be considered a core component. Communication cannot naturally be considered in isolation, so the contextualisation of appropriate verbal and non-verbal communication is important. Students at all levels should be able to: • Communicate effectively with service users from a variety of backgrounds • Contextualise verbal and non-verbal communication appropriately • Show empathy in communication Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres NHS 111 potential/ Clinical desk (adult/Paediatric and Maternity areas)

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Planning and Organisation

The planning and organization of care in paramedic practice often occurs in a compressed timescale when compared to other healthcare settings. This capability considers the need for accurate planning in terms of both the short term physical wellbeing (such as the need to plan access and egress) and longer-term health related wellbeing (such as the choice of destination or treatment option) of patients and colleagues. Students at all levels should be able to: • Demonstrate the ability to develop an appropriate plan in response to a situation • Demonstrate the ability to alter that plan when the situation changes • Integrate an appropriate level of knowledge and evidence into that plan Achievement Areas Pre Hospital Ambulance EOC dispatch/Call takers

The planning and organization of care in paramedic practice often occurs in a compressed timescale when compared to other healthcare settings. This capability considers the need for accurate planning in terms of both the short term physical wellbeing (such as the need to plan access and egress) and longer-term health related wellbeing (such as the choice of destination or treatment op-tion) of patients and colleagues. Students at all levels should be able to: • Demonstrate the ability to develop an appropriate plan in response to a situation • Demonstrate the ability to alter that plan when the situation changes • Integrate an appropriate level of knowledge and evidence into that plan Achievement Areas Pre Hospital Ambulance Hospital ED/Minor illness or Injury setting Walk in Centres under paramedic supervision NHS 111 potential (adult/Paediatric and Maternity areas)

The planning and organization of care in paramedic practice often occurs in a compressed timescale when compared to other healthcare settings. This capability considers the need for accurate planning in terms of both the short term physical wellbeing (such as the need to plan access and egress) and longer-term health related wellbeing (such as the choice of destination or treatment option) of patients and colleagues. Students at all levels should be able to: • Demonstrate the ability to develop an appropriate plan in response to a situation • Demonstrate the ability to alter that plan when the situation changes • Integrate an appropriate level of knowledge and evidence into that plan Achievement Areas Pre Hospital Ambulance (RRV/ACP) HART Critical care Teams / HEMS car etc Hospital ED/Minor illness or Injury setting Walk in Centres NHS 111 potential/clinical desks (adult/Paediatric and Maternity areas)

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Decision making and problem solving

Related to the communication and planning capabilities, paramedics need to have the ability to make fast, accurate decisions which solve, rather than contribute to, problems. The appropriate use and interpretation of assessment tool and the ability to react to unforeseen circumstances are key. Appro-priately seeking assistance and knowing the limitations of knowledge are also points to consider in this capability Students at all levels should be able to: • Demonstrate the ability to recognise problems impacting on practice • Demonstrate the ability to appropriately resolve those problems Achievement Areas

Pre Hospital Ambulance

Related to the communication and planning capabilities, paramedics need to have the ability to make fast, accurate decisions which solve, rather than contribute to, problems. The appropriate use and interpretation of assessment tool and the ability to react to un-foreseen circumstances are key. Appropriately seeking assistance and knowing the limitations of knowledge are also points to con-sider in this capability Students at all levels should be able to: • Demonstrate the ability to recognise problems impacting on practice • Demonstrate the ability to appropriately resolve those problems Achievement Areas Pre Hospital Ambulance

Hospital ED

(adult/Paediatric and Maternity areas)

Related to the communication and planning capabilities, paramedics need to have the ability to make fast, accurate decisions which solve, rather than contribute to, problems. The appropriate use and interpretation of assessment tool and the ability to react to un-foreseen circumstances are key. Appropriately seeking assistance and knowing the limitations of knowledge are also points to con-sider in this capability Students at all levels should be able to: • Demonstrate the ability to recognise problems impacting on practice • Demonstrate the ability to appropriately resolve those problems Achievement Areas Pre Hospital Ambulance (RRV/ACP) HART Critical care Teams / HEMS car etc Hospital ED/Minor illness or Injury setting Clinical desk NHS 111 potential (adult/Paediatric and Maternity areas)

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Learning through experience

The ability to critically reflect and change practice based on evidence is important to modern paramedic practice. The capability is demonstrated by the use of critical refection in both the formal and informal settings. From discussions about the progression of case to the formal recording using a model of reflection, learners should be able to demonstrate change based on experience and evidence. By the end of first year students should be able to: • Describe the things that influence their practice • Describe how change occurs within their own practice • Describe the way in which reflective practice contributes to high quality care Achievement Areas Pre Hospital Ambulance

The ability to critically reflect and change practice based on evidence is important to modern paramedic practice. The capability is demonstrated by the use of critical refection in both the formal and informal settings. From discussions about the progression of case to the formal recording using a model of reflection, learners should be able to demonstrate change based on experience and evidence. By the end of second year students should be able to: • Critically assess their own practice through reflection • Make changes to their practice as a result of reflection Achievement Areas Pre Hospital Ambulance

Hospital ED/Minor illness or Injury setting

Walk in Centres with paramedic support

(adult/Paediatric and Maternity areas)

The ability to critically reflect and change practice based on evidence is important to modern paramedic practice. The capability is demonstrated by the use of critical refection in both the formal and informal settings. From discussions about the progression of case to the formal recording using a model of reflection, learners should be able to demonstrate change based on experience and evidence. By the end of third year students should be able to: • Critically assess their own practice in light of evidence based best practice • Demonstrate how their own practice is changed by this reflection • Demonstrate how systems and organisations can change through reflection Achievement Areas Pre Hospital Ambulance

Hospital ED/Minor illness or Injury setting

Walk in Centres

NHS 111 potential/clinical desk

(adult/Paediatric and Maternity areas)

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Flexibility and resilience in response

Unexpected events are a cornerstone of paramedic practice. This capability seeks to ensure that graduates are able to respond to the unexpected in a way that retains professional focus. Changing care pathways in response to changing situations and appropriately managing anxiety is important in this capability. Students at all levels should be able to: • Demonstrate the ability to recognise challenging situations • Demonstrate the ability to appropriately manage or seek assistance • Recognise personal and professional limitations Achievement Areas Pre Hospital Ambulance

EOC

Unexpected events are a cornerstone of paramedic practice. This capability seeks to ensure that graduates are able to respond to the unexpected in a way that retains professional focus. Changing care pathways in response to changing situations and appropriately manging anxiety is important in this capability. Students at all levels should be able to: • Demonstrate the ability to recognise challenging situations • Demonstrate the ability to appropriately manage or seek assistance • Recognise personal and professional limitations Achievement Areas Pre Hospital Ambulance (RRV/ACP etc)

HART

Hospital ED/Minor illness or Injury setting

Walk in Centres with paramedic support

(adult/Paediatric and Maternity areas)

Unexpected events are a cornerstone of paramedic practice. This capability seeks to ensure that graduates are able to respond to the unexpected in a way that retains professional focus. Changing care pathways in response to changing situations and appropriately manging anxiety is important in this capability. Students at all levels should be able to: • Demonstrate the ability to recognise challenging situations • Demonstrate the ability to appropriately manage or seek assistance • Recognise personal and professional limitations Achievement Areas Pre Hospital Ambulance (RRV/ACP)

HART

Critical care Teams / HEMS car etc

Hospital ED/Minor illness or Injury setting

Walk in Centres

NHS 111 potential/ Clinical desk

(adult/Paediatric and Maternity areas)

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Appendix 8 Skills Matrix completion explained A skill matrix list is to be found in the rear of the PAD for all years.

Each year PAD contains a specific skill matrix. The skill matrix is aligned to level of practice expectations for each year group with GREEN being a must for the student to complete , AMBER being nice to complete and RED being the student must not practice or complete for that year

Evidence for skill completion and achievement is gained by:-

The Practice Educator witnessing the student to undertake and perform the skill promptly, effectively and safely in accordance with guidelines (JRCALC/SWAST) and /or University Gloucestershire Skills Drill Book

Practice Educators can sign any skill off relevant for the year of practice for the student.

It is the Practice Educators decision as to whether or not the skill needs to be witnessed and performed once, twice or three times before they agree to sign it off as achieved. Practice Educators can initial and date the small column’s as the student practices, but must sign the large column to indicate the skill is achieved in practice

Skill’s should also feature in the students reflective practice documents as further evidence they have performed the skill and thought about how well they did or where areas of improvement are needed.

Any skill not able to be achieved in the practice setting can be assessed by simulation or discussion with the student. This can be undertaken on Station or within the University setting.

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Appendix 9 - Cause for Concern in Practice Placement

This flow chart identifies the process to follow should a student be struggling in practice placement.

Practice Link Email - KBromwich@glos.ac.uk PS 4003 PS 5003 PS 6003

Student identified as a concern in practice It is important any areas of concern are identified as early as possible and

preferably within the first 3 weeks of placement

Practice Educator to discuss concern with student Document conversation and agree on an Action Plan setting a review date within 2

weeks period Inform Module Leader of Action Plan and SWASFT Education team

Consider tripatite meeting (Student, Practice Educator, University Link/Module Leader)

Review Action Plan and report progress to University Practice Link /Module leader

Practice concern resolved

End Action Plan

Continued concerns and Action Plan not resolved

Tripartite meeting with Student, Practice educator and Practice Link within 2 working days and SWASFT Education Team informed of meeting

Review concerns and Action Plan set for 2 week review Additional support/ training via University offered (Helpzone, Student Support, Simulation practice)