Simulation-based clinical assessment: redesigning a signature assessment into a teaching strategy

Introduction: Paramedics entering the professional workforce continually make judgements of their own, and their peers’, performances. With little exposure to these processes, exercising these judgements is difficult. Teaching strategies that use self-assessment, peer assessment and reflective practice should improve the acquisition of clinical reasoning and application of clinical skills (1-4). However, clinical programs such as paramedic programs present unique challenges in the development and assessment of clinical skills, because allowing undergraduate paramedic students to work with autonomy beyond their ability presents considerable risk to patient safety. Methods: This project used a mixed-methods approach to evaluate the new teaching strategy that used simulation-based clinical assessments (SCAs) for learning. Two focus groups, of 1-hour duration with eight participants, were conducted before and after exposure to the teaching intervention. In addition, a self-administered, anonymous voluntary online questionnaire was conducted three times during the semester after each of the three SCA rounds. Results: Twenty-seven students (69%) answered the pre-survey and 24 (62%) students answered the post-survey; 14 students completed both the pre and post-surveys. The results indicate that changing a SCA from a standalone assessment to a strategy that encourages student engagement has facilitated a deeper understanding and developed desired attributes. Conclusion: The data from this pilot project has demonstrated that requiring students to have an active role in learning activities by integrating the SCA into the teaching design has improved student confidence and understanding. The SCA used for learning has the potential to be a signature means for clinical educators to encourage and guide learning in paramedic science