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Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2016. / Purpose Emergency care education and training in South Africa is experiencing an important transformation period, involving migration from short course based training to a newly proposed, formalised, three-tier qualification system, aligned with the Higher Education Sub-framework. Many existing and experienced holders of short course emergency care certificates face the challenge of gaining access to formal emergency care programmes without meeting the minimum entry requirements. Recognition of Prior Learning (RPL) will therefore become one of the key strategies for planned migration of short course graduates into professional learning programmes. However, the research reports on RPL practice in the field of emergency care are scarce. Hence, valuable lessons about RPL in emergency care programmes are missed. The purpose of this study is to explore the efficacy of RPL practice within the National Certificate: Emergency Care (NCEC) Programme in the Western Cape, through the experience of ambulance emergency assistants, who applied for RPL on the Programme and the paramedic educators involved in the facilitation and RPL assessment on the NCEC Programme. Methodology The design of this descriptive exploratory study was qualitative, and was set in the interpretative paradigm using a case study mode of inquiry. The qualitative data was collected through semi-structured focus groups, individual interviews, and document analysis. The participants were from Cape Peninsula University of Technology (CPUT), Department of Emergency Medical Sciences, and the Western Cape Government College of Emergency Care (WCCEC). Collected data was interpreted by means of thematic analysis, set against the context of the study objectives and the theoretical framework. Finding The study revealed three main themes related to RPL efficacy in the NCEC Programme. These included the need for RPL training for educators involved in RPL, lack of support and guidance for RPL assessors and participants, and the need for careful selection of RPL assessment methods. The document analysis highlighted the gap between a comprehensive and sound RPL policy document and the practical implementation of these policies. Conclusion and Recommendations The emergency care field requires greater awareness and information on RPL processes, principles, assessments, and requirements. The higher education institutions, as the sole providers of the newly proposed formal emergency care programmes need to consider building capacity for RPL by means of training and dedicating academic staff to RPL, and developing comprehensive RPL policies, in collaboration with relevant stakeholders in the field. RPL assessment methods need to be more diverse and tailored to the individual RPL claimants. Further research on RPL will ensure a fair, social inclusive and redressing process during the planned migration of emergency care education and training. / M

This dissertation examines factors with influence on the organizational cultural competence of Emergency Medical Services (EMS) systems. The purpose of this study was to draw on theories of representative bureaucracy and transformational leadership to assess cultural competence in Emergency Medical Services systems from the perspective of EMS leadership, within careful consideration of the external environment in which EMS systems operate. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015 / FAU Electronic Theses and Dissertations Collection

published_or_final_version / Public Administration / Master / Master of Public Administration

PURPOSE. Domestic violence has a significant prevalence in the world, and certainly in South Africa, yet Emergency Care Practitioner (ECP) training and practice does not have any particular focus on domestic violence intervention. The absence of any clear response protocol to domestic violence in a Health Professions Council of South Africa (HPCSA) regulated profession, suggests the reliance on health practitioner discretion in this regard. This is problematic as the profession is male dominated and focused on tertiary levels of care. ECP's may be positioned to screen for abuse early, yet there is no evidence of success or failure in this endeavour. This study aimed to ascertain what the prevailing ECP knowledge, attitudes and beliefs around domestic violence in the Western Cape are, so that any factors preventing or nurturing early identification and appropriate treatment of domestic violence may be mitigated or supported respectively. METHODS. Health Professions Council of South Africa (HPCSA) registered ECP's in the Provincial Government- Western Cape (PGWC)- Emergency Medical Service (EMS) Metropole region voluntarily completed a questionnaire. MAJOR RESULTS. Only 49% of respondents could correctly define domestic violence. ECP qualification was associated with domestic violence definition in that Basic ECP's were more likely to incorrectly define domestic violence than the advanced ECP's. Eighty-one percent of respondents recognized less than thirty domestic violence calls in the preceding six months. The majority of ECP's (89%) experienced no special handling of domestic violence victims. No significant association could be found (Chi-Square: p = 0.2298) between qualification and knowledge of domestic violence laws. An ECP's qualification is no predictor of his/her legal knowledge about abuse. Qualification could also not be positively associated with the referral of victims, although the majority of practitioners of all qualifications (78%), had only sometimes referred victims or not at all. The majority of respondents expressed inadequate assessment and management of domestic violence patients. The majority also indicated that their ECP training was inadequate in preparing them for domestic violence intervention. CONCLUSIONS DRAWN. The attitudes and beliefs of Emergency Care Practitioners elicited from this study suggest a poor level of understanding of the extent and nature of domestic violence. There is a probable low detection rate amongst the majority of ECP's. There exists harbouring of myths that may confound the implementation of a pre-hospital protocol for domestic violence management. There is an inadequacy of current ECP practice with respect to domestic violence crisis intervention with regards screening, management and referral. The EMS response to domestic violence should be congruent with an appropriate health sector response and should include universal screening (asking about domestic violence routinely); comprehensive physical and psychological care for those patients who disclose abuse; a safety assessment and safety plan; the documentation of past and present incidents of abuse; the provision of information about patients rights and the domestic violence act; and referral to appropriate resources. The ECP curriculum should emphasise the particular nature and treatment of domestic violence. The study supports the need for the introduction of a comprehensive ECP protocol, in training and in practice. This information should prove useful to all who attempt to design educational programmes and clinical strategies to address this public health issue. / Thesis (M.PH.)-University of KwaZulu-Natal, 2006.

The objective of this study was to assess the relationships between Sense of Coherence and Burnout (i.e. Emotional Exhaustion, Depersonalisation and Personal Accomplishment) and to investigate job-related stressors and support resources in a sample of privately employed eThekwini paramedics. A survey design was used and a convenience sample (N=56) was taken from one emergency care organisation. Biographical variables and qualitative information regarding stressors and support systems were obtained and two inventories, the Maslach Burnout Inventory-Human Services Survey and the Orientation to Life Questionnaire, were administered. Results showed a predominance of informal support systems and individual case-related stressors. There were relationships between Sense of Coherence and Burnout and a significant difference in Personal Accomplishment in the 36-40 age group was found. Regression results indicated that Depersonalisation and Sense of Coherence predicted Emotional Exhaustion and Emotional Exhaustion demonstrated a main effect on Depersonalisation. Sense of Coherence was the only variable that predicted Personal Accomplishment in the current sample of paramedies. / Thesis (M.A.)-University of KwaZulu-Natal, 2007

Aim: The aim of this study was to explore the attitudes and practices of the emergency staff working in the level one emergency departments in the province of KwaZulu-Natal, with regard to witnessed resuscitation. Methodology: A qualitative approach was used to explore the attitudes and practices of the staff. Two semi - structured interviews were conducted with each participant, an initial and a verifying interview, with each interview lasting between 15 - 30 minutes long. The researcher applied the principle oftheoretical saturation and a total ofsix participants from two of the four level one emergency departments were included in this study. One provincial and one private emergency department were chosen. All of the interviews were taped and transcribed prior to manual analysis, in which categories and themes were identified from the data. Findings: The emergency staff disliked the idea of witnessed resuscitation. They believed it to be a harmful experience for the witnesses, a threat to the resuscitation process, threatening for the emergency staff, and impossible to implement in their emergency departments that are already short of staff and space. Although these were their dominant feelings, there were subtle references made during the interviews that revealed that there were some aspects of witnessed resuscitation that they liked once they had considered the practice. There were no written policies to dictate how the relatives were handled, but all the staff agreed that the relatives were asked to wait outside-of the resuscitation area, they were kept informed and then brought in when the patient was stable or had died. A number of recommendations are suggested for education, practice and further research in an attempt to introduce witnessed resuscitation as an option in KwaZulu-Natal's emergency departments. / Thesis (M.Cur.)-University of Natal, Durban, 2001.