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A critical analysis of pre-hospital clinical mentorship to enable learning in emergency medical care.Liebenberg, Nuraan January 2018 (has links)
Thesis (Master of Emergency Medical Care)--Cape Peninsula University of Technology, 2018. / For emergency medical care (EMC), clinical mentorship can be thought of as the relationship between the EMC students and qualified emergency care personnel. Through this relationship, students may be guided, supported and provided with information to develop knowledge, skills, and professional attributes needed for delivering quality clinical emergency care. However, this relationship is poorly understood and the focus of this research was to explore how this relationship enabled or constrained learning. Through having experienced mentorship, first as a student in EMC, then as an operational paramedic, mentoring students, I was privy to an insider perspective of clinical mentorship, and the experiences of fellow students‘. Through this experience the practices I observed may not have promoted learning. This is when my interest in pre-hospital clinical mentorship in relation to learning began. The aim of this research was to present a qualitative analysis of the clinical mentorship relationship in pre-hospital EMC involving the qualified pre-hospital emergency care practitioner (ECP) and the EMC student. The objectives included gaining an understanding of what enabled and/or constrained learning EMC, exploring clinical mentorship and learning in the pre-hospital EMC context, and gaining understanding of the role and scope of community members in the clinical mentorship activity system. The purpose of this study was to qualitatively document, by means of a thematic analysis, the pre-hospital clinical mentorship relationship, as well as document, by means of a Cultural Historical Activity Theory (CHAT) analysis, the clinical mentorship activity system. The focus of this qualitative documentation was the enablements and constraints to learning during clinical mentorship. This research also made possible recommendations for EMC clinical mentorship and education and may also inform (PBEC) policy, as well as work integrated learning (WIL) policy. Data collection included the use of diaries and focus group interviews. Analysis involved a two-part analysis, where data was reduced and understood with thematic analysis guided by Braun and Clarke (2006) six phase thematic analysis process (explained in Chapter three, Section 3.6). Thereafter, a CHAT analysis was conducted to uncover contradictions within the clinical mentorship activity system that made working on the object of activity difficult, thereby also uncovering constraints to learning. Inductive reasoning was applied to the thematic analysis to reduce data and identify themes and subthemes which provided insight into the enablements and constraints to learning in the pre-hospital EMC clinical mentorship relationship. The CHAT analysis of the data collected and analysed brought to surface the affordances, tensions as well as the primary-level and secondary-level contradictions of the clinical mentorship activity system. The thematic analysis of the clinical mentorship relationship provided limited understanding of the enablements and constraints to learning, and thus further motivated deeper analysis with CHAT. The results of this research included primary and secondary-level contradictions for almost all elements of the clinical mentorship activity system. Contradictions amongst the Division of Labour (DoL), the rules of the activity system, and the tools/resources of the activity system existed in that it constrained the interaction and activity of the subject and the community while working on the object of the activity system possibly achieving a lesser or undesired outcome of clinical mentorship.
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Principles of physics implicit in emergency medical rescue education and operational practice: a case study of motor vehicle related rescueBosman, Justice Selvyn January 2019 (has links)
Thesis (Master of Emergency Medical Care (MEMC))--Cape Peninsula University of Technology, 2019 / Introduction: Road traffic injuries are the ninth leading cause of death globally. Projections indicate that without new and sustained commitment globally to preventing such injuries, the situation will only worsen. Motor vehicle rescue does not lend itself to the prevention of road traffic incidents but through ensuring that all incidents are managed using sound evidence could contribute in positive outcomes for victims. It is unknown what contribution rescue education makes to the body of medical rescue knowledge in South Africa. Aims: The aim of this research was to investigate the relevance and scope of the principles of physics within medical rescue specifically in the context of motor vehicle rescue. It appears that current traditional methods of presenting rescue training, which is mainly procedural and technical, may contribute to 'segmented' learning. Research Methodology: Using an interpretive research design, multiple qualitative methodologies were employed. This methodological triangulation was intended to improve construct validity and trustworthiness of findings. A modified Delphi process through which questionnaires was repeatedly distributed to rescue experts was employed. Process tracing was used to evaluate the developed typical motor vehicle rescue case scenario narrative for underpinnings of the principles of physics. The Bachelor Emergency Medical Care Physics and Extrication subject guides was evaluated for its educational alignment during the document analysis. Legitimation Code theory as a theoretical framework was utilised to appraise the knowledge gap. Results & Discussion: Motor vehicle rescue incident may not always present in a similar manner due to various factors and influences. Development of the typical motor vehicle case narrative from which its physics principles could be identified was imperative. Most motor vehicle rescue related training occur with the vehicle in the upright orientation on all four wheels. This manner of frequent training may restrict rescue practitioners from moving beyond their 'typical' training knowledge when the situation presents a typical. The thematic document analysis of the BEMC Physics and Extrication subject guides lacked the necessary coherence which is required for a professional degree. It was deemed void of certain threshold concepts and structure which would allow the student to move between the theoretical and contextual knowledge. Motor vehicle rescue subject guides and most textbooks on the topic leaned towards a procedural and very technically detailed pedagogy, to the extent that it could contribute to segmented learning. Conclusion: Developing curricula that is underpinned by a theoretically sound evidence base would promote credibility of a qualification. Curricula by design inform the teaching, learning and the competencies which would ultimately be assessed. Professional degrees are intended to develop practitioners who would graduate with the knowledge and competencies to adapt to situations. In addition, graduate attributes of lifelong learning, reflective practice and the ability to contribute to the development of new knowledge is secondary to the goal of qualification attainment.
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