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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.

This study examined the nature and strength of relationship between specific related high school academic grades and the cumulative graduating average of students in five allied health programs at the British Columbia Institute of Technology. Lack of scientific studies on selection criteria for determining the cumulative graduating average of allied health professionals at the British Columbia Institute of Technology (B.C.I.T.) was evident. Educators argue that in order to enhance educational opportunities for institute students, there is a professional obligation upon the policy-makers to gather appropriate data to determine which factors contribute to the success of the allied health student. With the high cost of technical education, admission officers and admissions committees are accountable for their selection processes to the institute's administration, decision makers, provincial and federal funding sources, and society. The results of this study may assist admissions officers in selecting academic variables that indicate the cumulative graduating average so that a better match can be made between the students and their performance in allied health programs. The accessible population of 629 graduates from the allied health technologies in this study were biomedical electronics, medical laboratory, medical radiography, nuclear medicine, and prosthetics and orthotics. The dependent variable measurement of academic achievement for these students was their cumulative graduating average. Single variables consisted of the grade point average of the following: pretechnology academic requirements, high school English, high school algebra, high school biology, high school chemistry, and high school physics. Descriptive statistics, zero-order correlations, and stepwise multiple regression analysis were the statistical methods employed to determine which specific academic variable or multiple of variables exhibited a strong relationship between the cumulative graduating average and academic variables. The analysis identified certain variables that strongly related to the cumulative graduating average, both singly and in combination with others. Each of the program significant combination of variables are provided here in order of descending influence: Biomedical Electronics Technology- high school algebra; Medical Laboratory Technology- the pretechnology grade point average, high school chemistry, biology, and algebra; Medical Radiography Technology- high school biology and chemistry; Nuclear Medicine- the pretechnology grade point average, high school chemistry, and high school biology; Prosthetics and Orthotics Technology- the pretechnology grade point average and high school chemistry. Academic variables did not account for more than 34% of the total variables in any of the programs. The level of significance for individual variables was the convention, 0.05. Clearly, each program had its own character; however, the performance of students in the natural sciences were significant in four of the five programs. An attempt was made to investigate which specific high school subjects correlated highly with the cumulative graduating average of students at the B.C.I.T. through a inspection of five programs for five graduating classes. Relevant variables were identified that were indicative of academic achievement in each specific program of study. Investigating the nature and strength of relationship between preprofessional grades and the cumulative graduating average of allied health students at B.C.I.T. could benefit both students and admissions officers by supplying a piece to an educational puzzle that would demystify the selection process. The information presented may assist admissions officers and prospective allied health students make more suitable educational choices. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents andmental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective. Methods: A grounded theorymethodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020. Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approach Conclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.

Programs to prepare allied health professionals are the latest in a progression of health-related programs to be assimilated into college and university life. Like their predecessors, preparation programs for physicians and nurses, allied health programs developed almost willy-nilly in the past 50 years, and only within the past decade have begun to be taken seriously by the nation's leading colleges and universities. In this study, new departments of allied health that have been established in 133 senior colleges and universities with two or more programs accredited by the Committee on Allied Health Education and Accreditation were surveyed. From a sample of 36 institutions, fully useable responses were received from 114 heads of allied health departments and 90 heads of other academic departments, such as education, English, psychology, chemistry, and biology. The study revealed that there are significant differences in responses from allied health department heads and other academic area department heads in terms of personal characteristics (age, academic rank, and gender), departmental activities (allied health department heads place more emphasis on administrative tasks), and departmental goals. The most powerful variables differentiating responses between the two classes of department heads were percent of faculty with doctoral degrees, size of departments, percent of students in departmental courses who are departmental majors, emphasis given to teaching service courses, and emphasis on administrative activities. In summary, allied health departments (in contrast to other departments) are small (about six FTE), under credentialed, insular, engaged principally with their own majors, and committed primarily to the professional preparation of their students for future careers. Allied health department heads typically are experienced professionals who were brought to the institution from the outside to serve an indefinite term, and who appear to be overly concerned with the nuts and bolts of departmental administration. The researcher concluded that extant departments of allied health are still predominantly professional rather than academic in outlook and standard practice. / Ed. D.

Le métier de cadre de santé de proximité dans les structures hospitalières publiques s’est profondément modifié depuis ces dix dernières années. Ses missions très largement tournées aujourd’hui vers des fonctions de management et de gestion, l’éloignent de celles d’encadrement des équipes soignantes vers une qualité de soins aux patients. Certains ne se retrouvent pas dans ce changement de profil et vivent très difficilement ces évolutions. L’intention de cette thèse est de porter un regard sur ce qui entre en jeu dans cette tension et d’interroger les éléments de la formation qui permettraient de la déjouer. Parmi ces éléments, la formation à la recherche - une certaine recherche dont les contours seront précisés - pourrait-elle permettre au cadre de santé de redonner sens à sa fonction ? L’auteur s’attache tout d’abord à définir, au travers de l’histoire, de son évolution et de sa formation, la fonction du cadre de santé. Puis, il examine ce qui la caractérise aujourd’hui à partir de trois notions principales : manager, encadrer, accompagner. Finalement, il éclaircit la question du prendre soin dans la fonction de cadre de santé. Ces éléments permettent de comprendre en quoi la démarche de recherche peut être un levier pour mettre en valeur l'art du prendre soin dans la pratique du cadre de santé. / The position of nursing team managers in public hospital facilities has changed dramatically over the past ten years. It is now strongly focused on organization and administrative tasks, which draw them away from their role as nursing team managers dedicated to quality care to patients. Some of them resent this change in their job profile and find it very difficult to cope with this evolution. The intent of this thesis is to look into what causes this strain and to examine which elements in the training program could help prevent it. Among those elements, could research training (in a specific type of research to be defined further on) enable nursing team managers to enjoy their professional activity? First the author will define the function of nursing team manager through its history, its evolution and training methods. The author will then consider its specificities in the present day, based on three primary concepts: organization, management and support. Finally he will clarify the ‘care’ issue in the scope of the nursing team manager’s activity. These elements will give an understanding of how the research approach can promote the ‘art’ of ‘caring’ in the nursing team manager’s activity.

La récente réingénierie des études de soignants paramédicaux en général et celle de MK en particulier (en 2015), introduit une nouvelle dimension dans les cycles de formation : le raisonnement clinique. Défini par Higgs (2008) comme « processus de pensée et de prise de décision qui permet au clinicien de prendre les actions les plus appropriées dans un contexte spécifique de résolutions de problèmes de santé », celui-ci vise à développer et évaluer chez les apprenants leur capacité à lier des savoirs concernant la situation de la personne malade (bio-psycho et social) et des savoirs professionnels, techniques, cognitifs et relationnels. En s’intéressant au processus d’institutionnalisation du raisonnement clinique, cette thèse interroge les processus d’enseignement (notamment des tuteurs de stage) et d’apprentissage de cette pratique par les futurs MK, notamment à partir des différentes séquences proposées. Le raisonnement clinique fait appel à une pluralité de schèmes au sens de Pastré (2011) mobilisés par les apprenants pour analyser un problème de santé et construire un projet de soin pour la personne malade. La compréhension de la mobilisation de tous ces schèmes, le modus operandi des étudiants en situation d’apprentissage du raisonnement clinique occupe une place centrale dans cette thèse inscrite clairement dans une didactique professionnelle. Réalisée à partir d’observations de terrain, de séances d’apprentissage filmées, d’entretiens et d’hétéroconfrontations (N=20) auprès de patients, tuteurs libéraux et étudiants stagiaires, cette recherche a permis de catégoriser par une méthode qualitative d’analyse de contenu, à l’aide du logiciel N’Vivo, les 5 portraits des triades patient/tuteur/étudiant en s’appuyant, entre autres, sur les ressources mobilisées (Piot, 2009) et les configurations de tutorat (Kunegel, 2011). Nous tentons ensuite de repérer des grandes lignes de force ou de divergence entre les différents portraits. Le raisonnement en kinésithérapie serait un outil favorable à l’incorporation de savoirs théoriques abstraits mobilisés en situation pratique avec les patients, qui sont adaptés et incorporées par chacun. Il est un outil de bricoleur, un fil rouge qui permet l’adaptation au patient et dont les tuteurs cherchent à s’émanciper pour leur pratique de « la vraie vie », dans un style qui leur est propre, au sein du genre kinésithérapique. La première séance serait un moment d’étonnement voire d’éblouissement pour l’étudiant. Le patient est un tiers totalement intégré dans le processus de la séance, qui par sa fonction de médiation, aide à l’intégration des savoirs et à l’apprentissage du raisonnement clinique. Nous proposons une modélisation de celui-ci en co médiation. / The recent re-engineering of paramedic studies in general and of MK in particular (En 2015) introduces a new dimension in the training cycles: the clinical Rai-ringing. Defined by Higgs (2008) as "a process of thought and decision-making that allows the clinician to take the most appropriate actions in a specific context of health problem solving", the beneficial aims to develop and evaluate among AP-stakeholders their ability to link knowledge about the situation of the sick person (bio-psycho and social) and professional, technical, cognitive and relational knowledge. By focusing on the process of institutionalizing clinical reasoning, this inter-Roge thesis processes teaching (especially tutors of internship) and learning this practice by the future MK, especially from the different proposed sequences. Clinical reasoning uses a plurality of patterns in the sense of Pastré (2011) Mobili-Con by learners to analyze a health problem and build a care project for the sick person. The understanding of the mobilization of all these patterns, the modus-Randi of students in learning situation of clinical reasoning occupies a central place in this thesis clearly enshrined in a professional didactics. Based on field observations, filmed learning sessions, interviews and hétéroconfrontations (N = 20) with patients, liberal tutors and student interns, this research has allowed to categorize by a qualitative method Content analysis, using the No Vivo software, the 5 portraits of the patient/tutor/student triad based, among other things, on the resources mobilized (2009) and the tutoring configurations (Kunegel, 2011). We can then try to identify the main lines of force or divergence between the different portraits. The reasoning in physiotherapy would be a favourable tool for incorporating abstract theoretical knowledge mobilized in practical situations with patients, which are adapted and incorporated by each. It is a handyman's tool, a red thread that allows adaptation to the patient and whose tutor seeks to emancipate himself or herselffor the practice of "real life", in a style of his own, within the genus Kinésithérapique. The first session would be a moment of astonishment or even amazement for the student. The patient is a third party totally integrated into the process of the session, which through its function of mediation, helps the integration of knowledge and the learning of clinical reasoning. We propose a modeling of it in co- mediation.

Die derzeit geführten Diskussionen zu pädagogischen Neuerungen für die Notfallsanitäter-Ausbildung in Deutschland finden auf der Grundlage aktueller bildungsstruktureller Rahmenbedingungen des Notfallsanitäter-Gesetzes einschließlich der Ausbildungs- und Prüfungsverordnung für Notfallsanitäter sowie vor dem Hintergrund berufspädagogischer, berufsfelddidaktischer und allgemeindidaktischer Ansätze statt. Es geht vor allem um die Einführung eines umfassenden Berufsbildungskonzeptes, wenn eine zukunftsfähige Notfallsanitäter-Ausbildung auf wissenschaftliche, gesellschaftliche, wirtschaftliche sowie kulturelle Herausforderungen vorbereiten will. Dieser Beitrag zielt darauf ab, bildungstheoretische Überlegungen einschließlich kritischer Dimensionen im Kontext der Handlungsschwerpunkte von Notfallsanitätern zur Überwindung einer auf ausschließlich berufliche Verwertbarkeit gerichtete Bildung für die Notfallsanitäter-Ausbildung aufzugreifen. Dazu wurde ein Bestimmungsversuch rettungsdienstlichen Handelns mit Ableitung einer bildungstheoretischen Notwendigkeit unternommen. Daher war es naheliegend, eine geisteswissenschaftliche Haltung einzunehmen und das Verstehen des Sachverhaltes in den Mittelpunkt zu rücken. Folglich wurde sich bei der Erkenntnisgewinnung auf eine hermeneutische Theoriearbeit mit theoretischem Argumentieren unter Einbezug der aktuellen, gesetzlichen Ausbildungsrahmen bezogen. Die Beschreibungen zeigen auf, dass die Besonderheiten rettungsdienstlichen Handelns und die gesellschaftlichen sowie bildungsstrukturellen Rahmenbedingungen einer bildungstheoretischen Sicht als Grundlage für die Notfallsanitäter-Ausbildung bedürfen. Der Beitrag diskutiert, wie sich ein Bildungsbegriff als Metaparadigma der Notfallsanitäter-Ausbildung darstellen könnte und welche Konsequenzen sich hieraus trotz nicht zu verachtender Hürden für die pädagogischen Handlungsfelder und die zukünftige Forschung in diesem Bereich ergeben. / The current discussions on educational innovations concerning paramedic training programmes in Germany take place in accordance with the present conditional framework for education of the paramedics act, including training and examination regulations for paramedical health care professionals. Furthermore, approaches to vocational education, subject- related didactics and general didactics are taken into account. The focus will mainly be on the introduction of a complex vocational training concept in order to meet the requirements of paramedic training that will prepare for scientific, social, economic and cultural challenges. This article aims at discussing considerations concerning education theory, including critical analysis, and putting it into the context of the professional field of the paramedical discipline. However, this paper will not be limited to aspects of education that are directly linked to practical usage – but it will rather go beyond it. For this reason, it has been tried to identify the professional field of the paramedics and – for it will be necessary – to deduce information that might serve the needs of education theory. It seemed therefore to be obvious to take the position within humanities, and to put emphasis on the understanding of the issue. Consequently, as far as gaining knowledge is concerned, hermeneutic theory work and theoretical reasoning were taken into account, also involving the current legal requirements for the training framework. Descriptions show that, when it comes to the specific nature of the professional field of the paramedical discipline, and the social and the conditional framework for education, there is, as far as paramedic training is concerned, a need for taking a perspective that is based on education theory. The article discusses how an educational concept could be represented as a meta-paradigm for the paramedic training, and which consequences will arise in this respect, despite considerable obstacles to the educational fields of action and any future research in this area.

Dissertation submitted in fulfilment of the requirements for the Degree of Master of Technology: Emergency Medical Care, Durban University of Technology, 2011. / South African Advanced Life Support (ALS) providers follow an autonomous practice model of care. This advanced role profile is characterized by clinical skill competence and autonomous decision making whilst demonstrating a high level of awareness of their own ethical attitudes, values and beliefs. It is through a professional commitment that ALS providers deliver an advanced evidence based practice that should be maintained constantly within a dynamic environment. Continuous Professional Development (CPD) is seen as an instrument for this. CPD should also serve as a means to acquire professional excellence and going beyond the boundaries of meeting the base level standard with the aim of providing the finest quality of care in the interest of patient safety. Purpose of the research The purpose of this research is to identify gaps in the professional development of out-of-hospital ALS providers trained in South Africa by assessing frequency of performance of ALS clinical skills, by determining perceived level of competence and predictors of confidence, and by sourcing information on attendance of CPD activities and training needs. vi Methodology This study used a quantitative non-experimental design. Data was attained from an e-mail based descriptive survey that was limited to a precise and concise questionnaire. The data from 140 (N) ALS providers was subjected to a descriptive statistical analysis using the PASW statistics version 18.0 to systematically show patterns and trends. Frequency distributions were generated to describe data categories. Bivariate analysis was conducted using Chi-square and Pearson correlation tests. Results Results indicated that ALS providers performed clinical skills infrequently. Of the total number of respondents 140 (N), the average ALS clinical skills performance was 6 (4.8%) daily. In the 2-6 times a week category 8 (6.4%) ALS clinical skills were performed. ALS clinical skills performance in the once a week category showed an average of 7 (5.6%) and the once a month category, an average of 17 (13.7%) ALS skills were performed. An average of 31 (25%) ALS skills were performed in the once in six months category whilst an average of 54 (43.5%) were performed in the greater than six months category. CPD activities that are appropriate to ensuring the maintenance of competence for these clinical skills were not adequately undertaken. Medical updates were mostly attended by ALS providers, 52 (42.9%) whilst CPD events that addressed clinical skills, was mostly limited vii to the ACLS course 42 (34.7%). The needs assessment for CPD showed that 56 (53%) of respondents expressed a need for paediatric and obstetric simulated skill sessions, whilst 43 (40.9%) requested clinical skills workshops and 39 (37.1%) expressed a need for clinical practice in theatre and coronary care units. Conclusions and recommendations This study shows that ALS clinical skill competence is maintained by frequent practice and appropriateness of CPD activities. The infrequent performance of ALS skills coupled with the lack of appropriate and diverse CPD activity attendance results in poor maintenance of competence. The loss of competence can be related to poor reported levels of confidence which consequently places patient safety at risk. To safeguard against medical error and ensure patient safety, it is strongly recommended that CPD audits be undertaken on all ALS providers for appropriate CPD compliance related to clinical skills performance. In addition to a clinical skills audit, it is recommended that a national clinical skills registry be established with the intention of facilitating clinical skill surveillance, to determine a notifiable, high risk skill set. To safeguard against knowledge and clinical skill attrition and loss of competence, the delivery of CPD activities should be assessed for effectiveness and appropriateness.