PARA327 - Paramedicine in Practice: Complex Care

Year

Credit points

Campus offering

Prerequisites

For Bachelor of Paramedicine: PARA302 Paramedic Practice: Population Variances OR PARA317 Paramedicine in Practice: Lifespan Health

For Bachelor of Nursing/Bachelor of Paramedicine: PARA318 Paramedic Theory and Practice: Lifespan Health OR PARA320 Paramedic Theory and Practice: Population Variances

Incompatible

PARA328 Paramedicine and Complex Care

Unit rationale, description and aim

Given the contemporary demographic and epidemiological health trends worldwide, a paramedic must be well versed in assisting diverse and vulnerable people with complex needs, navigating the health care system and making independent, culturally safe and and multidisciplinary decisions. Underpinned by understanding of health determinants, body systems, evidence-based practice, as well as skills in clinical decision making and emotional intelligence, this clinical capstone unit utilises students existing knowledge and skills to further broaden the ability to evaluate practice, differentiate diagnoses, identify risk, apply sophisticated people-centred care in dynamic environments, and refer patients to appropriate health care pathways. Centered around the intersection of emergency care, community paramedicine and the developing work environments of paramedics, students will have the opportunity to build and consolidate these concepts and skills through exploring and solving complex clinical problems in case-based workshops and apply these in the practical learning and clinical placement environment. 

The aim of this unit is to impart high level knowledge and skills in advanced clinical decision making, collaborating with multidisciplinary team, working in dynamic environments, and provide wholistic health care, all within the context of paramedicine. This will establish students as a flexible and desirable practitioner for the modern and future health care system. 

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate appropriate clinical assessments and therapeutic, social, cultural and cognitive skills that are required to provide care for individuals affected by complex health aetiologies in dynamic environments (GA5, GA10)

LO2 - Create a people-centred care plan that is underpinned by an interdependent paramedic clinical reasoning framework, clinical assessments, the health care system, cultural awareness, therapeutic, social and cultural skills to assist those affected by complex health aetiologies while respecting the individual’s and their community’s wishes (GA3, GA4, GA5, GA6, GA8)

LO3 - Evaluate clinical decisions and ability to provide independent and interdependent compassionate care for complex aetiologies in dynamic environments (GA1, GA2, GA3, GA4, GA5, GA6, GA7)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA10 - utilise information and communication and other relevant technologies effectively.

Professional Capabilities for a Registered Paramedic

The Paramedicine Board of Australia is responsible for assessing, consulting on and setting the standards for paramedics practicing in Australia. These standards and relevant domains are articulated in the Professional Capabilities for a Registered Paramedic document. The learning outcomes of this unit are matched to the relevant capabilities, in order to align your development with the requirements of a paramedic. 

National Safety and Quality Health Service Standards (Second Edition)

The Australian Commission on Safety and Quality in Health Care Standards developed in this unit are:

Content

Topics will include:

Special Populations and Complex Care

• People with:
• Disabilities
• Chronic illness, including paediatrics
• Chronic mental health
• Co-morbidities
• Oncology complications
• Frequent re-presenting populations to health care services
• Cultural and linguistic diversity
• Palliative care and dying
• Palliative care approach
• Culturally safe practice and Australian First Peoples’ knowings and perspectives 
• Passive and active euthanasia
• Children and infants
• Caring for and maintaining dignity of the deceased and their family/community including cultural and ritual considerations

 Applied Models of Practice

• Paramedicine and connecting care:
• Salutogenesis
• Primary health care
• Extended Care Paramedicine
• Interprofessional education and applied interdisciplinary approach 
• Embedding referral pathways
• Extended consultations
• Technology
• Post-discharge care
• Preventing hospital admissions

 Environments

• Metropolitan
• Rural
• Digital
• Developing paramedic work environments

For the complex health aetiologies, students will integrate and apply the relevant concepts and skills of:

Approaches and Reasoning

• People-centred culturally safe care for complex health;
• Legal and ethical principles;
• Cultural Perspectives;
• Indigenous and First People’s perspectives;
• Advanced clinical decision making and reasoning;
• Advanced focused clinical and biopsychosocial assessments;
• Relating pathophysiology to presentations;
• Differential diagnosis;
• Advanced risks assessment;
• Acuity;

 Applying Care

• Advanced development and application of advanced management and care principles;
• Advanced therapeutic and social skills;
• Applied pharmacotherapy;
• Interdisciplinary and team-based care;
• Technology;
• Health care and referral pathways;

Experiences and Outcomes

• The individual’s experience of complex health and interactions with health care, and;
• Debrief, reflection and evaluation.

Learning and teaching strategy and rationale

PARA327 Paramedicine in Practice: Complex Care provides teaching and learning strategies that engage students with materials, concepts and experiences that will support achievement of the aims and objectives of the Unit as well as relevant Graduate Attributes and professional capabilities.

As a capstone clinical unit, PARA327 extends student's skills of becoming both an independent and social learner. Delivery methods will be multi-modal and comprised of virtual/online environments and face to face workshops.

Online learning will assist students in acquiring the fundamental theoretical concepts necessary for paramedicine. The information, delivery and exercises will be constructed in digestible portions which will allow for ease of understanding, flexibility and respect for individual learning styles. As students begin to apply the concepts in the subsequent workshops and practical laboratories, it is expected that they will have completed the online learnings before attending the face-to-face component. 

The workshops will allow the use of fundamental concepts acquired from online learning, apply analytical thinking, and engage in discussion and group work so students can begin to solve the case-based challenges posed. These challenges are designed with a real-world focus to apply knowledge to relevant clinical contexts. As students progress through the cycle of theory to practice, the online learning and workshops will have a direct relationship to practical classes. 

Practical classes will allow students to experiment with concepts developed during throughout the unit. Cases and management plans discussed and created in workshops will be further explored and refined by providing the opportunity to develop and enact skills, paramedic clinical decision making, communication strategies and attributes of teamwork. Varying levels of realism will engage students senses to advance psychomotor, emotional, social and cognitive skills. Within the practical class environment, methods of learning may include skills stations, role-play, facilitated scenarios and simulations, peer-to-peer learning, audio and visual practice recordings analysis, and/or structured feedback and debriefs. 

As the practice of paramedicine relies heavily on social interaction and cooperation, it is expected that students will emulate this within the learning environments.

To extend learning, students will have the opportunity to explore and apply knowledge and skills of paramedicine in the real-world environment. Supervised clinical placement will be provided within an appropriate emergency, urgent care, primary health care, simulated or another relevant environment. The supervised and facilitated clinical placement provides a safe environment where students can provide people centred care which is essential for successful practice within paramedicine. Clinical placement experiences will enable to reflect on practice and the principles of paramedicine.

It is expected that students will undertake a total 150 hours of study for this unit. The hours will comprise of the face-to-face methods, online learning and self-directed study in which students will engage with a range of online resources, readings, and prepare for and/or undertake assessments.

Assessment strategy and rationale

A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes, attain the graduate attributes and the meet professional capabilities required in paramedicine. With the ethos that assessments support and guide learning, students will see a direct relationship between each task and their development.

The practice portfolio will enable students to demonstrate practice throughout the unit. Authentic tasks and requirements within the practice portfolio with be targeted to the learning outcomes of the unit and their stage of development. The practice portfolio will provide a strong foundation to further integrate skills into a paramedic-decision making framework and application within the clinical environment.

The clinical logbook allows an opportunity for students to document clinical placement experience, receive feedback and develop good record management skills. This is imperative to achieve as a registered paramedic. Furthermore, reflection is a cornerstone attribute of a health professional. Thus, the associated reflection gives students the opportunity to reflect and subsequently develop application of decision-making skills, therapeutic skills, culturally safe practice and professionalism within a real-world environment. 

The Objective Structured Clinical Examination (OSCE) is considered important component within the paramedicine profession. It contributes to learning by providing the opportunity to apply theory, demonstrate skills in an isolated manner and or integrated within decision-making framework and practice. It aims to emulate real-world clinical presentations and problems where students will be tasked with providing solutions and care for. The OSCE allows for quick feedback on stage of development and competencies, which will assist with future clinical practice.

Given the nature of paramedicine and its associated risks, it is pertinent that students can demonstrate that they are fit and safe to practice within in the clinical practice environment. Thus, passing all three assessments in this unit are a hurdle requirement. These hurdles assess knowledge that is essential to the unit of study that students cannot progress in the course without. 

Overview of assessments

Representative texts and references

Bryant, B., & Knights, K. (2015). Pharmacology for health professionals (5th ed). Chatswood, NSW: Elsevier Australia.

Bullock, S., & Hales, M., (2018) Principles of Pathophysiology (2nd ed.). Melbourne, VIC: Pearson Australia.

Curtis, K., & Ramsden, C. (2019). Emergency and trauma care for nurses and paramedics (3rd ed.). Chatswood, NSW: Elsevier Australia.

Hall, J.E., (2015). Guyton And Hall Textbook of Medical Physiology. (13th ed.). Chatswood, NSW: Elsevier. Philadelphia, PA: Elsevier.

Talley, N.J. & O’Connor, S. (2018). Talley & O’Connor’s Clinical Examination. (8th ed.). Volumes 1 and 2. Chatswood, NSW: Elsevier.

Tortora, G., & Derrickson, B. (2016). Principles of anatomy and physiology (15th ed). Hoboken, NJ: Wiley and Sons.

Townsend, R., & Luck, M. (2019). Applied paramedic law and ethics (2nd ed.). Australia and New Zealand. Sydney: Elsevier.