PMEDPRA20 Clinical Studies B, Placement in Primary- and Specialist Health Care Services Course description

The course comprises clinical studies in relevant locations in the primary and specialist health services and aims to provide students with both breadth and in-depth competence. The students’ role will be to observe and participate in diagnostic work and therapeutic interventions. Knowledge, skills and methods acquired must be adapted to patients with issues of different complexity and degree of seriousness.

The learning outcomes build on earlier courses. The learning outcomes are actualised, integrated and acquired in clinical situations and form the basis for the development of clinical competence. The student must acquire knowledge, skills and attitudes that are necessary to solve tasks and challenges in clinical practice placement.

The student must have passed the first and second year of the programme or equivalent, with the exception of the courses PMED1050, PMED1060 and PMED1070.

After completing the course, the student should have the following learning outcomes defined in terms of knowledge, skills and general competence:

Knowledge

The student

• can describe the organisation of and interaction between the primary and specialist health services and explain the most important functions of the municipal emergency medical centres, emergency department and municipal emergency inpatient units
• can describe how the primary and specialist health services attend to the needs of particular groups, such as children, elderly people, pregnant/women in labour, persons with disabilities, people who are victims of violence and/or sexual abuse, persons with substance abuse problems and mental illness
• can describe how emergency medical centres, emergency department, emergency psychiatric service and maternity wards interact with other parts of the health service
• can explain patients’ rights in connection with assessment and the responsibility of the primary and specialist health services for handling acutely ill and injured patients
• can explain typical patient care pathways from arrival to the emergency medical centre/emergency department to discharge/arrival to ward
• can explain the principles for triage (prioritised levels of urgency) for patients who contact a municipal emergency medical centre or an emergency department
• can discuss how the different practice placement locations apply the principle of necessity, self-defence, the duty of disclosure and reporting to the police and the child welfare service
• can describe the most important observations, complications and interventions in connection with childbirth
• can explain the principles for sterile and non-sterile procedures and is familiar with the practice placements standard operating procedures for handling clean and unclean equipment
• is familiar with the most important principles of blood sampling and common diagnostic tests
• can explain how the practice placement uses digital solutions and medical-technical equipment, and how that impacts patient safety
• can describe how paramedics contribute to preventive and health promoting work
• can describe important principles for good inter-professional teamwork and a good working environment
• can describe relevant clinical guidelines for walk-in clinics and emergency departments
• knows the use and usefulness of a blood gas analysis

Skills

The student

• can perform basic wound care and assist in suturing
• can place, manage and remove a permanent transurethral catheter, and perform sterile intermittent catherisation and clean intermittent catherisation
• can maintain relevant precautions for contact and droplet infection and is familiar with precautions for airborne infection
• can carry out basic patient reception routines in accordance with updated knowledge, applicable laws and ethical principles
• can assist in a systematic primary and secondary survey of patients, establish monitoring, and contribute to diagnostic and therapeutic interventions
• can carry out systematic primary and secondary survey of patients, start necessary monitoring and recommend actions for further treatment
• can hand over patients to partners in a satisfactory manner in accordance with requirements for information and documentation
• can assist health care workers´ in receiving patients at risk of suicide, in mental health crisis and/or with substance abuse issues
• can communicate their own assessments to cooperating staff in a clear and structured manner
• can take care of patient and their next of kin, and give advice and information adapted to their needs
• can administer medication in accordance with local guidelines
• masters bag-mask ventilation and ables to contribute in a multidisciplinary team in the delivery of advanced airway interventions
• can recognise and handle a normal birth

General competence

The student

• can disseminate knowledge about primary and specialist health services
• can identify and handle professional and ethical dilemmas that arise in the paramedic’s work at the interface between health services´
• can discuss safeguarding of patients’ rights independently of gender, age, culture, language and ethnicity when working in the primary and specialist health services
• can reflect on how health care workers assess and treat patients with complex issues
• can deliver medical help in accordance with their own competence and limitations
• can reflect on how stress and crisis reactions in patients and next of kin influence communication and interaction in emergency medical situations

Work and teaching methods consist of clinical training, simulation and skills training, preparatory teaching for clinical training, seminars, work on the clinical training document, writing of reflection notes, and participation in reflection groups.

The course is taught over approx. 14 weeks and comprises clinical studies in different parts of the primary and specialist health services. The training establishments are:

• emergency medical centres
• emergency departments
• substance abuse and psychiatric services
• maternity wards
• anaesthesia departments

The content of the placement periods will vary with the activities at the practice placement locations and will therefore offer varied arenas for clinical exposure in terms of scenarios and complexity. Parts of the clinical studies can be replaced by simulation and skills training, if this provides a better learning outcome.

To document activity and achievement of the learning outcomes, the students must fill in a dedicated clinical training document together with staff at the practice placement location. The document is a tool to promote learning activities and to document attendance and achievement of different learning outcomes.

In addition to clinical activities, the students work on an individual reflection note. One written piece of feedback will be provided on the note, provided that the student submits it within the stipulated deadline.

The following required coursework must be approved before a student can take the exam:

• Submission of completed and signed clinical training documents
• Minimum attendance of 90% in clinical training, reflection groups, preparatory teaching for clinical training, simulation and skills training, and seminars
• An individual reflection note of 1,500 words (+/- 10%)

Practical-oral examination in groups of three to four students, based on an assigned problem statement, approximately 30 minutes.

The examination is conducted as a seminar in which all students are expected to participate.

Examination groups are given an assigned problem statement involving a clinical skill about two weeks before the examination. Based on this problem statement, the groups are required to deliver 20 minutes of theoretical instruction and practical demonstration of the skill. Other students in the cohort and examiners will be the recipients of the teaching session. After the instruction, there is a period of up to 10 minutes for oral questions from the examiners. The examination group is normally assigned a collective grade. In special circumstances, individual grades may be assigned.

All aids are permitted. The rules for source referencing must be followed.

Pass/fail.

All answers are assessed by two examiners. An external examiner is used regularly, at a minimum of every third completion of the course. When selecting answers for external evaluation, a minimum of 10 percent of the answers shall be included, with no fewer than 5 answers. The external examiner’s assessment of the selected answers shall benefit all students.

None.