Postgraduate Education in Intellectual Disabilities, Mental Health and Quality Improvement in Practice Programme description

Programplanen for videreutdanning i utviklingshemming, psykisk helse og kvalitetsforbedring i praksis er utarbeidet i samarbeid med Oslo universitetssykehus, Regional seksjon psykiatri, utviklingshemming/autisme, PUA, KPHA, og Nasjonal kompetansetjeneste for utviklingshemming og psykisk helse, NKUP.

Formålet med studiet er å utdanne brukerorienterte og reflekterte yrkesutøvere som har kunnskap om og kompetanse til å bidra til god psykisk helse for personer med utviklingshemming. De skal kunne identifisere lidelser/sykdom slik at personer med utviklingshemming får tilbud om behandling, samtidig som de skal kunne inngå i et helhetlig og tverrfaglig tilbud tilpasset den enkelte bruker.

Nasjonale og internasjonale studier viser at personer med utviklingshemming er mer sårbare for å utvikle psykisk lidelse og atferdsforstyrrelse enn befolkningen generelt. Likevel er personer med utviklingshemming og psykisk lidelse underrepresentert når det gjelder utredning, behandling, forskning og faglig oppmerksomhet både i Norge og internasjonalt. Personer med utviklingshemming er heller ikke en særlig påaktet gruppe i forbindelse med nasjonale satsninger på bedring av psykisk helse i befolkningen. Mangel på kunnskap hos tjenesteytere både i de kommunale tjenestene og i spesialisthelsetjenesten, kan blant annet medføre at symptomer på psykisk lidelse misoppfattes og tilskrives personens funksjonshemming. Dette er en viktig del av forklaringen på underrapportering og underdiagnostisering av psykisk lidelse blant mennesker med utviklingshemming.

Psykisk lidelse og utviklingshemming generelt har blitt mer fokusert i løpet av de siste tiårene. I dag er det enighet om at mennesker med utviklingshemming utvikler de samme psykiske lidelsene som andre. En gruppe pasienter som er særlig sårbar for å utvikle store og sammensatte vansker ved psykisk lidelse, er personer med utviklingshemming og neuropsykiatriske tilleggstilstander som autismespektrumforstyrrelser (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourettes syndrom etc. Spesielt personer med ASD vil ofte utvikle omfattende vansker forbundet med psykisk lidelse. Disse vanskene kan gi seg utslag i såkalt utfordrende atferd. Slik atferd har tradisjonelt blitt sett på som problematferd og ikke som symptom på psykiske vansker. Det er derfor et stort behov at fagpersoner som har kontakt med personer med utviklingshemming og tilleggsvansker, er i stand til å gjenkjenne tegn på psykiske vansker og samhandle terapeutisk med den enkelte bruker.

Relevans for arbeidsliv

Etter endt utdanning vil kandidatene ha gode forutsetninger for å følge opp brukere med sammensatte vansker ved utviklingshemming og psykisk lidelse. De vil kunne identifisere symptomer og kartlegge utfordringer. Videre vil de kunne bidra i klinisk omsorg og terapeutisk virksomhet. Kandidatene vil dessuten kunne anvende lovverk som regulerer tjenestene og kjenne til hvordan disse tjenestene innen psykisk helsevern organiseres.

I de kommunale, hjemmebaserte tjenestene som yter bistand og helsetjenester til mennesker med utviklingshemming er det stort behov for kompetent oppfølging, noe som mangler i kommunene. Kandidatene vil kunne veilede kollegaer i, delta i faglig forbedringsarbeid og inngå i tverrprofesjonelle team. Det planlagte utdanningstilbudet vil derfor imøtekomme et etterspurt behov i landets mange kommuner.

Relevans for videre utdanning

Studiet er kunnskapsbasert og bygger på forskning, erfaringsbasert kunnskap, brukerkunnskap og brukermedvirkning, som er i tråd med samfunnets krav. Gjennom utdanningen stilles det økende krav til refleksjonsnivå og utvikling av analytisk holdning og vurdering. Studentene tilegner seg kompetanse slik at de kritisk kan vurdere teoretisk kunnskap, erfaringer og egne handlinger.

Utdanningen ligger på bachelornivå, og planen for studiet bygger på Lov om universiteter og høyskoler og forskrift om studier og eksamen ved OsloMet - storbyuniversitetet.

Everyone who wishes to take a bachelor’s degree in paramedic science in order to practise as a paramedic, or as the starting point for further studies.

In accordance with the Regulations concerning Admission to Higher Education, the admission requirements are Higher Education Entrance Qualification or prior learning and work experience. Candidates must also have:

• a Class B driving licence, acquired on 1 March in the year of admission at the latest
• passed the physical admission test, including a self-declaration on swimming ability

Applicants who accept an offer of a place on the programme must also submit a transcript of police records, cf. the Regulations concerning Admission to Higher Education.

Students will acquire a certificate of competence for driving emergency vehicles in the course of the programme. Applicants are therefore responsible for clarifying whether they meet the medical requirements for a class D driving licence.

In accordance with the Section 12-8 of Act relating to Universities and University Colleges, the use of headwear that covers the head or the face is prohibited both in connection with teaching and in exam situations. This also applies to students on clinical placements.

After completing the Bachelor’s Degree Programme in Paramedic Science, the candidate should have the following overall learning outcomes defined in terms of knowledge, skills and general competence:

Knowledge

The candidate

• has broad knowledge of human anatomy, physiology and pathophysiological processes, and responses to illness and injury
• has broad knowledge about clinical examination, tentative diagnostics and medical and non-medical treatment of women in labour, acutely ill and injured patients, and people with mental health disorders and/or addiction problems
• has broad knowledge of pharmacology relating to the paramedic’s function and areas of responsibility
• has broad knowledge of relevant laws, regulations and ethical perspectives and can reflect on these in their professional practice
• has knowledge of injury mechanisms, structure of joint emergency interoperability, management and risk assessment in connection with work in the ambulance service and in the Norwegian overall protection organisation
• is familiar with the ambulance services’ place in the emergency and health services, the discipline’s history, traditions, distinctive nature and social responsibility
• has knowledge about patient safety, communication with patients and next of kin, and interaction across disciplines, cultures, with minority language speakers and enterprises and levels in the health service
• is familiar with research and development work in the discipline and has a basic understanding of evidence-based practice, including research ethics, research design and methods for collecting and analysing materials
• has knowledge about microbiology, infectious agents, infection risk and measures to prevent infection

Skills

The candidate

• can identify, observe and assess symptoms and signs of illness and injury, mental health disorders and substance abuse and provide medical and non-medical treatment in a responsible manner
• can, based on own examinations and assessments, refer the patient to the best effective level of care
• can drive an emergency vehicle in accordance with the applicable guidelines
• can work at, and take charge of, the response at an accident in cooperation with own personnel and other emergency services
• can recognise, document and report signs of neglect and abuse, with particular focus on children, elderly people and vulnerable individuals
• can carry out independent work in line with principles for health promotion and preventive work and in accordance with general hygiene and infection procedures
• can reflect on their own professional practice in accordance with relevant laws, guidelines and user participation, and search out and receive guidance with regard to their own conduct and professional practice
• can handle birth outside of hospital, including taking care of the mother and the new-born baby
• can use medical emergency equipment and communication tools and assess the usefulness of digital tools
• can document own practice with focus on comprehensive health services, including record-keeping, non-conformity reports, reporting adverse events and statutory notification of other authorities

General competence

The candidate

• is familiar with the health service’s role in emergency preparedness, and can contribute to preventive preparedness work, evaluation and follow-up after incidents and exercises
• is familiar with new thinking and innovation processes that are relevant for the paramedic discipline and can actively contribute in the development of the discipline and the paramedic’s role in society
• can apply and reflect on the connection between public health, social inequality, work inclusion, a good working environment and equitable health services, and see this in connection with ethical and discipline-related issues
• can plan and carry out projects that take place over time, work independently, in teams and across disciplines, to acquire skills and contribute to improved patient safety and the provision of comprehensive health services
• can exchange points of view related to key subject matter, orally and in writing, facilitate learning through simulation and skills training and thereby contribute to good practice

The programme’s learning outcomes cover a broad spectrum. The work and teaching methods facilitate the integration of knowledge, skills and general competence and are designed to have the greatest possible transfer value to professional practice. Emphasis is therefore placed on using a variety of work methods and alternating between theoretical studies and clinical training.

The aim of the paramedic science programme is to educate independent, proactive and dynamic candidates that can handle social change and cultural diversity. For the same reason, emphasis is placed not only on the content, but also on the learning process itself, in which students develop their ability to make independent assessments based on critical reflection and interaction with patients, next of kin and colleagues, which are key skills. Good learning outcomes are first and foremost dependent on the students’ own efforts. Own effort means both benefiting from teaching and academic supervision and following this up with independent work in the form of theoretical studies and practical skills training. Normal study progress requires students to make great personal efforts in the form of study groups and individual work.

Different types of digital technology are used in the programme to stimulate student-active learning and collaboration. These resources can be used in students’ preparations for teaching activities, as support in collaborative processes or to help practise or test the student’s own knowledge.

The students will receive follow-up throughout the programme in the form of supervision and feedback. The students will at times assess each other’s work and provide feedback to each other.

More detailed descriptions of the most common work and teaching methods used in the programme are provided below. The individual course descriptions state which work methods each course employs.

Independent work

A paramedic must be able to make independent assessments and decisions, and stand by them, based on interaction with patients, next of kin and colleagues. Some of the thematic areas will not be addressed in the organised teaching. Students are expected to acquire this knowledge through self-study, alone or in cooperation with fellow students in study groups.

Study groups

In the theoretical part of the programme, the students will be split into group of up to seven. The groups are assigned a lecturer as supervisor. Working with issues and assignments in cooperation with other students is intended to support the learning of subject matter and provide training in cooperation and interaction skills, which are necessary in professional practice. Group supervision is also used to show the connection between the organisation of the programme and future professional practice and is intended to facilitate planning and evaluation of individual students’ and the study group’s learning process. Getting the study groups to work effectively is both a learning tool and a learning goal.

Simulation and skills training

Simulation and skills training is integrated in almost all courses and makes up a key part of the programme. The students will acquire skills through practical training with medical emergency equipment, models, manikins and on each other. Skills are placed in context through scenarios, which should be handled either by simple role play or through complex simulations. Students develop their observer and paramedic role through supervision and teaching that promotes reflection on their own professional practice. The professional field is closely linked to simulation and skills training in that a range of active paramedics contribute as teachers. This creates a close connection between the training and day-to-day clinical work.

Lectures

Lectures are mainly used to introduce new material and to provide an overview. Highlighting main elements, shedding light on connections and pointing out relevant issues within a topic will form the basis for the students’ own learning.

Seminars

The purpose of seminars is to process subject matter and facilitate discussion between students and teaching staff. Oral dissemination is emphasised. The students shall be given an opportunity to practise their academic formulation and presentation skills. They are encouraged to express their own opinions and reflect on their own actions and attitudes.

Written assignments and bachelor’s thesis

Through written assignments and the bachelor’s thesis, students will formulate research questions for assignments and work on them over time, either individually or in cooperation with other students. They will learn theory and develop skills in using and referencing sources, analysis, discussion and written and oral communication. The primary purpose of this is to develop their ability to reflect critically and search for relevant research knowledge, and their ability to work in an evidence-based manner.

Clinical practice placement makes up about one-third of the programme and is divided into periods of placement in the ambulance service and in different parts of the primary and specialist health services.

The placement periods are intended to give students competence in integrating theoretical and evidence-based knowledge with clinical understanding. In clinical situations, the students also learn about patients’ and next of kin’s user knowledge. Clinical training is an important qualification arena for developing clinical competence. Students will continuously alternate between theoretical in-depth studies, simulation and skills training at the university and clinical training in the field of practice in order to develop clinical competence.

Practice placement arenas for this programme are mainly located in Oslo and Eastern Norway. The students may need to commute to and from the location of the practice placement. Students must comply with the practice placements guidelines for work clothing. Special requirements for tests or vaccination may be applicable at some practice placements institutions.

Clinical training

The practical part of the programme totals 37 weeks. The majority of these, 24 weeks, are made up of supervised clinical training in the ambulance service. The remaining 13 weeks are spent in different places in the primary and specialist health services.

Placement in the ambulance service

The clinical training is split into two courses in the second (16 weeks) and third (8 weeks) years of the programme. This training is supervised, which means that a supervisor from the ambulance service follows up the student throughout the training period. This is carried out in cooperation with a contact lecturer from the university. Separate training documents have been drawn up for the placement periods. The learning outcomes from the course descriptions are specified in these documents. The document is intended as a tool for the student and supervisor to actively link the clinical training to the learning outcomes, and to document the student’s progress. This is used as a basis for assessment in cooperation with the contact lecturer from the university.

Clinical training in the primary and specialist health services

This training is spread over approximately thirteen weeks in the fifth semester. The aim is for the student to gain increased understanding and experience with patient care pathways in other parts of the medical emergency chain in primary and specialist health services. Relevant training establishments can include municipal health services, somatic and psychiatric hospital departments, specialised hospital departments, substance abuse care, mobile teams, and private actors. In addition to the training itself, the course consists of seminars, simulation and skills training, teaching, writing reflection notes, and working in study and reflection groups. Parts of the clinical training can be replaced by simulation and skills training at OsloMet if this provides a better opportunity to ensure that learning outcomes are achieved.

The student will be taken care of and guided by different health personnel at the various training establishments. To ensure continuity, students will have regular contact with a university teacher throughout the training period. The final competence will be assessed in a concluding exam seminar with a practical-oral group exam.

Critical incidents

There is a relatively high possibility that the students will experience particular demanding and serious incidents during the placement periods. Measures have therefore been taken to protect the individual students by established peer support schemes. The students must therefore sign a consent form at the start of the programme confirming that they have been informed of the above. It is the students’ independent responsibility to contact the peer support scheme as needed to process critical incidents. If necessary, the student will be referred to the Student Welfare Organisation’s health service.

Certificate of competence for driving emergency vehicles

Students must pass both a theoretical and a practical test in driving emergency vehicles in order to complete the paramedic programme. The students must meet the requirements stipulated in Section 6 of the Emergency Vehicle Regulations before they can start the training. Among other things, this means that the students must a) document in the form of a medical certificate that they meet the medical requirements for a category 3 driving licence, b) have reached 20 years of age, and c) have held a class B driving licence continuously for the past two years.

During the second and third years of the programme, the students receive theoretical and practical training in groups. All students in the year group must have taken the theoretical and practical tests before completing the course PMEDPRA30 in the sixth semester.

The tests are organised and assessed by the Norwegian Public Roads Administration. OsloMet will cover the costs related to the theoretical and practical tests up to three times. Students must pay for any further attempts. In order for OsloMet to issue the diploma, the theoretical and practical test must be passed within one year after the student has attempted the test for the third time.

For more information about the training requirements and the practical and theoretical tests in emergency vehicle driving, reference is made to the regulations relating to training, testing and competence in driving emergency vehicles (the emergency vehicle regulations – in Norwegian only).

Increasing globalisation of the labour market and rapid social changes make it increasingly more important to have international professional experience, language and cultural knowledge. Internationalisation contributes to raising the quality of education and strengthens the academic community on the programme, at the same time as it prepares the students to become global citizens and acquiring new perspectives.

The programme’s focus on multicultural and global issues prepares the students for professional work in a multicultural society. International specialist literature is used extensively in the programme, which gives students access to English specialist terminology and relevant knowledge about current international trends.

Internationalisation takes place through activities on the home campus and through exchange programmes between students and staff at OsloMet and foreign educational institutions.

OsloMet has exchange agreements in place with universities and university colleges in Europe. Exchanges may be relevant:

• in the fourth semester, in connection with the course PMED2110 Mental Health, Substance Abuse and Communication (20 credits).
• in the sixth semester, in connection with the course PMEDPRA30 Clinical Studies C, Placement in the Ambulance Service (10 credits) and PMED3900 Bachelor’s Thesis (15 credits).

Students can only go on an exchange if the partner institution offers courses in subject areas corresponding to those covered at OsloMet in the semester the exchange applies to.

The institution will also receive students from foreign educational institutions in the spring semester. Incoming students may for example take the following course combinations:

• PMED3010 Assessment and Treatment of Sick and Injured Patients, Part 2 (15 credits) and PMED3900 Bachelor Thesis (15 credits)
• PMED1410 Assessment and Treatment of Sick and Injured Patients, Part 1 (25 credits)

It may also be relevant to offer these courses in combination with courses related to other study programmes at the Faculty of Health Sciences.

Nordplus has also established cooperation through the Nordparamedics network, in which student exchanges of up to two weeks are possible in the sixth semester. Reference is otherwise made to the criteria that apply to student exchanges and the information about stays abroad.

The courses PMED1410 Assessment and Treatment of Sick and Injured Patients, Part 1 and PMED3010 Assessment and Treatment of Sick and Injured Patients, Part 2 will normally be taught in English. Other courses may also be offered in English for international students as needed. The students can decide whether to write their bachelor’s thesis in English or Norwegian. Students who go on exchanges must write their thesis in English if the exchange is in a country outside Scandinavia.

Required coursework means all forms of work, tests and compulsory attendance that are requirements for a student to be assessed/permitted to take the exam or complete periods of clinical training. Required coursework is assessed as approved/not approved. The coursework requirements for each course are described in the respective course descriptions.

The purpose of the coursework requirements is to:

• promote progress and academic development in the programme
• encourage students to seek out and acquire new knowledge

The programme’s main coursework requirements are in the form of compulsory attendance, written assignments and practical tests.

Compulsory attendance

The study programme emphasises a social learning environment with student-active learning methods. The students are expected to attend scheduled teaching in order to foster knowledge, skills, suitability and clinical competence. Attendance is compulsory in areas that are important to the competence of a paramedic, and where the student cannot acquire knowledge and skills through self-study alone.

The minimum attendance requirement is:

• 90% compulsory attendance in all simulation and skills training
• 90% compulsory attendance in all forms clinical practice placements
• 80% attendance at seminars and study groups

Other activities may also be subject to compulsory attendance requirements. Teaching activities that require attendance will be marked as mandatory in the student’s timetable.

Students are responsible for ensuring that they meet the attendance requirements. If a student exceeds the limit for absence, the person responsible for the course will consider whether it is possible to compensate for absence by meeting alternative requirements, for example individual written assignments. Whether or not it is possible depends on the extent of the student’s absence and which activities he/she has missed. Absence from compulsory teaching activities that cannot be compensated for may lead to delayed progress in the programme.

Separate regulations on attendance apply to placement in the ambulance service. For more information, see ‘Assessment of placement in the ambulance service’ below.

Written assignments

Several courses include compulsory written assignments. Written work that is not approved must be reworked before re-submission. If the work is not approved on re-submission, the student cannot take the ordinary exam/assessment. Students are entitled to a third attempt before the resit/rescheduled exam. If a piece of required coursework is not approved, this may lead to delayed progress in the programme.

Separate regulation apply to written coursework requirements related to placement in the ambulance service; see the course descriptions for PMEDPRA10 and PMEDPRA30 for more information.

More detailed requirements for written work, deadlines etc. are set out in the teaching plan for the course in question.

Practical tests

Practical skills that are important for professional practice are tested in practical tests. If a student’s practical test is assessed as ‘not approved’, he/she will be given another attempt before the ordinary exam. The student cannot sit the ordinary exam if the practical test is not approved after two attempts.

Students are entitled to a third attempt before the resit/rescheduled exam. If a piece of required coursework is not approved, this may lead to delayed progress in the programme.

Separate regulations apply to the practical test related to placement in the ambulance service in the course PMEDPRA30; see the course description for more information.