Sub-Section 3-490-48 - Paramedic Academy Clinical Requirements

CMH EMS Education Manual

Definitions

Clinical experience is defined as a planned and scheduled educational student experience with live patient contact activities in settings, such as hospitals, clinics, free-standing emergency centers, and may include field experience.

Field experience is defined as planned and scheduled educational student time spent on an EMS unit, which may include observation and skill development, but which does not include team leading and does not contribute to the CoAEMSP definition of field internship.

Field internship is defined as planned and scheduled educational student time on an ALS EMS unit responsible for responding to critical and emergent patients who access the emergency medical system to develop and evaluate team leading skills. The primary purpose of field internship is a capstone experience managing the Paramedic-level decision-making associated with prehospital patients.

Eligibility

To be eligible to attend clinical rotations, the student must maintain passing status (min 70% overall grade) in the Paramedic Academy. Urine drug screen may be required prior to starting clinicals. CMH Lab will be used for these drug screens. Administrative contact for CMH Lab is Paulette Ivey.

Staff Substitutions

At no time may a paramedic student be substituted for EMT or paramedic staff. If the paramedic student is also an employee of the clinical site:

General Requirements

Students are required to participate and be eligible to participate at all clinical sites without exception. Students must also comply with the facilities’ policies and procedures. CMH is not obligated to locate an additional clinical site to accommodate a student for any reason.

Courses with a clinical component require mastery of the clinical objectives in order to successfully complete the course. The clinical component of any course is an integral portion of that course. Clinical experiences are graded on a pass/fail basis. If a student fails in clinical, he or she will fail the course. Students will be sent home from the clinical setting for unsafe or unprofessional behavior and may be grounds from dismissal from the course.

Inability to Encounter Live Patients

If the minimum number of patient contacts and skills listed for each clinical requirement is not completed by the end of the minimum hours required, additional hours must be scheduled to meet the contact requirements.

In the event a student is unable to obtain the minimum number of live patient encounters or skill competence, he or she should request in writing for an evaluation and alternative action plan. The deficiency will be evaluated on a case-by-case basis to develop an action plan that may include (but not limited to):

• Termination from the program,
• Extension of deadlines, and/or
• Alternative methods to demonstrate competence in scenario-based high-fidelity simulations. Simulations will replace live encounters on a 1:1 ratio basis with the following exceptions:
• At least two pediatric live encounters must be done on live pediatric humans and may not be simulated.
• All required team leads in Sub-Section 3.490.70 - EMS 536 (Paramedicine Field Internship) Course must be done on humans and may not be simulated.

Scope

If, at any time during a clinical rotation, a student is asked to perform outside his/her scope of training or has not been approved by the lead instructor, that student shall immediately tell the requestor that they are not trained for that procedure and are not allowed to do it. Clinical skills are approved by the lead instructor once the student has shown proficiency in a laboratory setting.

Identification

All students will be required to wear a CMH-issued ID badge during all classroom, skills, and clinical rotations. The name badge shall be returned upon course completion (or having dropped the course). Students will assume replacement cost if their name badge is lost, mutilated, or destroyed. Replacement cost will be $10 each.

Documentation

Platinum Planner will be used to document and track skills, labs, scenarios, simulations, and clinical contacts. Documentation is the responsibility of the student. The patient medical record number must be documented with the skills performed. If the medical record number is not included, the patient encounter and skills associated will be returned to the student and will not count until the medical record number is attached. If, during spot checks and subsequent investigation, a falsification is found, disciplinary action will be taken and may include termination from the program.

When documenting live patient contacts and skills in Platinum Planner, the first line in the narrative must contain a medical record number trackable to the patient. This could be a hospital number off a face sheet or an EMS run number. Spot checks will be done to ensure accurate documentation.

Clinical Double-Dipping Policy

When documenting skills, you may document as many skills on the same patient as you actually perform (i.e. medication administration), however, patient assessments may only be documented once per patient per patient visit. If you assess the same patient on different shifts, both assessments may be counted. If the patient leaves and returns for a second visit (or calls 911 a second time while riding the ambulance), both assessments and both team leads (if applicable) may be documented.

Clinical Skill Requirements

Double-asterisks (**) with a green background in the table indicate these requirements are typically extremely difficult to obtain on live humans. Special high-fidelity simulations will be scheduled during lab time to obtain these skills.

The table below meets or exceeds CoAEMSP Student Minimum Competencies (Table 1).

The table below meets or exceeds CoAEMSP Student Minimum Competencies (Table 2).

The table below meets or exceeds CoAEMSP Student Minimum Competencies (Table 3).

The table below meets or exceeds CoAEMSP Student Minimum Competencies (Table 4).

CMH EMS Education Mission: "Provide state-of-the-art education to develop and support a team of exceptional emergency medical professionals."

CMH EMS Education Manual is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Based on a work at http://ozarksems.com/edman-4-240.php.