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Paramedic Psychomotor Skills Manual

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Paramedic Psychomotor Skills Manual GLEMSA/DU Skill Sheet Name ______________________ Introduction This is the Great Lakes EMS Academy / Davenport University Consortium Paramedic ALS Psychomotor Skills Manual. This manual is part of the student’s permanent record. The student will have possession of this book throughout the Paramedic course. The student should try to bring this to class every day and also with them to their various clinical experiences. In 2016, the Great Lakes EMS Academy has changed some of the methods in training, evaluation and documentation of skills training. These changes have occurred to make sure that we are in compliance with the NREMT Paramedic Psychomotor Competencies Portfolio (PPCP). This new portfolio structure will necessitate very involved documentation by the student. Psychomotor skills are an important component of safe and effective out-of-hospital care. Delivery of care, at its most fundamental level, is when and where the importance of EMS is demonstrated to the public. Compassionate care using the complete affective skill set can result in a positive image of EMS and lead to medical and public support for the profession. Psychomotor Skills include the skills lab and scenario lab components. Psychomotor education begins in the skills lab component, where psychomotor learning takes place. The skills lab component is the setting for educational imprinting, cognitive integration, frequent drilling and autonomic development of psychomotor skills. The scenario lab component provides students a contextual opportunity to demonstrate what they have learned in a simulated environment based upon the psychomotor skills established in the skills lab. Once students have demonstrated skill competence in the simulated environment, they progress to assessing and treating real patients in the clinical phase with adequate supervision. The clinical phase in a student’s education includes “planned, scheduled, educational student experience with patient contact activities in settings, such as hospitals, clinics, free-standing emergency centers, and the ambulance.” Generally speaking, we try to teach skills within the first days of class. We follow short discussion on skills with demonstration and then practice…practice…practice. During practice time the students are expected to participate in learner-lead skills practice. Following practice, the student will go through skills evaluation. During evaluation a passing score is determined by how many points the student receives from the skill sheet. The minimal score for successful completion is found on the bottom of each of the skill sheets. Next, we will put the student into scenario-based training at the earliest time possible. Only after the completion of scenario-based training may a student practice that skill in the clinical environment. So, for example, students will learn how to start an IV in the second week of class. They will be practicing the skill on a manikin arm, which is setting on a table. The next week will already be “testing” for that skill. Scenario-based training will be the next step. The student will then be “signed off” in their clinical manual. At that time, the student will be able to start IVs in the clinical environment. Paramedic students are required to successfully test out several times for each of the skills. The opportunity to test will begin within the first few weeks of class. As adult learners we all need to be challenged and see progress. As we are taught and then practice skills, our abilities and confidence increases with experience. Students who fail skills testing will have an opportunity to retest. Students may need to complete remedial training outside of the regularly scheduled time frames for class. At the end of each module, the faculty will be reviewing the student’s practical skill sheets to assure that the student has passed all of the required skills testing. If there is a problem with the student’s documentation for skills evaluation, the student will be required to show competency in that skill (pass a skill station). To be Successful To pass each practical skill, the student must obtain a score that is at least as high as the minimum score designated at the bottom of the skill sheet and must not violate any of the critical criteria (auto fail). The student must physically go through all of the steps on each practical skill in order to sufficiently learn it. Simply repeating what is printed on the practical skill sheet is not sufficient, and the student will fail the examination if he or she does that. The student must demonstrate that he or she is capable of physically performing the practical skill, not simply repeating printed lines of text. Each skill must be practiced several times in order to sufficiently learn it. Simply watching an instructor demonstrate the skill or watching other students practice the skill is not sufficient. The student must physically practice the skill themselves several times in order to sufficiently learn it. “Standard Precautions” is the first step on each practical skill, and failure to take appropriate standard precautions is a critical failure on many practical skills. Therefore, the student should form the habit of always taking standard precautions before every practical skill. Many steps must be performed in a specific manner in order to obtain the corresponding point or to avoid violating critical criteria. Alternatively, many steps can be successfully completed in a variety of manners, and instructors practice different styles of demonstrating these steps. Students are responsible for understanding what constitutes critical criteria and which procedures are open to personal variation in style. Some steps must be performed at specific points during the practical skills while others can be performed at points other than the ones printed on the practical skill sheets. Students are responsible for knowing which procedures must be performed at specific points in the practical skills. The most common reason that the student fails a practical skill is because of anxiety. Stay calm and go through the practical skill at a comfortable pace. If the student forgets what to do next, he or she should remain calm and mentally repeat the steps that he or she has already completed. If the student wishes, he or she is also allowed to physically repeat any steps that he or she has already completed. A huge part of skills training at the Academy is the documentation of that skills training. Pretty much, everything you do during the practical aspect of class needs to be documented on paper and on FISDAP. People do not fail paramedic class because they are not able to start an IV or intubate a manikin. They fail because they are not able to document their performance in the Lab and clinical environment. 2 Skill Sheets This manual is full of skill sheets that we will be using throughout the time that we are training together. We will often use these skill sheets throughout the module and then at the end switch to a NREMT skill sheet. It is important for students to learn the skill sheets. However, when it comes to doing the skill in the field in a dynamic setting with extra pressure, students need to know why they are doing things and be comfortable with the procedure as a whole. Routinely we teach the student a skill then we practice that skill for a week. The following week, we try to test that skill. Then later we incorporate the skill into scenarios and we use an abridge version of the skill sheet to “test” students while they are doing the skill during a scenario. Students should always try to perform skills as though they are being tested at the NREMT. Preparatory Module We include all of the skill sheets that we will start with during the Preparatory module. During this module we will be teaching you several ALS SKILLS: 1. Intravenous (IV) therapy, 2. Establishing an intraosseous (IO) line 3. IM and SQ injections 4. IV Drug Administration 5. Use of A nebulizer for medication administration 6. Use of Nasal Mucosal Atomizer Device (MAD) for Medication administration 7. Use of a glucometer 8. Supraglottic Airways We have several SCENARIO skill sheets that we use during this module. They consist of: 1. Cardiac Chest Pain 2. Shortness of Breath 3. Stroke 4. Altered Mental Status (AMS) 5. Acute Abdomen 6. Normal Childbirth 7. Abnormal Childbirth 8. General Medical Complaint 9. Hemorrhage control and shock Management 10. Splinting 11. Trauma Patient Management At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets: 1. Intravenous (IV) therapy, 2. Establishing an intraosseous (IO) line 3. IM and SQ injections 4. IV Drug Administration 5. Supraglottic Airways 6. Pediatric Airway Compromise 7. Medical Emergency Scenario 8. Traumatic Emergency Scenario 3 Cardiology Module During the second module (Cardiology), we will give the students several more SKILL SHEETS. They include: 1. Adult Oral-tracheal Intubation 2. Pediatric Oral-tracheal Intubation 3. Task analysis for defibrillation 4. Task analysis for cardioversion 5. Task analysis for pacing 6. 12-Lead ECG 7. IV Drip Skill Sheet 8. NREMT Dynamic Cardiology 9. NREMT Static Cardiology We have several SCENARIO skill sheets that we use during this module. They consist of: 1. Cardiac Chest Pain 2. Shortness of Breath 3. ACLS – Bradycardia 4. ACLS – Tachycardia 5. ACLS – Cardiac Arrest – VF/VT At the end of this module, students are TESTED on the following skills using the NREMT Skill Sheets: 1. Ventilatory Management – Adult 2. Ventilatory Management - Pediatrics 3. NREMT Dynamic Cardiology 4. NREMT Static Cardiology Medical Emergencies I During the third module (MEI), we will give the students more SKILL SHEETS. They include: 1. Comprehensive History 2. Comprehensive Physical Exam We have several SCENARIO skill sheets that we use during this module.
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