St John Clinical Prospectus - February 2021
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St John Clinical Prospectus February 2021
Contents Introduction 4 Clinical Pathway overview 5 Clinical courses 6 Overview 6 New Zealand Certificate in Emergency Care (First Responder) 7 Operations Risk Management 8 First Responder Course 9 Operations Induction 11 Ambulance Driving Course 12 New Zealand Diploma in Ambulance Practice (NZDAP) 14 Primary Response in Medical Emergencies (PRIME) 17 Emergency Medical Assistant (EMA) course 18 Major Incident Support Team (MIST) 19 Event Co-responder 20 Continuing Clinical Education (CCE) 21 Generic course important info 24 English language requirements 24 Enrolling on a course 26 Pastoral care 26 Simulations 27 Learner consent and safety 28 What to wear 29 Completion requirements 29 Recommended reading 30 Clinical placements and mentors 30 Withdrawal from a course or programme 31 Disciplinary procedure 32
Assessments 33 Types of assessment 33 Advanced Driving Assessment (ADA) 35 Assessment attempts 39 Assessment and conflict of interest 40 Written assessments 41 Extensions for assessments 44 Assessment results 45 Clinical practice levels and authority to practise 46 Clinical practice levels and authority to practise (ATP) 46 First Responder 47 Emergency Medical Assistant (EMA) 51 Emergency Medical Technician (EMT) 52 Paramedic 54 Intensive Care Paramedic (ICP) 54 Extended Care Paramedic (ECP) 55 Rapid Sequence Intubation (RSI) endorsement 57 Urgent Community Care (UCC) endorsement 59 ATP Credentialing Committee 59 ATP review panel 60 The Supervised Clinical Practice Programme and Clinical Internship 61 Tertiary Paramedic Programme 61 Tertiary ICP Programme 62 Supervised Clinical Practice Programme 62 Clinical Internship Programme overview 64 Clinical Internship: Precepting phase 66 Clinical Internship: Clinical assessment phase 67 Clinical Internship: Clinical supervision phase 68 Clinical Internship: Clinical discussion phase 68 Further information on the Clinical Internship Programme 69
Appeals 70 Appeal against assessment or course removal if appropriate 70 Appeal against an advanced driving assessment (ADA) result 72 Appeal against a clinical assessment 73 Feedback and complaints 75 Feedback and complaints 75 Quality management system (QMS) 76 Other clinical learning resources 77 MySitrep 77 Online Learning Campus 79 Clinical Wiki 79 Clinical Focus 81 Clinical apps 81 Clinical email addresses 83 Notes 84
4
Introduction
The Clinical Prospectus outlines the clinical and operational education
pathways and other educational resources available to St John personnel.
It describes:
> Courses developed and/or delivered by the Clinical Team.
> How the Clinical Team interacts with learners, and the associated
processes.
> How personnel can access support and deal with complex issues.
> How to obtain and maintain a clinical practice level/authority
to practise/clinical endorsement, including entering the Clinical
Internship Programme.
> Other clinical resources available to support and enhance learning.
Personnel engaging with education provided by the Clinical Team, or
assessment facilitated by the Clinical Team must be familiar with this
document and refer to it if they have any questions. Additional assistance
or information can be provided by a Clinical Support Officer, or by
emailing clindevhelp@stjohn.org.nz.
This Clinical Prospectus may be revoked and reissued at any time at the
discretion of the Assistant Clinical Director and/or Assistant Director –
Clinical Delivery and Support. Personnel are encouraged not to print this
document, but instead refer to the most recent version of the prospectus
which will be available on the Clinical Wiki.
St John Clinical Prospectus | 5
Clinical Pathway overview
Join St John Note: To maintain a practice level or
role, personnel complete all mandatory
components of the Continuing Clinical
Complete St John Education (CCE) programme.
General Induction
Note: First Responders who are
required to drive a vehicle must also
Complete (or re-validate) complete an Ambulance Driving Course
Level 2 Workplace First Aid (after Operations Risk Management).
Certificate
NZ Certificate in Emergency Care Complete the
(First Responder): Emergency Medical
> Operations Induction Module Assistant Workbook
(paid personnel
> Operations Risk Management Module FIRST employed as an
> First Responder Module RESPONDER
Emergency Medical
> Certificate workbook Assistant only)
Successful completion of New Zealand
Diploma/National Diploma pre-entry EMERGENCY
quiz (70% pass mark. Quiz available on MEDICAL
the Campus) ASSISTANT
Selection by Manager
New Zealand Diploma/ EMERGENCY
Clinical Assessment MEDICAL
National Diploma
TECHNICIAN
Self funded
Successful application, entry and
Approved university
completion of the Paramedic
papers/courses PARAMEDIC
Internship programme
Successful application, entry and
Approved university
completion of the Intensive Care INTENSIVE
papers/courses CARE
Paramedic Internship programme
PARAMEDIC
Refer to page Apply to ATP and Accreditation Rapid Sequence
16 for academic Manager for RSI endorsement Intubation
requirements with DOM endorsement endorsement
6
Clinical courses
Overview
> The Clinical Team is responsible for the design, development, delivery,
maintenance, and moderation of all internal clinical curriculum in
St John. A multitude of courses are offered, some of which personnel
will only do once, and others which personnel will attend on a
recurring basis in order to maintain their clinical practice level.
> This section provides an overview of each course, to include:
– The topics within the course.
– How the course is structured.
– The duration of the course.
– Pre-requisites for the course.
– Whether the course is linked to NZQA unit standards.
– The modes of learning included in the course.
St John Clinical Prospectus | 7
New Zealand Certificate in Emergency Care
(First Responder)
> This certificate course has been designed by St John in consultation
with the ambulance sector and is the base qualification for ambulance
personnel in St John New Zealand. The purpose of this qualification
is to provide New Zealand ambulance personnel with the skills to
confidently and competently intervene as a First Responder and
sustain life until handover to a more qualified health care professional
occurs.
> By completing this qualification, personnel will be able to:
– Operate successfully, lawfully and ethically as a First Responder. (FR)
– Assess and manage medical and trauma conditions as a First
Responder.
– Make decisions as a First Responder within your designated area of
responsibility.
– Communicate and collaborate effectively to achieve the best
outcome as a First Responder.
> This qualification is a 40-credit level 3 certificate requiring
participation in online learning activities, in-class modules and
post course self-directed learning. The learner has seven months to
complete and submit for assessment. Upon successful completion
of the required components, the following unit standards will be
awarded:
– 28542: Demonstrate and apply knowledge of professional and
ethical behaviour in a health or wellbeing setting.
– 29321: Provide basic emergency care.
– 29322: Demonstrate knowledge of emergency response systems
in New Zealand.
– 29323: Gather and record information to support patient
assessment.
– 29324: Demonstrate understanding of the use of common
medications relevant to the emergency care First Responder
context.
– 29325: Adapt strategies to manage complex emergency situations
arising in an emergency care first response context.
8
> This certificate course is divided into two main modules: Operations
Risk Management and First Responder.
> A current level 2 First Aid certificate is required as a pre-requisite for
entry into the certificate programme.
Operations Risk Management
> The New Zealand Certificate in Emergency Care (First Responder) is
comprised of two modules – First Responder and Operations Risk
Management (ORM).
> ORM is a two-day course designed to enable new ambulance
personnel to identify hazards which they will be exposed to, allowing
them to take practical measures to eliminate, isolate or minimise
those hazards, and to become familiar with concepts and equipment
that are used commonly in ambulance practice.
> Learners are required to complete online learning activities prior to
attending the face to face classroom component of ORM. These online
learning activities cover the following topics:
– Operations risk management. This learning activity includes
sub-topics on communication, infection control, manual handling,
scene management and working with young people.
– Electronic patient report form (ePRF). This learning activity
provides learners an introduction to the functions of the ePRF,
reinforces learning using an interactive scenario situation, and
discusses health information privacy.
– National health index (NHI). The NHI database is a powerful
tool that has the ability to connect the data collected by the
ambulance service with the wider health sector. This learning
activity provides a comprehensive overview of the NHI database,
our responsibilities in searching the NHI database, and how this
impacts on ambulance practice.
– Personal safety awareness. This learning activity has been
designed by an external agency called Maybo. It focuses on what
action the law allows ambulance personnel to take if they find
themselves in a situation where they have to defend themselves.
– Positive interactions and choices. This learning activity has been
designed by an external agency called Maybo. It focuses on how
to make good decisions when emotions are running high and/orSt John Clinical Prospectus | 9
personnel are under pressure. It will discuss how to make good
choices and communicate positively.
– Understanding human behaviour. This learning activity has
been designed by an external agency called Maybo. It focuses
on the definition of the rational and emotional mind, the fight/
flight/freeze response and how these affect a person’s interactions,
triggers of escalation, and the levels of escalation a person may
experience.
> The two-day classroom component of ORM covers the following
topics:
– Electronic patient report form, to include an introduction to
ePRF, how to transfer ePRF information, how to ensure privacy is
maintained, and how to troubleshoot ePRF.
– Manual handling, to include techniques, equipment and scenarios.
– Risk assessment processes.
– Conflict management theory.
– Assessing the need for physical intervention, and basic
manoeuvres.
– Physical intervention in ambulance practice.
First Responder Course
> The New Zealand Certificate in Emergency Care (First Responder) is
comprised of two modules – First Responder and Operations Risk
Management (ORM). Due to the manual handling and equipment
skills taught within the ORM module, personnel must complete ORM
prior to attending a First Responder course. The ORM section of the
assessment workbook must be completed as soon as possible after
the face to face class time.
> Learners are required to complete online learning activities prior to
attending the face to face classroom component of First Responder.
These online learning activities cover the following topics:
– Scene management. This includes what to consider when
approaching a scene, the types of personal protective equipment
(PPE) that are available, what to consider when entering a
scene, the equipment required to be taken into a scene and its
placement, and what to consider when exiting a scene.10
– Vital signs. This includes the process of obtaining vital signs
such as respiration rate, pulse rate, blood pressure, level of
consciousness, oxygen saturations, temperature, and blood
glucose level.
– Ambulance Communications Centres. The Ambulance
Communication Centres are where 111 calls are answered and
responses coordinated. This online learning activity includes
information on how Comms operates, what tools Comms
use to determine the most suitable priority for dispatch, the
communication methods through which ambulance personnel
can interact with Comms, other functions within Comms, and how
response determinants work.
> The in-class component of the First Responder module is four days
in duration. It is the foundation clinical course within St John and will
provide learners with essential knowledge and skills to perform safely
and effectively as a First Responder within St John or organisations
who engage in emergency service situations. Topics covered over the
four days of in-class learning include:
– Identifying the roles and responsibilities of the First Responder.
– Understanding common terminology used by the ambulance
service.
– Performing a primary and secondary survey.
– Interviewing the patient and any bystanders.
– Understanding when and how to take a set of vital signs (including
3-lead ECG acquisition).
– Identifying information required for a handover.
– Principles of resuscitation, including CPR, AED use, airway
management and oxygen administration.
– Understanding and treating shock and trauma – including
haemorrhage control, fractures and dislocations, burns, thermal
problems and spinal injuries.
– How to care for yourself and your patient.
– Principles of pain relief and how to administer pain relief if
required.
– Assessment and treatment of respiratory emergencies including
COPD, asthma, stridor, anaphylaxis, and foreign body airway
obstruction.St John Clinical Prospectus | 11
– Assessment and treatment options for cardiac chest pain.
– Assessment and treatment principles for other medical conditions
including childbirth, stroke, seizures, and diabetic emergencies.
> Learners will be provided with a First Responder Learner Manual in
class, which can be kept for future reference as required. They will
also be provided with an Assessment Workbook, which includes all
assessment information needed as evidence for NZQA requirements.
Instructions on submission of this workbook will be provided to the
learners in class.
> ‘Recruit’ epaulettes will be issued to those who have completed the
First Responder Course, but their Assessment Workbook has not been
submitted and signed off by the relevant Clinical Support Officer. ‘First
Responder’ epaulettes will be issued following:
– Attendance of the First Responder course, and
– Completion of the Assessment Workbook, and
– The Assessment Workbook has been submitted and signed off by
the relevant Clinical Support Officer.
Operations Induction
> The Operations Induction Course is designed to equip new
personnel with the tools and information required to start working
in Operations. The course consists of six national modules (delivered
over two days of face to face classroom time) and three local modules
that can be modified to suit local needs.
> Many of the topics introduced in Operations Induction are covered
in more depth in other foundation courses and are included in this
course to provide an overview of how all aspects of Ambulance
Operations function, and to ensure that new personnel understand
how to access information and know where to find help and support.
> Learners will be provided a workbook in class, and this will be a
resource that personnel may keep and refer to as required. Further
details regarding the requirements of the Operations Induction course
are provided within this workbook and during class.
> Operations Induction is not a pre-requisite for other foundation
courses, nor does it require completion of pre-requisite foundation
courses.12
> To complete the Operations Induction course, all the following must
be completed and signed off.
Module Delivered by Method
Pre-course – Resilience podcast Self-directed Online
Pre-course – Wellbeing and
Self-directed Digital or print
resilience plan
Module 1 – Introduction to St John Operations Classroom
Module 2 – Joining the
Operations Classroom
Operations team
Module 3 – Doing the right thing Operations Classroom
Module 4 – Communications Operations Classroom
Module 5 – Health and wellbeing Operations Classroom
Module 6 – ICT, types of leave,
Operations Classroom
and professional bodies
Workbook
Module 7 – Local area: People Operations
and on station
Module 8 – Local area: Workbook
Operations
Familiarisation and on station
Workbook
Module 9 – Local area: Processes Operations
and on station
Ambulance Driving Course
> The Ambulance Driving Course provides an holistic approach to driver
education, focusing on both skills and knowledge, whilst recognising
that attitudes, behaviours, and human factors impact the way people
drive.
> Learners must complete pre-course online learning prior to coming to
the two-day face to face classroom/practical driving component. This
consists of:
– Completion of the online pre-entry quiz, which focuses only on the
NZ Road Code and basic driving knowledge.St John Clinical Prospectus | 13
– Completion of one online learning activity, which contains
information on:
• Attitudes and behaviours.
• Fatigue.
• High risk driving.
• Vehicle induction.
• Urgent driving.
• Stopping distance.
• Road craft.
• Efficient driving.
– Completion of the end of online learning quiz, which tests
knowledge of information contained within the online learning
activity.
> A Clinical Administrator will confirm that learners have completed all
of the online modules prior to attending the face to face sessions.
> Learners will then attend two days (16 hours) of face to face classroom
and practical driving, with a Clinical Support Officer (with NZTA ‘I’
endorsement) or an externally contracted Driving Instructor. Topics
covered during this time include:
– Lower risk team driving.
– Policy/legislation.
– Vehicle induction.
– High risk driving.
– Slow speed manoeuvring.
– Practical driving operation (note this makes up most of the two
days).
> At the end of the second day, the CSO/Driving Instructor will
determine whether each learner is safe and competent to proceed
to the next stage (supervised drives). Learners will be required to
successfully complete five non-urgent supervised drives and five
urgent supervised drives, before progressing to the Advanced Driving
Assessment (ADA) and course completion phase. A more in-depth
description of supervised drives, and the associated process can be
found within the Ambulance Driving Course Learner Manual and the
Clinical Wiki.14
> Following completion of all supervised drives, and submission to
clindevhelp@stjohn.org.nz, the learner will receive notification
that they have provisional permission to operate an ambulance
unsupervised. A Clinical Support Officer (with an NZTA ‘I’
endorsement) will be notified and arrange a time to conduct an ADA
within six months of completion of the face to face component of
the Driving Course. Once the learner has passed their ADA, they have
full permission to operate an ambulance unsupervised. This must be
completed within six months of the face to face classroom time.
> To see what the ADA template looks like, click here. For more
information regarding the ADA process, refer to the ADA section in
this prospectus.
New Zealand Diploma in Ambulance Practice
(NZDAP)
What is the New Zealand Diploma in Ambulance Practice (NZDAP)?
– The NZDAP course is the primary qualification required to apply
for authority to practise at EMT level.
– It is a level 5 vocational course delivered by Clinical Support
Officers, and consists of approximately 1200 hours of learning, 120
credits, and will take approximately 18 months to complete.
– It is important that anyone undertaking this course is aware of the
required commitment, in terms of time and effort. Learners need
to allow an average of 10 hours of study per week, plus road time,
and classroom time when block courses are being held.
What are the unit standards that make up NZDAP?
The NZDAP is awarded by the New Zealand Qualifications Authority
(NZQA) once learners have completed all the required unit standards. The
unit standards covered as part of NZDAP are:
> 24858: Demonstrate knowledge of the management of patients with
acute diabetic emergency symptoms in an ambulance context.
> 24862: Demonstrate knowledge of management of trauma to the
integumentary system, and musculoskeletal injury.
> 24863: Demonstrate knowledge of the management of patients with
symptoms of shock in an ambulance context.St John Clinical Prospectus | 15
> 24864: Demonstrate knowledge of management of patients with
acute obstetric conditions and the newborn in an ambulance context.
> 24865: Demonstrate knowledge of the management of patients with
acute paediatric conditions in an ambulance context.
> 24866: Demonstrate knowledge of the management of patients with
acute geriatric conditions in an ambulance context.
> 24867: Demonstrate knowledge of environmental conditions and
their effects on patients in an ambulance context.
> 24868: Demonstrate knowledge of the management of patients with
acute mental illness in an ambulance context.
> 24869: Apply integrated clinical practice in an ambulance context.
> 24870: Demonstrate knowledge of pharmacology in an ambulance
context.
> 29415: Demonstrate knowledge of management of patients with
acute respiratory and cardiovascular symptoms in an ambulance
context.
> 29416: Demonstrate knowledge of the management of patients with
acute neurological presentations in an ambulance context.
> 29417: Demonstrate knowledge of the management of patients with
acute abdominal symptoms in an ambulance context.
> 29418: Demonstrate knowledge of processes to support patient
safety and comply with legislation in an ambulance context.
What are the pre-entry requirements?
Personnel must complete pre-entry requirements before being enrolled
on the NZDAP course:
Must have a minimum of six months’ experience as a First Responder
before applying for a position on the NZDAP course (using the CDT100
form). Exceptions to the six months’ experience may be considered on
application to the Clinical Programme and Moderation Team.
> Must pass a pre-entry quiz online:
– Completed online via Microsoft Forms here.
– Requires minimum score of 70% to pass.
– Personnel are allowed two attempts to pass, followed by a six
month ‘cool down’ period before further attempts are allowed.16
> Must complete the pre-entry checklist:
– Completion of this checklist ensures that learners are competent
and confident with all FR skills, and therefore are ready to build on
those skills in the NZDAP course.
– It is a practical FR skills checklist and completion must be observed
by someone who has been nominated by the learner’s Station
Manager (SM)/Territory Manager (TM).
– The checklist must be signed by the learner, observer, and SM/
TM. The completed, signed checklist must be sent to the regional
clinical administrator for processing.
What is the general structure of the NZDAP course?
> Once a learner has been enrolled in a NZDAP course, they will receive
an information package providing further information about course
structure, timetable, bring your own device (BYOD) specifications, and
more.
> The NZDAP course involves many different types of learning and
tasks, to include block course attendance, workbook completion,
self-directed learning activities, and quizzes. The table below provides
an overview of the structure of each module.
Workbooks
4–5 weeks Submit 4–5 weeks Submit Module
Module Classroom Classroom and
self-directed Workbook self-directed Workbooks One
One Days 1–2 Days 3–6 operational
learning 1a learning 1b and 1c complete
shifts
4–5 weeks Submit Module
Module Classroom
self-directed Workbooks and operational shifts Workbooks Two
Two Days 1–5
learning 2a and 2b complete
4–5 weeks Submit Module
Module Classroom
self-directed Workbooks and operational shifts Workbooks Three
Three Days 1–5
learning 3a and 3b complete
Module
Module Workbook and Submit
Operational shifts Four
Four case logs workbook
completeSt John Clinical Prospectus | 17 NZDAP and the supervised clinical practice programme > Learners on an NZDAP course are automatically enrolled on the St John Supervised Clinical Practice Programme and may practice skills under supervision as defined with the CPGs after they have been formally taught that skill and passed any required assessments. > Enrolment on the St John Supervised Clinical Practice Programme will extend to six months past completion of the NZQA qualification, after which time the learner will have to apply to the ATP Team for an extension if they have not yet been granted ATP at EMT level. Primary Response in Medical Emergencies (PRIME) > The PRIME programme is funded by the Ministry of Health and ACC and administered by St John. It has been developed to provide both the coordinated response and appropriate management of emergencies in rural locations. > The PRIME programme utilises the skills of specially trained General Practitioners and/or nurses in rural communities to support the ambulance service where the response time for assistance would otherwise be significant or where higher medical skills than may otherwise be available would assist with the patient’s condition. > A PRIME practitioner carries a pager and is mobilised by the Ambulance Communications Centre throughout New Zealand following an emergency call. The PRIME programme activates the practitioner within a local roster system that provides a response capability which is usually 24 hours, 7 days a week. > PRIME practitioners are required to undertake an initial PRIME training course (five days in length) followed by a refresher course for trauma and medical emergencies once every two years. > For more information on the PRIME programme, or the PRIME training courses (initial or refresher), visit the PRIME page on Heartbeat.
18
Emergency Medical Assistant (EMA) course
> Emergency Medical Assistants (EMAs) are clinically qualified and
competent ambulance personnel who has been trained to streamline
the assessment and treatment provided by personnel with authority
to practise (ATP). Their focus is on assisting personnel with ATP to
provide optimal patient care.
> The EMA course is a five day course, and learners must complete the
following courses prior to attending:
– Operations Induction.
– Operations Risk Management.
– Ambulance Driving Course.
– First Responder.
> Topics covered within the EMA course include:
– Values and professionalism.
– Competencies and pre-requisites.
– Assessments.
– Operations Manual.
– Vehicle preparedness.
– Vehicle equipment and resources.
– Defibrillator familiarisation and use.
– CPGs and checklists.
– Assisting ambulance personnel (general information).
– Crew resource management.
– Patient handover.
– Assisting an EMT.
– Assisting a Paramedic.
– Assisting an Intensive Care Paramedic.
– Assisting PRIME responders.
– Electronic patient report forms (ePRF).
– Major incidents.St John Clinical Prospectus | 19
> Assessments will be conducted throughout the EMA course, to prove
learning. There will be three main types of assessments:
– Self-sign-off. The EMA will read the required material to gain
familiarisation and understanding. Once complete, the self-sign-off
table will be initialled and dated as complete.
– Crew sign-off. The EMA will work through the learning objectives
by way of self-study and crew member-assisted learning to achieve
the objectives. Once the requirements have been filled, a crew
member with ATP (relevant to the skill) may sign off the EMA in the
sign-off tables.
– Clinical Support Officer sign-off. On completion of the training
manual (provided in class), a CSO will meet with the EMA for a
review of the manual and fill out the completion sign-off form.
Major Incident Support Team (MIST)
> The role of MIST is to enable the
deployment of purpose-built Command
Units and other specialist major incident
vehicles to support frontline ambulance
personnel during major incidents or
large planned events. Examples of
these incidents include the Christchurch
earthquakes, Otira bus crash, Kaikoura earthquake, Whakaari/ White
Island eruption, and the Christchurch mosque shooting.
> MIST supports the response to these incidents by:
– Setting up radio communications.
– Coordinating logistics for patient movement.
– Ensuring records are maintained around scene decisions.
– Providing structure and a routine framework to larger scenes.
– Assisting with the organisation and deployment of clinical
resources.
– Setting up tents and other treatment areas.
– Deploying consumable caches.
– Ensuring scene safety and adherence to health and safety
requirements.20
> A MIST Team Manager is trained to a CIMS4 level and has overall
responsibility for ensuring there is a MIST response. A MIST Team
Member is trained to a CIMS2 level and is responsible for providing
the response and ensuring the Commander on scene is supported.
> MIST personnel do not have to be clinically trained, and the initial
MIST training consists of CIMS, ambulance driving, operational risk
management, and MIST- specific equipment training (for example, use
of radios and other computer infrastructure).
> MIST personnel will be expected to attend one training session per
month to ensure currency with equipment and St John equipment is
maintained.
> MIST personnel will be involved in a minimum of three simulate
deployments per year, conducted in conjunction with Police and FENZ
(and other agencies, for example airports), to ensure MIST is in a state
of operational readiness, and allied agencies are aware of the MIST
capabilities and function.
Event Co-responder
> The purpose of the Event Co-responder role is to work alongside a
qualified Event Medic (First Responder or higher), in order to assist
in the delivery of Event Health Services as well as provision of basic
first aid.
> Event Co-responder is gained after:
– Completion or revalidation of Workplace First Aid Level 2, and
– Completion of Operations Risk Management, and
– Completion of Operations Induction.
> Some personnel may choose to become Event Co-Responders while
on the pathway to becoming a First Responder (as described in
the ‘clinical practice levels and authority to practise’ section of this
prospectus).St John Clinical Prospectus | 21 Continuing Clinical Education (CCE) What is CCE? > To enhance patient outcomes and to ensure patient safety, it is imperative to maintain clinical competency. While the responsibility to maintain this competency rests with the individual, St John actively supports this through provision of CCE. > There are three main components to CCE: formal face to face training, informal face to face training, and independent learning. More information on each can be found later in this section. > For some rounds of CCE, personnel may also be required to complete online learning activities as part of their CCE, prepare cases for discussion prior to CCE attendance, or read aspects of the CPGs and/or First Responder Field Guide. Minimum annual CCE requirements > Each clinical practice level has its own minimum annual CCE requirements. > First Responders are required to complete: – 8 hours of informal face to face training. – 8 hours of formal face to face training. > Emergency Medical Technicians (EMTs) are required to complete: – 16 hours of formal face to face training. – 8 hours of independent learning. > Paramedics are required to complete: – 16 hours of formal face to face training. – 16 hours of independent learning. > Intensive Care Paramedics and Extended Care Paramedics are required to complete: – 16 hours of formal face to face training. – 24 hours of independent learning. > Emergency Medical Assistants are required to complete the annual CCE requirements relevant to their clinical practice level.
22
Formal face to face CCE
> These are sessions delivered by permanent Clinical Support Officers
and focus on elements that are not able to be easily facilitated online,
such as simulations, clinical discussions, and skill stations.
> Registration for CCE:
– Depending on your area and role, you may be automatically
rostered to attend your CCE session(s) or you may need to book in
on a session via MySitrep.
– Personnel must be registered for the CCE session they attend;
‘walk-ins’ cannot be accommodated.
> Personnel may only attend the CCE relating to their current practicing
level. The only exceptions are:
– First Responders on the New Zealand Diploma in Ambulance
Practice pathway may attend EMT CCE, or
– An EMT practicing as a Paramedic Intern may attend Paramedic
CCE (from the period they have been formally accepted into the
Internship Programme and assigned a Preceptor), or
– A Paramedic practicing as an approved ICP Intern may attend ICP
CCE (from the period they have been formally accepted into the
Internship Programme and assigned a Preceptor).
> Attendance of formal face to face CCE:
– Learners attending formal face-to-face CCE must wear operational
uniform. This is to:
• Foster a professional learning environment, and
• Ensure clothing worn is appropriate to enable practical
sessions, and
• Enable operational deployment in the event of a major
incident.
– Personnel who are not able to work frontline may not attend CCE.
This includes personnel with ACC injuries and medical problems
that do not have a return to work programme enabling them to
work frontline on emergency ambulance (or PTS).
– There will be no routine provision of ‘wash-up’ sessions for formal
CCE. Any exception to this will be rare and will cater only to thoseSt John Clinical Prospectus | 23
who have a valid reason for non-attendance (for example, on ACC
or parental leave).
– All personnel are expected to positively engage with the CSO and
fellow learners during CCE sessions, to promote a safe learning
environment for all.
> Non-attendance of formal face to face CCE:
– CCE attendance is mandatory for all those who hold a clinical
practice level.
– Anyone with an authority to practise who fails to attend all
required CCE will be referred to the ATP Credentialing Committee
for review of their ATP (refer to OMP 4.5).
– First Responders are also expected to attend CCE to maintain
clinical competency. Those who fail to complete their CCE
requirements will be required to revalidate their clinical
competencies as defined by the relevant Clinical Practice Manager
(this may be completion of a skills checklist, or re-attendance of
some or all of a First Responder course). Failure to comply with
the stipulated requirements will result in removal of the First
Responder clinical practice level.
Informal face to face training
> This is an aspect of CCE specific to First Responders. It was
implemented to recognise the training that occurs locally on station
(for example, delivered by Station Managers/Volunteer Team Leaders).
> A bank of lesson plans and associated resources is available on the
Clinical Wiki for personnel to download and use for station training.
Independent learning
> This aspect of CCE is designed to recognise the learning/training
that personnel undergo externally to St John that is relevant to
their clinical practice level (for example, those completing tertiary
paramedicine study).24
Generic course
important info
English language requirements
> This section is for personnel whose first language is not English,
or who come from a country where the language of instruction in
schools is not English.
> If personnel are coming from a country with an annual student visa
approval rate of at least 80%, they are required to provide evidence
of:
– Achievement of an NZQA- approved English Proficiency
Assessment, or
– Achievement of the required score in the internationally
recognised English Proficiency tests outlined in Table 1 within the
last two years.St John Clinical Prospectus | 25
Table 1
Test Score required
International English Language Academic score of 5.5 with no band
Testing System (IELTS) score lower than 5.
Test of English as a Foreign Language Score of 530 (with an essay score
(TOEFL) paper-based test of 4.5 for test of written English)
Test of English as a Foreign Language Score of 46 (with a writing score
(TOEFL) internet-based test of 20)
Cambridge English Examinations > First Certificate in English (FCE)
or FCE for schools with a score
of 154, with no less than 154 in
each skill, and
> An Occupational English Test
(OET) at grade C in all sub tests.
New Zealand Certificate in English Level 3 achievement with an
Language (NZCEL) endorsement of either general,
workplace, or academic.
Pearson Test of English (academic) Academic score of 42.
City and Guilds International English > B2 communicator, and
for Speakers of Other Language > Score of 42.
(IESOL)
> If personnel are coming from a country with an annual student
visa approval rate of less than 80%, they are required to provide
evidence that they:
– Have gained NCEA Level 3 and met New Zealand University
Entrance requirements, or
– Hold a Bachelor’s degree of at least three years from New Zealand,
Australia, Canada, The Republic of Ireland, South Africa, the United
Kingdom, or the United States of America, or
– Have achieved a Certificate in English Language Teaching to Adults
(CELTA), or
– Have achieved one of the English Language competency tests
specified in Table 1.26
Enrolling on a course
> If personnel are new to St John, they will be contacted in order to
organise enrolment on foundation courses.
> For any other course (for example, New Zealand Diploma in
Ambulance Practice), personnel will need to:
– Be up to date with individual CCE requirements, and
– Have line manager approval, and
– Fill in and submit the CDT100 form.
Pastoral care
Individual attention
> Everyone is given some individual attention during courses.
> Learners should approach a lead Clinical Support Officer in the first
instance if they believe more support is required.
> The Operations Manual contains more information on guidance and
support for those employed by St John in a paid or volunteer capacity.
Learning difficulties/disabilities
> If personnel have learning difficulties or a physical disability,
additional assistance or guidance can be sought via Clinical Support
Officers.
> Personnel may be given one on one tuition to ensure they are
developing the skills required to achieve the course requirements. This
may include physical ability to complete the course. Assistance of this
nature will be arranged in coordination with the line manager.
> If personnel have a known or suspected learning difficulty, they
should notify their Clinical Support Officer as soon as feasible prior to
the commencement of the course. This will enable development of a
learning plan as early as possible to set the learner up for success. This
will usually involve the learner undergoing an Education Psychology
evaluation initially, and then a subsequent meeting with the learner’s
line manager and representative from the Clinical Programme and
Moderation Team to develop a robust learning plan to suit the learner.St John Clinical Prospectus | 27
> Clinical Support Officers may contact learners if they appear to
be having difficulty with learning, to establish remedial measures
in collaboration with the learner and Clinical Programme and
Moderation Team.
Simulations
What are simulations?
> Clinical simulation is often used as a mode of learning in class.
They can sometimes be confused with an assessment as it involves
learners doing something practically and having a review of their
performance.
> There are two types of simulation – macro-simulations and exercises.
> Macro-simulations. These are used throughout all St John clinical
courses. This is when learners are given a brief of an incident and they
enter a staged scene and perform their skills on a manikin or someone
acting as a patient.
> Exercises. This type of simulation focuses on large-scale incidents
associated with on-scene management, rather than focused patient
care. The exercise may have one or more of the following components:
– The situation is discussed, and decisions are agreed based on
information that is supplied by a Clinical Support Officer.
– Learners work with colleagues and other emergency service
workers.
– Learners are involved in an actual scene of a simulated emergency,
usually involving many patient actors.
How does a macro-simulation usually work?
> St John tries to make clinical simulation as real as possible. This
depends on the facilities that are available where the course is being
held. In some locations St John has dedicated simulation rooms, and
in other locations a little more improvisation is needed.
> A Clinical Support Officer will brief learners on the incident that they
will ‘attend’. Learners will usually work with another learner in a typical
two-person crew.
> The simulation may be filmed for debriefing. During the simulation,
the other learners from the class may be observing. They may do so28
from another room so that those involved in the simulation are not
interrupted by their presence.
> Learners in the simulation will need to treat it like a real incident and
do what they would normally do. The Clinical Support Officers work
to make the situation as realistic as possible to enable the learner’s
interaction and responses to be realistic.
> The manikins often talk – the voice will come from the manikin’s
mouth. Therefore, learners will need to talk to the manikin as though
they are a real person.
> A Clinical Support Officer may or may not be present with the learner
during the simulation, so any patient questioning will need to be
directed to the patient (just as would occur in a real situation).
> After the simulation, the gear is tidied away and then the learners
join the rest of the class. Learners may watch the recording of the
simulation with the rest of the class and everyone will be making
notes around points that the Clinical Support Officer wishes to
focus on.
> There may be a facilitated group or class discussion about your
scenario. During this discussion the Clinical Support Officer may ask
specific learners various questions or ask them to expand on their
discussion points.
Learner consent and safety
Participation in practical scenarios
> When learners participate in a course, the Clinical Support Officer will
use formal and informal instruction and practical scenarios.
> Participation as a simulated patient is expected during scenario
sessions.
> Those who actively participate in practical sessions are deemed to
have given their consent by virtue of their participation.
> There are some forms of patient assessment that require exposure
of certain areas of the body, for example exposure of the chest when
obtaining a 12 ECG or exposure of the abdomen when performing
an abdominal assessment. For these types of assessments, explicit
consent must be obtained and learners may withhold this consent if
they are uncomfortable.St John Clinical Prospectus | 29 Safety of yourself and others > You, other learners, and the Clinical Support Officers are expected to comply with good infection control practices in accordance with the Operations Manual. > You, other learners and the Clinical Support Officers are to ensure all practicable steps are taken to minimise the likelihood of injury and serious harm to themselves or others. > Those who are on ACC must discuss with their line manager and HR whether it is appropriate to be on an educational course. There are specific rules relating to CCE which can be found in the CCE section within this prospectus. > The principles outlined in the St John Health, Safety and Wellness Plan will be followed in all activities. > All personnel must ensure they adhere to principles outlined in the Fatigue Management Policy (HSW 5.11) and the Clinical Operations Fatigue Management and Driving Policy (OMP 3.4.1), available on Heartbeat, as hours spent on a clinical course are considered ‘work hours’ and will impact on the individual’s driving hours. This also includes attendance at sim suite, which is a work-related activity on work premises, so personnel should not be attending prior to a night shift as it will impact on driving hours. What to wear > Operational uniform must be worn for all classroom sessions and clinical placements unless otherwise directed by a Clinical Support Officer. > If operational uniform has not yet been issued, personnel must wear tidy, comfortable, non-revealing clothing and closed-toed shoes. Completion requirements > Learners must fulfil all elements of each course to pass. > Where a learner does not progress or fulfil the requirements of the course in a timely manner, a representative from the Clinical Team will notify the learner’s line manager and the learner may be removed from the course or programme. > Sessions must be completed in the order specified by the Clinical Team and the learner must remain on the same course unless otherwise agreed with the relevant Clinical Practice Manager.
30
Recommended reading
> Any reading learners are required to complete as part of a course will
be outlined within the course itself.
> There are no set textbooks for courses, only some recommendations
which may aid learning.
> Stations often keep small libraries of relevant textbooks which
personnel may be able to access.
> The Clinical Wiki is also an excellent resource for clinical personnel,
where articles, skill sheets, podcasts, instructional videos, and other
publications such as Clinical Focus can be found.
Clinical placements and mentors
> A clinical placement may include working on ambulances, at
events, or at a medical facility and may be part of course or
programme completion requirements. Personnel must know what
the requirements are for the specific course or programme they are
registered for/enrolled in.
> The learner’s operational line manager is primarily responsible for
ensuring their personnel on St John courses get the clinical placement
they need (this is why course enrolment applications require manager
sign-off ). In some circumstances, clinical placement may be organised
by a Clinical Support Officer.
> Most clinical placements will require a portfolio of evidence to be
completed. Part of a portfolio often involves completing exemplars on
incidents when the learner was involved (either directly or indirectly)
with patient care. The requirements of exemplars vary from course
to course so learners will need to establish what is required for their
course.
> When learners are working at a clinical placement, they are able to
administer the skills of the practice level that they would gain on
successful completion of the course, providing:
– They have been trained to perform the skill(s), and
– The skill(s) are practiced under the direct supervision of someone
holding the clinical practice level being studied for (or above).
Refer to the St John Clinical Procedures and Guidelines for more
information.St John Clinical Prospectus | 31 > The learner’s operational line manager is responsible for organising and allocating mentors where required, although commonly the learner or Clinical Support Officer may organise this. > A mentor is either assigned to the learner or is someone who the learner happens to be working with. The mentor must be working at a clinical practice level which is at least the equivalent of the practice level that the learner is studying for. > The mentor must not be a member of the learner’s immediate family or partner unless agreed in advance with the lead Clinical Support Officer, the learner’s line manager, and the mentor. Failure to seek agreement beforehand may deem portfolio entries invalid. Withdrawal from a course or programme Withdrawal from a course or programme initiated by the Clinical Team The Clinical Team reserves the right to remove learners from a St John course at any time, noting that this will only occur where there is a valid reason to do so. The following is an indicative list of reasons a learner may be removed from a course: > Failure of two attempts at an assessment. > Time enrolled in the New Zealand Diploma of Ambulance Practice exceeds 18 months. > Time enrolled in the New Zealand Certificate of Emergency Care (First Responder) exceeds seven months. > Failure to submit (or sit) an assessment by an agreed deadline (this includes workbook requirements). > Failure to complete all CCE requirements. > A clinical competency review advises the learner that they are removed from a course following investigation of an adverse incident. > Failure to adhere to a remedial action plan (RAP). This may be a result of: – Failing to adhere to the timings within a RAP. – Failing an assessment against the requirements of a RAP. > Failure to demonstrate clinical competence at the learner’s current practice level.
32
> The learner’s professional conduct during a course does not align with
St John’s values. This will be a joint decision between the relevant
Clinical Practice Manager and the learner’s line manager.
> The workbook fails to demonstrate safe and competent practice on
the second submission.
> The workbook fails to demonstrate safe and competent practice on
the first submission if the learner has been issued an extension past
the two-year course expiry date.
> The learner changes organisational roles to a position that no
longer supports that clinical practice level, authority to practise or
endorsement.
> The learner has not provided proof of identification within seven
working days.
Withdrawal from a course or programme initiated by the learner
> If a learner wishes to withdraw from a course or programme, they
should contact:
– Their line manager, and
– Their lead Clinical Support Officer or Clinical Administrator.
> If a learner wishes to withdraw from the Clinical Internship
Programme, they should contact the Clinical Internship Manager.
Disciplinary procedure
> For the duration of the course, learners are subject to the disciplinary
procedures of St John.
> Those in St John who are supplied accommodation after hours are
subject to the disciplinary procedures and usual HR policies of St John.St John Clinical Prospectus | 33 Assessments Types of assessment General > Most internal St John clinical courses have some form of educational assessment because assessment of learning is an important part of teaching. > Assessment methods for each individual course can vary and are explained in more detail in the relevant course manuals. > Assessments will be fair, valid, consistent and transparent. > It is the learner’s responsibility to ensure they are clear about the requirements of any assessments that they are completing or submitting (this includes portfolios of evidence). > If a learner is unsure about the requirements of an assessment, they should contact their lead Clinical Support Officer at the earliest opportunity for clarification.
34
Formative assessment
> Formative assessments are generally used as an indication of progress
through a course. Types of formative assessment include (but are not
limited to):
– Assignments.
– Examinations.
– Practical demonstrations.
– Simulations.
– Verbal assessments.
– Workplace assessments.
> Formative assessments are used to identify whether there is a
requirement for remedial work, which can be conducted over the
duration of the course (as required) rather than at the end of the course.
> The Clinical Team reserves the right to remove a learner from a course
where substantive failure of a formative assessment has occurred.
Summative assessment
Summative assessments are assessments that the learner must pass in
order to progress. Types of summative assessment include (but are not
limited to):
> Assignments.
> Examinations.
> Practical demonstrations.
> Simulations.
> Verbal assessments.
> Workplace assessments.
> Workbook completion.
Practical clinical assessment
> Parameters of practical assessment:
– Learners may be required to participate in practical assessments
where their individual skills and knowledge will be tested.
– Prior to the start of a practical assessment, the learner may ask
assessors to clarify any requirements.St John Clinical Prospectus | 35
– During the assessment session, learners are required to
demonstrate individual competence and use only the resources
provided.
– Video recording is common in practical assessments. The file
provides evidence of the assessment and may be used for
moderation purposes. Learners may review your video files on
request.
> Sharing or receiving of assessment information:
– Learners must act with integrity and not ask fellow learners for
assessment information, share information, or seek support during
an assessment as this may disadvantage others who are yet to be
assessed.
– If a learner shares or receives assessment information that
unfairly advantages them during an assessment session, they
will be referred to the appropriate manager who will decide the
appropriate course of action.
– The appropriate manager will notify the learner in writing of the
decision within ten working days of the referral. This may result in
removal from the course or programme.
Advanced Driving Assessment (ADA)
What is an Advanced Driving Assessment (ADA)?
> The purpose of an ADA is to ensure personnel maintain a safe level
of competency in the operation of an ambulance and to ensure
personnel can demonstrate contemporary knowledge of the New
Zealand Road code and associated regulations.
> All operational personnel are required to undertake an Advanced
Driving Assessment (ADA) every three years.
> The ADA process will be fair, transparent, nationally equitable and in
line with other assessment processes outlined within this prospectus.
Standards
> The ADA will be conducted in the type of vehicle personnel being
assessed would normally drive in their working role. In situations
where personnel hold more than one driving role within St John, they
should be assessed in the type of vehicle that poses the greatest risk.36
> The ADA will be conducted by New Zealand Transport Agency (NZTA)
qualified St John Clinical Support Officer Driving Instructors (CSOs) or
on occasion, externally contracted Driving Instructors.
> The ADA will be conducted using a St John ADA form which has been
developed to industry accepted standards.
> The ADA will be based on a NZTA Class 1 driving standard.
> Personnel will be assessed using specifically developed driving routes,
noting that variability may occur based only on traffic conditions on
the day.
> ADA routes will follow the same type of structure with a similar type of
traffic exposure, noting this may be difficult to achieve in some rural
areas.
> ADAs should occur in areas where there is enough variability in
traffic conditions to demonstrate full competence in the driving
task(s), noting this may be difficult to achieve in some areas. Clinical
Practice Managers (CPMs), in consultation with Field Operations, will
determine where personnel will be assessed.
> Where possible an ADA will occur during working hours, noting this
will need to comply with aspects of OMP 3.4.1 Clinical Operations
Fatigue Management and Driving Policy and operational workload.
> The step-by-step technical aspects of how an ADA will occur will be
consistently followed by the national team of St John CSOs and will be
subject to the same moderation processes as other areas within the
Clinical Team.
> The Driving Review Panel will provide a level of oversight and will
consist of:
– Assistant Director of Operations Clinical Delivery and Support
– Clinical Programme & Moderation Manager
– People & Organisational Strategy representative
– Transport Service Licence (TSL) holder
– Health, Safety & Wellbeing Manager
– Two (2) St John CSO DIs (including the CSO Driving Subject Matter
Expert).You can also read
