The skills-maintenance, competence paradigm for the evolving role of a Paramedic
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The UK paramedic profession has undergone significant development since professional regulation almost twenty years ago. Improvement planning within the NHS has also driven change. The result is a large and developing paramedic skill set. The skills performed and incidents attended by paramedics are highly variable in relation to the frequency with which they will be encountered as well as the procedural complexity. This consideration, in the context of the literature around clinical skills practice, competence, confidence and perception of performance invites inquiry in relation to competence of paramedics, as well as their ability to recognise practice issues. The aims of this study were to: (i) develop a map of incidents attended and skills commonly used in one UK ambulance service, (ii) assess the performance of clinicians across different types of skills and (iii) explore clinicians’ perceptions of their competence and confidence in relation to their objectively assessed performance. The study was carried out in two phases: Phase one was a retrospective review of clinical records (n=600), seeking to establish the frequency of incidents attended and skills practiced by UK paramedics and Phase two examined actual and perceived competence in clinical skills across a range of frequency and complexity, it also explored confidence (n= 69 paramedic participants). This was achieved through participation in a simulated clinical scenario and completion of a number of measures, participants also completed questionnaires in relation to the scenario and clinical skills.
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