Simon Downs

Background Pain is one of the most common symptoms presented by patients of all ages to ambulance services. Whilst children in pain are only a small proportion of the number of patients that pre-hospital care services attend, in only 40% of these cases is it deemed necessary for analgesic medication to be administered. At conception there were no identifiable UK studies considering the influence factors clinicians have in the assessment and treatment of out-of-hospital pain within a paediatric cohort. Aim

Why you should read this article: • To enhance your understanding of the purpose of an action plan to support a nursing student or nurse • To learn about the procedure for writing an action plan with a nursing student or nurse • To know which stakeholders to involve in the development of an action plan

Pain is one of the most common symptoms presented by patients of all ages to ambulance services. While children in pain make up a relatively small proportion of the patients attended by prehospital care services, medical intervention is needed in only 40% of cases. This might go some way to explaining why management of paediatric pain is perceived as poor. Aim: To establish and explore published barriers and facilitators to out-of-hospital pain management for children aged

Clinical decision-making is a multifaceted construct, requiring the practitioner to gather, interpret and evaluate data to select and implement an evidence-based choice of action. Clinical reasoning is a difficult skill for students to develop due in part to the inability to guarantee awareness or opportunity to develop within time spent in practice. While professional developments within the past few years have established a supportive preceptorship programme within NHS trusts for new paramedic registrants, enhancing activities to develop these crucial skills within a pre-registrant programme should be prioritised to enhance the abilities of students and subsequent new registrants. A better understanding of the reasoning processes used during clinical decision-making may help health professionals with less experience to develop their processes in their own clinical reasoning. To embed such awareness and enhanced practice, the lead author, a third-year student paramedic at the time of writing, presents a reflective consideration of a patient encounter using the hypothetico-deductive model to evaluate and critically explore his own reasoning and processing within a meaningful patient interaction.

Background: There is increasing demand for access to mental health support services both for ongoing care and at time of crisis. Preparation of undergraduate students for encounters with those with ongoing mental health care and/or at a time of psychological distress/crisis remains sporadic and difficult to encompass. Simulation gives students opportunities to develop technical and non-technical skills through the recreation of an experience that is as close to reality as possible. Method: An exploratory evaluation of teaching practice of student self-perceptions of self-awareness and self-regulation in encountering clinical situations with persons in high states of arousal and potential conflict was conducted. To evaluate the exercise and its value, students were asked to self-evaluate their confidence and knowledge both prior to and subsequent to the teaching exercise. Results: There was a positive shift in self-awareness and self-regulation post training. Confidence in being able to de-escalate a situation was reported as the key outcome to take from the session, along with techniques on how to de-escalate a scenario. Conclusion: While it is not possible at this stage to definitively measure the impact of the teaching on practice or draw firm conclusions for education providers, the evaluation exercise does evidence individual impact and enjoyment. The teaching approach may prepare the future workforce with the skills and knowledge needed to provide high-quality care.

Aims: This study aims to evaluate an established teaching tool for developing the Clinical Reasoning skills of student Paramedics, ascertaining the feasibility of this as an ongoing method for enhancing the teaching of clinical reasoning potentially alleviating the identified issues of transferring. Methods Utilising a qualitative approach to seek opinion and experience of the students undertaking the learning activity to ascertain level of enjoyment, student relatability and awareness of the skills it wished to develop. Data collected via an online survey tool was then analysed to draw theme and particular comment. Findings Student enjoyment and engagement was evident, the exercise permitted independence of thought and working; promoting students to self-appraise the effectiveness of the working strategy. Conclusion The results of this case study indicate the exercise could be effective in its premise of developing students’ clinical reasoning skills. It compliments established teaching strategies, such as core lectures, seminars and supervised practice.