National Occupational Competency Profiles for Paramedicine

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					NATIONAL OCCUPATIONAL COMPETENCY PROFILES
            FOR PARAMEDICINE


             EDUCATORS’ STEERING COMMITTEE

               PROJECT ADVISORY COMMITTEE



  February 10 – 12 2000, Radisson Fireside Lodge, Sun Peaks BC




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                REPORT OF MEETINGS




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                                Attendance

Educators’ Steering Committee:
Robbin Norgren (Justice Institute, BC)
Gary Lock (SAIT, AB)
Derek Cox (SIAST, SK)
Drew Christenson (Manitoba Health Emergency Services, MB)
Chris Robertson (Michener Institute, ON)
Claude Desrosiers (Urgences Santé, PQ)
Mike Nolan (Holland College, Atlantic Provinces)
Nick Doucet (Canadian Forces)

Advisory Committee:
John Ash (Saskatchewan)
Dennis Davis (Newfoundland)
Claude Desrosiers (Québec)
Nick Doucet (Canadian Forces)
Ron Laverty (Ontario)
Bill Leverett (British Columbia)
Merideth Morrison (Ontario)
Wayne Morris (Ontario)
Mike Nolan (Prince Edward Island)
Brian Schwartz (Ontario)

Project Steering Committee Representative:
Darrell Paranich

Guests:
Brian Field (focus group facilitator)
Gordon Jones (physician representative)

Facilitators:
Mary Beth Gibbons (Project Director)
David Cane (Project Consultant)

Administrative arrangements:
Mary Ann Peressini
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Advisory Committee members not attending:
Barry Kidd (Yukon)
Marty McNamara (Ontario)
Pierre Poirier (Alberta)
Linda Nugent (Manitoba)




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                    EDUCATORS’ STEERING COMMITTEE


The committee met Thursday February 10 (9 am – 8 pm), and Friday February
11 (8.30 am – 4.30 pm).


                               Topics Discussed

Day 1

1. Welcome & introductions

2. Logistical arrangements

3. Current status of competency profiles project
      Validation process, review by training programs, review by Advisory
         Committee, preparation of Final Draft Profiles, PAC approval, CMA
         approval
      Curriculum blueprint project
      Essential Skills Profile; project to integrate essential skills and
         occupational competencies

4. Role of Educators’ Steering Committee

5. Review of feedback and validation data; suggested changes to draft
   competency profiles

   The results of the analysis of validation questionnaire survey data and focus
   group feedback were reviewed in detail. As a result the group proposed a
   number of changes to the draft competency profiles.

6. Process for teleconference with programs


Day 2

1. Teleconference with programs

This took place from 9-11.30 am. Participants were:

Augustana University College, Alberta (Dale Bayliss)
Canadian Red Cross, New Brunswick (Shelley O’Brien)
Canadian Red Cross, National Office (Rick Caissie)
HCCSJ, Newfoundland (Wayne Patzalek, Ken Roche, Barry Trickett)
NAIT, Alberta (Joe Acker, Tania Younghans)
Portage College, Alberta (Kirk Nyquist)
SIAST, Saskatchewan (Don Brickner)
St Clair College, Ontario (Greg Skomash)
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The group briefly reviewed the analysis results and discussed in detail the
proposed changes to the competency profiles. Some further changes were
made.

2. Finalization of recommendations on draft profiles

In the light of the teleconference, the group further discussed the competency
profiles and prepared a final list of proposed changes for submission to the
Project Advisory Committee the next day.

The changes proposed are included in the separate document entitled: “Recs for
Advisory Committee”.


3. Review of curriculum blueprint project; input on process for Toronto meetings

The group discussed the proposed process for the curriculum blueprint project.

The key steps and timelines were revised as follows:

    Initiation Meeting (March 5 & 6 2000, Toronto)

    Draft blueprints developed by Working Committees (March – December
     2000)

    Advisory Committee meeting to review and finalize draft blueprints
     (January 2001)

    Draft blueprints distributed to programs and other stakeholders (January
     2001)

    Regional forums held (April & May 2001)

    Working Committees finalize draft blueprints (June & July 2001)

    Advisory Committee meets to finalize blueprints (August 2001)

    Curriculum Blueprints endorsed by PAC (August 2001)

In addition the following key strategies were suggested:

    Each of the 4 Working committees should have co-chairs – one co-chair
     being appointed from the Advisory Committee, the other from among the
     participant group

    A master template should be prepared ahead of time, for use by the
     Working committees; we should examine the possibility of basing the
     template on work done in the US
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    The tasks of each of the 4 committees should be sequenced to ensure
     that the profiles are built in a logical order and that effort is not duplicated

    The developing blueprints should be posted on the Website for review by
     all participants

    A medical resource person (physician) should be appointed for each
     Working Committee

    During the Initiation Meeting (March 2000), each Working Committee
     should have time to meet independently.



                       PROJECT ADVISORY COMMITTEE

The Committee met Saturday February 12 (9 am – 3.30 pm).


                                Topics Discussed

1. Review of agenda

2. Update on current status of project:

        Validation process, review of results by training programs
        Final review by Advisory Committee, preparation of Final Draft Profiles
        Submission to PAC for approval, submission to CMA
        Essential Skills Profile; integration of essential skills and occupational
         competencies
        Curriculum blueprint project
             appointment of working committee chairs
             medical advisors

Working Committee co-chairs were appointed as follows:

EMR:   Bill Leverett
PCP:   Claude Desrosiers / Merideth Morrison
ACP:   Mike Nolan
CCP:   Ron Laverty

A number of suggestions were made regarding possible physician medical
advisors in addition to Gordon Jones and Brian Schwartz. Mary Beth will follow
up in consultation with Gordon and Brian.

3. Ongoing role of Advisory Committee


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Curriculum blueprinting will take place under the ongoing guidance of the
Advisory Committee, which will meet twice during the blueprinting phase of the
project.

Note added by David (Feb 15): at the recommendation of HRDC, we were to add
two new Advisory Committee members during blueprinting – one additional
employer rep, and one additional union rep. Given Merideth Morrison’s new
management position (and following the support of her new employer) she will
function as a second employer representative. Will be appointing a
representative of the Ontario Public Service Employees Union (OPSEU) but were
unable to identify a representative prior to the February meeting. Given Gordon
Jones’ ongoing role as a medical advisor to the project, I suggest we consider
Gordon a regular member of the Advisory Committee from now on).

4. Review of:

         validation information
         recommendations from program reps
         other feedback

The Committee reviewed the validation data and discussed at length the specific
recommendations of the Educators’ Steering Committee.

The key recommendation to eliminate the competencies for hands-on driving at
all levels was very strongly supported.

The key recommendation to change competency 5.6e (perform IV cannulation) to
an academic (A) competency at the PCP level was unanimously supported. This
competency at the PCP level will be flagged for possible increase to clinical (C) in
the next revision of the profile (likely in 2002).

The Committee discussed a request from SAIT to retain within the PCP profile
competencies 5.1a (airway maneuvers) and 5.3f (BVM) as degrees of
competency “S”. The Educators’ Steering Committee had recommended that the
degrees of competency be “C”. SAIT’s rationale was that it was impossible to
obtain student clinical exposure to these skills due to other demands on clinical
space, and that retaining the competencies as “C” would effectively eliminate
SAIT from implementing the profile and from obtaining accreditation. SAIT also
believes that there is research evidence that these skills can be effectively taught
in simulation. Committee members recognized the difficulty SAIT was
encountering, but felt that these two competencies were among the most
important skills of a PCP. The Committee voted unanimously to retain 5.1a and
5.3f as clinical competencies. Committee members emphasized that if clinical
exposure to the skills could not be achieved, preceptorship exposure may be
possible. The group directed that a letter should be prepared for SAIT, outlining
the Committee’s position, and describing alternate ways of obtaining student
exposure.



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The Committee reviewed a communication from the BC Ambulance Service, and
discussed BCAS’s concerns and recommendations. The Committee directed
that a detailed response should be prepared.

The Committee discussed the possibility of introducing an additional degree of
competency, “Sh”, denoting simulation with a human subject. The group did not
support introducing a new degree of competency, but directed instead that the
definition of degree of competency “S” should be modified to include the words “it
is assumed that all items required for evaluation in a simulated setting in
Competency Areas 4 & 5 will be performed on a human subject where legally
and ethically acceptable”.

The Committee discussed the possibility of changing the name of the PCP
practitioner level to avoid the use of the words “primary care”. There was no
support for a change, on the basis that any title would give rise to some degree of
confusion, but that this would be eliminated over time.

The Committee made the following specific changes to the recommendations of
the Educators’ Sub-Committee:

All profiles:   delete 4.5k

ACP:            change 4.5e, 4.5f, 4.5g, 4.5h, 4.5I, 4.5j to “X”
                change 5.1l to “A”

CCP:            change 5.6e to “P”
                change 5.9h to “C”
                change 5.9k to “A”
                change 5.9l to “C”

The Committee reviewed the “Medication Groups” chart, and supported its
attachment as an appendix to the profiles.

With the above changes and notes, the four competency profiles were approved
as a FINAL DRAFT for submission to PAC, with the recommendation that they be
approved at the Annual General Meeting.

The final draft is attached as the separate document entitled: “Final Draft
Profiles”.




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