EMS 284 - Paramedic Clinical Capstone

Current Oregon EMT, AEMT, or EMT-Intermediate license and completion of EMS 273 , and EMS 283  with a “C” or better.

Course Description: This is the field capstone of the paramedic course. Individual student meetings with the clinical coordinator and/or clinical instructors will be conducted throughout the course of the term. Students will ride as a third on an Advanced Life Support medical unit, not as part of the minimum staffing, and complete ALS-level calls as to meet or exceed the requirements outlined in Oregon Administrative Rule. 

Course Learning Outcomes:

• CLO#1: Safely perform numerous emergency procedures on live patients of various age groups.
• CLO#2: Perform a comprehensive patient assessment and formulate and implement a treatment plan for patients with a variety of medical and traumatic emergencies. (ILO: Critical Thinking)
• CLO#3: Evaluate leadership in the management of multiple personnel on emergency scenes. (ILO: Communication)
• CLO#4: Evaluate workplace expectations regarding attendance, safety, conduct, and professionalism.

Internship Requirements

1. Students must complete a minimum of 270 hours of ambulance ride time and 50 advanced life support calls for completion of the field capstone. 

40 advanced life support (ALS) calls are mandated by the Oregon Department of Human Services as a minimum for successful completion of the paramedic course (OAR 333-265-0010).  Ten additional miscellaneous advanced life support calls will be required for successful completion of the Rogue Community College Paramedic Degree Program.

The calls are broken down into the following categories:

• 10 Respiratory related or respiratory arrest
• 10 Cardiac related or cardiac arrest
• 10 Trauma related
• 10 General Medical, excluding respiratory and cardiac related
• 10 Additional ALS calls from any of the above categories

1. Advanced Life Support (ALS) calls are defined as calls that require ALS assessments or interventions including ECG monitoring, defibrillation, pacing, cardioversion, ALS drug therapy, intravenous access, intubation, etc.  Non-transport ALS calls may be counted, as long as the ALS assessment and differential diagnosis is adequately documented on the chart, but a minimum of 40 calls must be transports.

An example of a valid non-transport call would be a cardiac arrest that required intubation, drug therapy, and/or defibrillation prior to the discontinuation of resuscitative efforts.  For further clarification see the ALS Call Criteria list.

Basic Life Support (BLS) calls are defined as any call that requires BLS assessment and management only.

Criteria for Capstone Completion

NOTE: Overall completion of the field capstone program consists of the three phases of proficiency. Below, these three phases are outlined. In addition, each student will be required to complete all other documentation requirements contained within the Internship Manual and all required reading/written assignments.

Observation Phase (1-2 Shifts or 10 patient contacts)

During the observation phase, the preceptor will demonstrate the team leader role. These alarms will not count towards the student’s instruction phase grade. At the discretion of the preceptor, students will be allowed to demonstrate skills proficiency during this time.

The purpose of the observation phase is to demonstrate to students the roles and responsibilities of team leadership. This period also allows the students to begin acclimation to the field capstone environment.

Instruction Phase (10-40 ALS contacts)

The instruction phase is the period during which the preceptor no longer assumes the role of team leader. The student will now serve in this role.

During the Instruction phase, the preceptor will critique each patient contact. Scores will be provided on a scale of 0 to 2, with 0 showing unsuccessful and 2 showing successful.

During the instruction and evaluation phases, the student receives prompts to improve assessments and treatment skills. These prompts help students develop a “rhythm” in the field environment and to expedite patient care. Students that receive more than three (3) prompts will receive an unsatisfactory score for that given area. Students that receive repetitive prompts for the same area and on multiple contacts will receive an unsatisfactory score. If this trend continues, remedial training, or an action plan may be implemented at the discretion of the clinical coordinator.

Evaluation Phase (Remaining ALS contacts)

Following successful completion of the instruction phase, each student then moves to the evaluation phase of the field capstone.  The evaluation phase will encompass the remaining ALS calls required for successful completion after the student has successfully completed the instructional phase of capstone. Students that receive greater than 1 prompt during these remaining calls will receive an unsatisfactory mark. If the student reaches the required ALS contacts for program completion, but continues to receive unsatisfactory remarks, the student, the preceptor, and the clinical coordinator will complete a student counseling report, outlining areas needed for improvement. Deadlines, at that time, will be established for successful completion or removal from the program.

 

ACTI Code and Course Type
210 Career / Tech Preparatory

Length of Course:
A required state minimum of (270) and a standard RCC delivery of (297) of clinical/lab hours per term, not to exceed (324) hours per term, of ambulance internship. Hours and clinical times vary depending on clinical site availability and actual experience.