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EMJ editorial competency assessment
  1. Colville Laird
  1. Correspondence to:
 Colville Laird
 Associate Editor:

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The need to look at assessment of competence in prehospital care education

At the present time there is a need to look at the assessment of competence in prehospital care education. This is necessitated by the changing structure of the Health Service particularly the delivery of unscheduled care. These changes are resulting in new types of practitioners, mostly from the ambulance and nursing professions, taking major roles in providing this service. These professions require a system, which allows the practitioners and their supervisors to assess their competence to practice. In addition to this, such certification should ideally give these practitioners credits, which can be accumulated and ultimately lead to university level qualifications.

The reality of such training is that only so much of the training can be achieved by teaching and study, whether it be in a classroom environment or computer/internet based. Much of this learning has to take place in either supervised practice preceded or accompanied by training in simulated clinical situations.

Training of doctors has traditionally been based around introductory periods of study followed by relatively long term periods of clinical exposure – on the basis that during the clinical exposure practitioners will come across a sufficiently wide range of clinical circumstances to make them safe to practice. We have all, the nursing profession more than the medical profession, moved towards competence based training; however, Health Service economies, shorter working times, and greater patient expectations of privacy mean that traditional educational methods of long term exposure to clinical circumstances will no longer meet the student’s educational needs. Time served has never guaranteed adequate breadth of exposure to the full range of clinical circumstances that should be necessary for practice. In view of these limitations one solution lies in competence based assessment. As many of the issues have a direct effect on both Emergency Department and Prehospital care we have started to look at these issues. In this issue of the Journal we publish an article to set the scene and stimulate the readers’ thoughts in this evolving area. Further articles will appear in future issues. Your contributions are welcome.

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