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Diploma in Primary and Urgent Care

Following the Board of Trustees acceptance in 2017 of the offer from the South East Coast Ambulance Service for the intellectual property rights to their Specialist Practitioner examination, the College of Paramedics obtained funds from an external stakeholder to pilot the examination on a twelve-month basis.

Why has the College of Paramedics now taken over the exam?
It is important that the College, in its role representing the profession, makes appropriate statements and employs specific processes that supports its members and the wider professional group to function safely and effectively in these roles. The examination and associated work-place based assessments were reviewed by the College and seen as a ready-made process that would enable it to in part do this with limited financial investment.

Why is the College of Paramedics awarding a diploma?
The College established the Faculty Examination Assessment Committee (FEAC) to oversee the implementation of examination assessments and further develop the examination award.

In accordance with the College’ Articles of Association, article 2.1 states the College has the power;

‘to establish scholarships and to grant prizes, awards, diplomas and certificates of merit and proficiency and qualifications in connection with the profession’
Therefore, the College’s award for the examination will be the Diploma in Primary and Urgent Care. 
The College believes that establishing and maintaining the status and pedigree of this assessment can only be achieved by awarding it sufficient importance and merit.

Why is this important for the profession?
Professional examinations such as these are common across higher professional groups and important for benchmarking clinical practice and standards. This benchmarking provides a level of governance by assuring employers, employees, patients and insurers that clinical practitioners have reached required standards to practice in an environment that presents many challenges including uncertainty and ambiguity.
Representatives of the College have met, and work is ongoing with the Royal College of General Practitioners (RCGP) to discuss how the examination and award can be further collaboratively developed as a governance standard for those who wish to develop and work in primary care. 

What does the examination consist of?
The examination comprises of triangulated assessment which includes;

  1. A period of Work-Place Based Assessment (WPBA). It is expected that applicants would have completed an appropriate period of WPBA prior to applying to undertake the examination;
  2. 15 x 10 minute Objective Structured Clinical Examinations (OSCEs), and,
  3. A three hour Applied Knowledge Test (AKT) paper formed of 150 single best answer (SBA) questions. 

The overall assessment process uses an established triangulated approach to assessment whereby the WPBA tests ‘performance’ and the examination elements tests ‘competence’. The competence element of assessment uses clinical skills and communication testing OSCEs and AKT multiple choice SBA questions that test application and integration of knowledge, skills, communication, and attitudes across a broad spectrum of clinical presentations framed by decision making in the context of risk stratification rather than risk avoidance.

Who is the examination for?
The examination was originally developed for paramedics working as paramedic practitioners. The College is working to deliver the examination to practitioners at ‘specialist’ level of practice and who work in primary and urgent care. The examination assessment provides the core entry standard required to use the term specialist by providing an assessment that through its process is a defensible governance standard on which practice is recognised and can grow.

What about existing specialists or advanced practitioners?
Where practitioners are established and already working in the primary or urgent care environment the College is developing a process of sponsorship whereby an employer or an appropriate clinical supervisor signs a declaration stating that WPBA standards have been met and maintained. They would then be eligible to apply for the examination.

2018 College Examination dates
On 19th May 2018 the first College examination was held at the Medical School, St. George’s University Hospital, with a total of 31 candidates attending. The examination was overseen by the College’s examination manager, chief examination officers, and examiners. The College’s FEAC proposes there will be two further examination dates in mid-October as part of the pilot scheme. The OSCE and AKT assessments are currently undertaken on different dates. The OSCE examination can assess a maximum of 32 candidates per day and the AKT is undertaken at set locations. 

Future development and interest?
After the October examinations the pilot will be reviewed. This will include financial viability and the future potential credibility of the examination award as part of an evolving profession. The ongoing work with the RCGP will also form part of this review. Paramedics who are interested in applying to undertake the exam please e-mail: yvonne.cooze@collegeofparamedics.co.uk