Weighting: 50% of overall unit grade 

Assessment Due Date : Monday of Week 8, (5th May) 0900. 

Minimum Requirements: 50%

Preamble

In this written assessment you will be presented with a simulated case and asked to address several components of paramedic practice: patient presentation, pathophysiology, management, legalities of resuscitation and death notifications.

Task Description

You are presented with a sixty-five-year-old female complaining of discomfort in her chest and abdomen. The patient was doing the grocery shopping when she began to feel generally unwell with discomfort in her chest and abdomen and a ‘banding’ sensation across her chest and into her back. She is mildly short of breath, nauseous and feeling generally unwell. She drove herself home and symptoms continued to worsen, prompting her to call an ambulance.

The patient has very recently been diagnosed with stage 4 breast cancer and has verbalised to her husband that she doesn’t want to undergo chemotherapy, preferring that she lives the remainder of her life with dignity and comfort. She has not undergone a formal documentation process of her wishes. Despite her diagnosis, she feels well within herself and continues to work and participate in activities she enjoys.  

Past medical history: hypertension, type 2 diabetes and hyperlipidaemia, new terminal diagnosis of stage 4 breast cancer.

Social history: non-smoker, occasional drinker, lives with husband and supportive extended family live locally.

Medications: aspirin, perindopril, metformin

Observations are:

·         GCS 15

·         Heart rate: 90bpm

·         Respiratory rate: 22/minute

·         Oxygen saturations: 94% room air

·         Blood glucose level: 14.2mmol/L

·         Blood pressure: 160/88mmHg

·         Temperature: 37.0 C

·         12 lead ECG: Sinus rhythm with ST elevation in I, aVL, ST depression in II, aVF

Part A (750 words)

You are to write a response which addresses the following components:

1.      Determine the provisional and differential diagnoses based on the presenting information.

2.      Discuss the underlying pathophysiology of the patient condition.

3.      Analyse and evaluate the management options available for this patient.

Part B (750 words)

The patient deteriorates despite implementing the appropriate pre-hospital management and they now present in cardiac arrest. Her husband states there is no Do Not Resuscitate Order or Advanced Health Directive. He presents to you a Statement of Choice. He asks you not to resuscitate her.

In your response you are required to:

1. Discuss the documentation required to make a legally binding decision regarding resuscitation and how the Statement of Choice should be interpreted in this context.
2. Present a clear argument for ceasing or continuing resuscitation.
3. Reflect on the professional responsibilities of paramedics providing end-of-life care.

Part C (750 words) 

Regardless of your decision to start or withhold resuscitation, the patient now meets life extinct criteria. Using your own cultural background, discuss how you as a paramedic would approach a death notification.

In your response you must:

1. Analyse how your personal cultural background shapes your communication style and could influence your approach to delivering death notifications.
2. Compare and contrast your cultural approach to death notifications with another culture, identifying key differences in customs, communication norms and emotional responses.
3. Propose strategies for improving your skills in delivering death notifications and communicating in cross cultural contexts.

The expected word count for your written assessment is 2500 excluding references (use the above word counts as a guide). You do not need to structure this as an essay as introductions and conclusions are not necessary. Please use subheadings to assist in structure. You will be assessed in accordance with the rubric provided on the unit Moodle page.

Please upload your assignment as a PDF.

Please refer to the Generative AI Permission Document available on your Moodle site for guidelines on the acceptable and unacceptable use of generative AI in this unit. 

Assessment Due Date 

·         Residential Block A: 22nd May

·         Residential Block B: 29th May

During the compulsory residential school, you will undertake an in-class test designed to assess your ability to interpret commonly encountered pre-hospital ECGs. You will have thirty minutes to interpret ten ECGs. You are required to demonstrate your ability to apply the 5-step method to correctly diagnose the ECGs.

This will be a closed book, written exam with no collaboration with other students permitted.   

During the compulsory residential school, you will participate in two simulations, designed to replicate commonly encountered cardiac conditions, providing opportunities to assess your knowledge and understanding of any topic or material covered throughout the unit by means of structured, simulated patient interactions. They will also be designed to assess your ability to perform a thorough and accurate patient assessment and use this information to formulate a provisional diagnosis. In combination with your patient assessment and provisional diagnosis, you will be required to implement appropriate and timely clinical interventions, procedures and/or skills commensurate with your current scope of practice. Scene management and effective communication skills, including the ability to deliver a clinical handover to a senior clinician (i.e. CCP/ICP/MICA) or other healthcare professionals, will also be assessed. 

Assessment Due Date

Residential Block A: 23rd May

Residential Block B: 30th May

A marking rubric for this assessment task will be provided on the unit Moodle page. You are required to pass both simulations to pass the assessment task. If you fail one simulation, you will be offered to re-attempt a similar simulation. Failure to pass the re-sit will result in an overall failure grade for the unit. If both simulations are below the pass mark, no re-attempt will be available. The assessment will be based on marking criteria covering the following key points:

·         Systematic Approach

·         12-lead ECG acquisition and interpretation

·         Resuscitation management

·         Pharmacology

·         Graduate attributes: communication, problem solving, critical thinking and professionalism.

Assessments will be moderated by the Unit Coordinator and therefore finalisation of grades will not be made available at the completion of your assessment until moderation is completed. 

You will be required to complete an online test that will consist of various multiple-choice questions, 12 lead ECG interpretations and short answer responses testing your knowledge on the content from the semester. 

You will be required to answer each question to receive the marks allocated to that question. Non-attempts will score a zero mark for that question. Quizzes may not be reattempted. When the time limit expires, open attempts will automatically be submitted. This is an individual assessment with no collaboration allowed.

In the absence of an approved extension, there will be no opportunity to complete the task after closing date.