This study determined the usefulness of experiential learning for psychomotor skills development of EMS students in PSCEMS Saudi Arabia. FISDAP tool was used in EMS education for documenting, tracking, and assessing students’ skills performance. In this study, the trustworthiness of the students input to FISDAP is granted. However, all the skills assessment form entries were validated by the preceptor and the clinical instructors/ coordinators. The criteria were well established for passing the skills and number of times the specific skills should be performed. The time duration of the five clinical practice courses was one day in a week for 9 hrs. /day. Whereas during the internship year, the time duration was five days in a week for 9 hrs. /day.
This study mainly focused on most essential psychomotor skills such as health assessment, airway management, intravenous insertion, medication administration, endotracheal intubation, and ventilation. Therefore, to integrate theoretical knowledge into practice a wide variety of clinical placements were utilized such as in- field (Ambulance based training), hospital (Emergency Room (ER), Operation Room (OR), Intensive Care Unit (ICU) and high-fidelity simulation labs. The findings of this study are promising and show that experiential learning is useful and effective way to develop psychomotor skills and competencies in EMS students. These findings are consistent with previous studies (12) that experiential learning was effective strategy for clinical skill competency development in nursing education. It helped students to gain mastery in history taking and physical examination. Consistently, experiential learning in ambulance services in the undergraduate nursing program in prehospital emergency care was successful in development of student’s comprehensive care approach, clinical reasoning, reflective practice, and self-awareness (18). It also promotes the students’ interaction and communication skills in interdisciplinary healthcare teams (13, 16).
The students’ performance in psychomotor skills was different between the clinical practice during the 3 years program and during the one-year internship period. The finding indicates that the students’ skills performance fall below the minimum requirement during the clinical practice and significantly improved during the time of internship period. The overall success rate range between 26.58%, to 35.74% across all the psychomotor skills in clinical practice. However, during the internship year student’s success rate range between 85.49–99.4% across all the psychomotor skills. These findings are consistent with the previous study (19) that internship year brings more opportunity and time for the students to be engaged in hands on practice and it showed students improvement in most of clinical skills over time. Moreover, it is noted that experiential learning during internship improves students’ interpersonal skills, self confidence, and their psychomotor skills competencies level (20). Experiential learning approach ultimately prepares EMS students for the transition to work life (21).
There were certain challenges during the practicum period of the program, which could have affected students’ performance. Those are time constraints, limited number of cases overall in some days of practice, presence of students from other educational institutions in the practice and limited number of opportunities to perform certain rare skills such as endotracheal intubation. These challenges were overcome by providing the students the opportunity to practice these skills in high fidelity simulation labs. In simulation labs students can practice without the fear of any harm to the patients. Moreover, students had the opportunity to perform, reflect, discuss with each other, and provide feedback. It is suggested that simulation based experiential learning is helpful is developing medical students’ professionalism, ethical and cultural competence without jeopardizing the safety of the patients. (11, 14). Also, the students were able to practice intubation in the OR if they did not get the opportunity in the ambulance services. Moreover, Internship year gave the students the time and opportunity to practice and gain competencies in required skills which they were unable to achieve during the clinical practicum period. It is important that different variety of teaching strategies and clinical placements are offered, and the time duration of those clinical practice is important for the preparedness of EMS students for professional working life (7, 22).
Paramedics are an important part of health care system and specially in the prehospital care. Therefore it is essential to provide quality-based education and give them the required knowledge, skills, and competencies to be able to provide safe, efficient, and ethical care to the wide variety of patients group. Competency based teaching approach is essential for EMS education and thus efforts should be directed towards the development of this area for the better progress of the discipline in health care (23). A scoping review by Alshammari et al. (24) proposed five core competencies for EMS education. These are communication, clinical skills, teamwork, critical thinking and decision making, and professional behavior. In a Delphi study from Saudi Arabia these competencies emerged for EMS education, such as legal and ethical practice, safety procedures, respect and non-discrimination, decision making and critical thinking and clinical practice (25). Therefore, the findings of this study will be useful for educational institutions in planning and developing strategies to facilitate psychomotor skills and competencies development in EMS education. It would also help educators and educational institution to plan pedagogies focusing on experiential learning. FISDAP is a new tool in EMS education in Saudi Arabia and obviously may have many challenges. Faculty members, staff and student training is crucial to use the tool effectively and efficiently. FISDAP could also be costly, and every institution might not be able to afford it. Therefore, Further studies are needed to fine out the perspectives and challenges of using FISDAP from both students and faculty members perspectives.