The competition consists of a combination of scenario based activities and academic evaluations. These are conducted at various locations throughout the college. At the beginning of the day you will be given a schedule and a map. You will be broken into groups of three to four teams (usually a college team, PCP team and an ACP team). This will be your group for the day that will rotate together to each competition station. As well, volunteer guides will be assigned to help you find your way and carry equipment.
Scenario Based Evaluations:
There will be several scenario based activities. As your group approaches a scenario station, you will be asked to stop at a specific marshalling area. There you will be given call information. From there you will be lead into the scenario area and the simulation will begin. Scenarios are generally done concurrently i.e. there will be three or four identical simulations and all of the teams in your group will perform at the same time.
A combination of actors, hi fidelity and low fidelity simulation could be used at any scenario station. Patients are programmed to be as realistic as possible and any other feedback will come from the judges assigned to each station. Casualty simulation and props will be used as much as possible to enhance the realism of the simulation.
There will be a minimum of two judges assigned to any scenario. Judges will be qualified at or above the level of performance that they are evaluating i.e. ACPs will judge ACPs.
To avoid any potential conflict, judges may not evaluate their own teams. Judges will be responsible for evaluating the scenario against and objective scoring template and well as providing scenario specific feedback to your assessment and management. There will also be a head judge at each station to address any scenario specific or continuity issues.
Evaluations for scenarios follow a very specific template and are based on a check sheet. Judges are instructed to evaluate teams on what they hear and what they see. You do not have to say everything that you are doing but you should make it clear to the judges. It is expected that when you perform a specific assessment that you will do it correctly and then verbalize your finding. If you are going to initiate a treatment it is acceptable to state what it is that you are doing and then perform the skill correctly, you do not have to go into detail i.e. it is acceptable to state that you are going to intubate the patient and your rationale but you do not have to state every step in the process, just perform it correctly.
A copy of a GENERIC SCORING TEMPLATE is also provided.
The first thing that you will likely notice is that there seems to be a great deal of detail around specific areas like primary survey, vital signs, etc The actual scoring is heavily weighted (between 70 and 75%) towards your treatment decisions and scenario specific management. There is always a concern amongst teams that they will not be heard or not get credit for something that they did. Judges are instructed to give teams the benefit of the doubt i.e. if one judge hears or sees a team perform correctly but the other does not, the team will get credit.
Scope of Practice
Your scope of practice is defined by the National Occupational Competency Profile and the Basic LIfe Support Patient Care Standards as well as current standards defined by BCLS, ACLS, BTLS and PHTLS. No specific set of Medical Directives will be utilized for the purposes of competition. You may assume that you are authorized to perform the skills and interventions that are normally associated with your practice. You do not have to contact a physician for authorization, you may assume that you have authorization however, you are accountable for any procedure that you do.
Critical errors are defined as any act of commission or omission (what you did or didn’t do) that would put the patient at risk (unnecessarily worsen the patients condition). The penalty for such an act may mean no points for the patient scenario at all or at least no points from that point forward. Judges are instructed to consult with the head judge before assigning a critical error.
Notes and Notebooks
You are allowed and encouraged to bring blank paper on which to make scenario notes. You are also encouraged to keep those notes with you. You may not use pre-printed forms or notes
Generally, scenarios are 18 minutes in duration and run in real time. If you choose to report to a receiving facility, that must also occur within the time limit. At the end of the scenario, you will be asked to pack up your equipment with the assistance of your volunteer guides and prepare to rotate to the next station.
While the is no specific list of equipment the Ontario Land Ambulance Equipment Standard can be used as a guide. In general we recommend that teams keep in mind that the equipment they bring they will need to move/carry with them throughout the day. Teams are permitted to “pack” their equipment in a manner of the choosing. Generally teams use a format similar to that which the encounter in their practice, which we encourage. Some scenarios may require specific pieces of equipment which will be made available to you. All equipment should be in working order and you will be expected to apply it correctly. Teams should notify the team liaison if there is equipment on the list that they cannot provide. No team will be penalized for specialized equipment that they cannot provide.
It is expected that teams will treat scenarios as realistically as possible. Included is the importance of effective patient interaction. In specific scenario in the past the quality of patient interaction has been evaluated by the patients themselves.
Viewing for spectators and supporters is encouraged. Team supporters are reminded that they may not interact or assist the team in any way during the actual scenario. Viewing areas are generally set aside for spectators.
Confidentiality and Security
To ensure fairness, competitors and spectators may not discuss specific scenarios. The use of electronic devices to communicate information regarding scenarios is also not permitted.
Different forms and combinations of academic evaluation have been used in the past.
A formal written test has often been used. These are usually in the form of a multiple choice or fill-in-the-blanks or combination of the two. Occasionally the questions are posted on a screen so that spectators may observe as well.
A bellringer exam has also been used in the past. Bellringers involve the teams rotating through a series of stations that present a clinical problem. This may involve an anatomical model, diagnostic finding (12 lead, etc) or patient presentation. Teams will be given a fixed period of time (generally 1 minute) at each station to record their answer and then move to the next station.
Teams have been interviewed by other health care and emergency responders regarding their activities on a scenario. Evaluation is typically around recall and the specific critical detail that would be important to relate later e.g. actions at a crime scene.
Generally patient simulations count for between 400 and 700 points depending on the complexity of patient care. If there are two patients in a scenario then points could be anywhere between 1000 and 1300 points. Academic evaluations usually count for the same as any one patient (300 to 600 points). At the end all points are tallied and the results are announced at the banquet.
Review and Appeals
All potential controversies and questions of scoring are reviewed by the competition committee prior to the announcement of the results.
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