A validated tool for assessing task-oriented physical preparedness of South African emergency medical care students

Abstract

ABSTRACT Introduction This study focused on the development of new knowledge and the delivery of a scientifically defendable, pragmatic tool for the assessment of the physical preparedness of South African emergency medical care (EMC) students. The study was premised on the understanding that emergency care and rescue environments (both operational and training) can be physically demanding, potentially hazardous and are consequently associated with a risk of work-related injuries and illnesses. During their training, EMC students are exposed to a number of different disciplines and learning environments such as mountain rescue; water rescue; confined space rescue; rope rescue; and fire search and rescue. These diverse exposures in turn mean that EMC students require physical abilities and attributes that would allow them to participate successfully in each of the diverse learning experiences and environments they would encounter during the course of their training. For this reason, universities offering emergency care programmes require a suitable assessment tool that is recognised as both a valid and pragmatic way of assessing the physical preparedness of their students. Aim of the study The central aim, and unique contribution, of this doctoral study was the development of a valid tool for the assessment of physical preparedness of South African EMC students enrolled in an undergraduate professional Bachelor of Health Science Degree in Emergency Medical Care (BHSc EMC). Methodology The study followed an exploratory, sequential mixed methods design, beginning with a literature review that included a review of existing published literature and documentation to contextualise and frame the research. The findings from the literature review were used to inform the development of a purpose designed survey questionnaire which consisted mainly of closed ended questions generating mostly quantitative data. The survey questionnaire was pre-piloted before being distributed to respondents who were emergency medical care students registered for either their third or fourth year of study in the BHSc EMC programme, as well as academic staff members engaged in the teaching of the Medical Rescue and/or Physical Preparedness modules at the participating higher education institutions (HEIs). The quantitative data from the survey questionnaire was then analysed and the outcomes were used to develop an agenda for follow-on focus group interviews. These, in turn, produced qualitative data to develop a deeper understanding of the research problem and current context. A critical reflection on the findings constructed from the literature review, the questionnaire, and the focus group discussions allowed the researcher to design a specific battery of tests. These tests focused on comparing existing elements and approaches used by the universities for the assessment of physical preparedness to already accepted and validated tests. The final phase of the study involved a sample of students from the participating universities completing the battery of tests that were specifically selected for the study. Analysis of, and critical reflection on the students’ performance in the testing phase of the study as well as pragmatic considerations relating to the setting up and conducting of each test in the EMC student education context were then used to develop, refine and defend the final physical preparedness tool proposed by the researcher. Results The research found that there is support from both the academic staff and emergency medical care students for universities offering emergency care programmes to develop, maintain and assess an EMC student’s level of task-oriented physical preparedness using a standardised validated tool. Out of the 117 emergency medical care students who completed the survey questionnaire, 73/117 (62.4%) strongly agreed and 40/117 (34.2%) agreed that it is important for a BHSc EMC student to be physically fit. Similarly, 10/12 (83.3%) of the academic staff strongly agreed that the BHSc EMC student must be physically fit, and 2/12 (16.7%) agreed. The focus group interviews allowed the researcher the opportunity to explore three important concepts that had been identified during the survey questionnaires in more detail. It was agreed by both the academic staff and emergency medical care student participants that the physical preparedness assessment should be standardised and that the tool should be “user friendly” and pragmatic considering the EMC education context. The study found that a physical performance test with absolute standards is best suited to assess the level of task-oriented physical preparedness of BHSc EMC students in the context of general physical fitness. Cardiovascular endurance (aerobic capacity); muscular endurance; muscular strength; flexibility, and swimming aerobic capacity were identified as the components of fitness essential for an EMC student to engage successfully with the physically strenuous content of the BHSc EMC programme. The tool that was developed and validated by the researcher to assess the essential components of fitness for EMC students includes a modified sit-and-reach test; a flexed-arm hang test; the maximum push-up test; the seven-stage abdominal strength test; a grip strength test; a 5km run test and a 200m swim test. Conclusion EMC students are exposed to a number of different rescue disciplines and learning environments during the course of their undergraduate education and training. A minimum level of physical preparedness is required to support successful participation in the associated learning activities. Universities offering emergency care programmes are therefore required to formally assessment the level of physical preparedness of their students. The tool used for such an assessment should be shown to be valid and pragmatic. A physical performance test with absolute standards comprising a battery of tests that include a modified sit-and-reach test; a flexed-arm hang test; the maximum push-up test; the seven-stage abdominal strength test; a grip strength test; a 5km run test and a 200m swim test is a pragmatic, scientifically validated tool for the assessment physical preparedness of EMC students. Further research needs to be conducted to develop norms and standards for each of the tests making up the developed tool, including studies that explore the impact and success of different approaches relating to the use of physical fitness testing as a selection/entry requirement for EMC programmes including the approaches to facilitation of physical fitness education and training within local BHS EMC programmes.