Aim of the assessment
The purpose of reflecting on your placement experiences and completing this assessment is to:
• Develop your questioning techniques in relation to those experiencing mental health challenges.
• Explore and incorporate the Mental State Examination into your overall systematic approach.
• Develop your observation techniques for early detection of people experiencing mental health challenges.
• Identify therapeutic techniques utilised by Paramedics and compare these with options available within the course materials.
• Compare your patient’s current presentation with any diagnoses from their past medical history.

Section 1.

Provide a brief description of the case to which you were called. This should include:
• Age, sex and any cultural identity considerations important to the person suffering the mental health challenge.
• Time of day and conditions at the scene.
• History of incident to which you were called and the individual’s description of the problem (this will become relevant in the insight and perception sections).

Section 2.

This section relates to your observation and questioning surrounding the mental state examination. Using the following as a guide please document the findings of your Mental State Examination. Please include questions you would ask to gain further information from your patient.
• Appearance
• Behaviour
• Speech and language
• Mood and Affect (feelings)
• Thought content (thinking)
• Perception
• Cognition or Cognitive Functioning
• Insight and Judgement

Section 3.

Compare your patient’s current presentation with any diagnoses from their past medical history. What aspects of their presentation match their diagnosis/diagnoses. If the person does not provide or does not a diagnosis or diagnoses related to mental health please provide a provisional diagnosis which you believe may be relevant to the person.

Section 4.

Document any therapeutic techniques your team may have undertaken during your time with the person.
For example this may include any de-escalation techniques, pharmacological interventions, involvement of significant others or appropriate referral utilised to assist the person suffering a mental health challenge. Please note this list is only an indicator of what may be included and is not comprehensive.
If no or little therapeutic options were used please provide what therapeutic options you would utilise.

Assessment criteria

The following outlines the requirements to gain a high distinction for this assessment piece.

Section 1.
Present a succinct evidence based description of the individual and scene.
AND
Uses contemporary language descriptors associated with the Recovery Based Framework.

Section 2.
Documents (for the person outlined in Section 1) all components of a Mental State Examination (MSE) using the above as a guide.
AND
The MSE is succinct and specific to the patient and the challenges they are suffering in all aspects.
AND
Questions developed to illicit further information are specific to the individual’s mental health challenges and current circumstances in all instances.

Section 3.
Compares the findings of the MSE with any past diagnosis/provisionally diagnoses the patient identified.
The comparison is succinct and each area of the MSE is matched with the relevant diagnosis/diagnoses. OR
If no diagnosis/diagnoses are available clearly state this fact and provide a provisional diagnosis based on the presentation.

Section 4.
Provides a succinct and detailed account of all therapeutic techniques utilised with the individual
AND
Provides a succinct detailed account of the effects they had (positive or negative -if any).

Introduction

The aim of the three day residential school is for you to put into practice the lessons learned on placement/s and in Assessment 1 (your reflective case review) in a safe but challenging environment.
Throughout the first two days of residential school you will practice Objective Structured Clinical Examinations (OSCEs) (or practical scenarios as they are sometimes known) and receive feedback from Qualified Paramedics. During this time you will be provided with feedback regarding how you can improve or hone your practical skills in this subject area.
The third day of residential is where (at scheduled times) you complete your on-campus assessments including two long cases and a documentation exercise.
Aim of the Assessment

The purpose of this assessment is to
• Examine your questioning techniques in relation to patients experiencing mental health challenges.
• Assess your ability to incorporate the Mental State Examination into your overall systematic approach.
• Gauge your ability to communicate with patients experiencing varying forms of mental health challenge in a caring and professional manner.
• Evaluate your ability to deliver a range of therapeutic options in a simulated but challenging environment. This will not only include the ability to deliver clinical care for situations such overdoses of varying types, but also focus on the ability to de-escalate highly emotive consumers experiencing mental health challenges.

In effect, this is you developing work ready practical skills and knowledge to prepare you for the challenging clinical environments you will face on graduation.

This assessment is made up of two components:
1. 2 x Long cases
2. 1 x Documentation exercise

Assessment 1. 2 x Long cases

Along with a partner you will have 20 minutes to communicate with, assess and manage a patient suffering a mental health challenge commonly seen in the field.
The primary officer will be the only one being assessed and you will be allocated 20 minutes to complete the case. During the next 10 minutes you will be expected to clean up the assessment scene and assist with restocking as you would be in the workplace.

There will be a break between doing your long cases.

Duration of Assessment: 20 minutes + 10 minutes of clean up and restocking.
Weighting: 35% of Course Total (this will be an average of marks from your two OSCEs).

Documentation exerciseFollowing the first long case you will be require to document a Mental State Examination on the person you have treated. This is NOT necessarily an Emergency Examination Order or Assessment Order but rather just the mental State Examination using the guide from your moodle site.

You will be provided with a form in either a paper format or on an electronic device to complete. Many services still utilise paper based patient records.

Time frame to complete: 30 minutes.
Weighting: 15% of Course Total

The above components of the On-campus Assessment tasks are completed at designated times during your residential school. Assessors will submit results electronically and these will be posted via your Moodle site.
**The On-campus assessment task must be completed at the dates and times allocated during the residential school: in the absence of an approved extension there will be no opportunity to complete the assessment at a later date, and there will be no opportunity to apply a 5% per day late penalty.
**The Clinical Practicum Attendance Procedure is applicable for this assessment item. Students should view this prior to attending residential school (copy included within your Moodle site).

To gain a high distinction within the On-campus activities you will be required to:


Long Cases Assessment Criteria
Section 1.
Interpersonal Communication and professional behaviours - Uses clear, concise, communication techniques to achieve assessment and management goals.

Section 2.
Patient Assessment - Clear articulation of all components of discipline specific assessment in particular Mental State Examination.

Section 3.
Discipline Specific Management/Referral - Complete appropriate management within scope of practice (ACP II Queensland Ambulance Service, unless an alternative is negotiated with Course Coordinator).

Documentation exercise Assessment Criteria

Section 1.
Grammar and Spelling - Practitioner makes no errors in grammar orspelling whilst documenting.

Section 2.
Components of the Mental State Examination - Documents all aspects of the Mental State Examination with examples of patient behaviour in each.

Section 3.

Terminology - Uses accepted Mental Health/Medical terminology within the various dimensions/categories of the Mental State Examination.

Introduction

Assessment three is focused on two crucial areas within the mental health arena, self-care and minimisation of the effects of the job on Paramedics and cultural communication aspects when assisting people who identify as Indigenous.
Your Assessment task is in two parts:
1. Development of a poster AND
2. Answering a cultural communication question within a written assignment

Task 1 Poster (can be developed as a group or individually)
Introduction
The incidence of Post-Traumatic Stress Disorder and Secondary Trauma in Paramedics and other emergency services has in recent times become the focus of a number of studies (people are talking). This said while many Australian and International Ambulance Services have peer support programs in place for staff experiencing these mental health challenges, there hasn’t been the same degree of focus on preventative and awareness programs for this same group.
In all things medical, prevention is better than cure.

Details
For task 1 you are required to prepare a poster that can be used as a comprehensive learning resource for Paramedics and Managers/Supervisors in an Ambulance Service. The focus of the poster is:
• The effects of PTSD and secondary trauma.
• How to minimise the effects of PTSD and secondary trauma.
• Therapeutic options to assist the person experiencing PTSD and secondary trauma.

The poster should include the following information on both conditions.
• Introduction
• Definitions
• Epidemiology
• Aetiology
• Symptomology
• Methods for early detection including self-care detecting methods such as stress scales.
• Therapeutic options aimed at assisting the person. This should be backed up with references wherever possible.
• Reference list.

Each section should be succinct and a graphic/s should be incorporated into the poster to increase visual appeal.

Task 2 Written Assessment (Individual assessment)

Section 1

Dispatch Details: Called by the Queensland Police Service (QPS) to a 19 year old aboriginal male who is jumping at shadows and not ‘talking normally’. QPS are on scene.
Time of Day: 2000 hours (Summer time in the tropics).
Time to Hospital: 15 mins
Time to Scene: 10 mins
CCP back up: 15 minutes from time of call.
Other Ambulance back up: Nil

On arrival at scene

Windscreen survey: Shows a small house on a suburban street. The yard is full of people with around 60 to 70 outside the house, on the street and generally milling around.

Scene detail: There are 10 Aboriginal teens in a small corner of the backyard with the patient. There is also a small group of older people sitting on the patio out of the way of the main groups.
The girlfriend of the patient leads you to the male who is literally jumping at shadows.

General Appearance: On approaching, you notice the patient (Cedric Grey) is shirtless has very well defined musculature and scaring on his upper torso indicating he has been through an cultural ritual of becoming a man. He is confused about day, time and events but recognises his family on scene. As you get nearer to the patient you see him lunge at one of the Police Officers hugging him and he refuses to let go. Cedric is non-violent but appears to be suffering auditory and visual hallucinations about someone wanting to hurt him.

Presenting History: Patient’s girlfriend informs you he is from the remote Indigenous community of Aurukun (see map below, Aurukun lands are marked in red) and has schizophrenia. He travelled to Cairns for a family funeral two weeks ago and forgot his medications. The funeral for his 20 year old Cousin Brother (not a typo, this is an Indigenous relative or cousin on the mothers side in Caucasian terms) was earlier in the day and all of the extended family gathered at the family home in the suburbs.
Cedric has not consumed any alcohol or drugs during his stay.

**This assessment is based on a real case attended by Paramedics. Details have been altered so no person can be identified.

Question 1

Given what has been discussed within your resources for ‘Mental State Assessment in a Culturally Diverse Society’ and your prescribed text, how would you manage this situation in a culturally sensitive manner?
Note: This question is not about the clinical situation or even about the Mental State Assessment it’s about communication. Communication underpins your ability to identify a patient’s mental health condition (if one is there) and determine an effective treatment pathway.

There is an obvious need for this patient to attend hospital but what would you say and do to get him there?
• Think about people you could use to potentially convince the patient to attend hospital.
• Think about statements you would make and to whom (on scene) to assist you to get this patient into the vehicle and accept treatment.

Your task is to document your communication strategy for this situation. It’s important to note this is about you and your interaction not a prescriptive response.
What works for a solidly built, bald, middle aged Paramedic may not work for a petite 21 year old female or indeed a 30 year old male built the same way with ink and dreadlocks.
Document in detail who you would target to assist you and what you would say to them to get them to assist you.

Assessment Criteria

To attain a high distinction for this assessment piece you will be required to fullful the following:

Poster Assessment
Section 1.
Coverage of the topic (excluding therapeutic options) - Presents succinct and comprehensive coverage of the topic within each section of the poster.

Section 2.
Layout and design - All text and graphics on the poster are in focus and can be easily viewed from 2 metres. AND Information is organised with titles and subheadings consistent with the text below it.

Section 3.
Demonstrated knowledge of therapeutic options - Presents a succinct and comprehensive list of therapeutic options. AND Provides specific references for all options.

Section 4.
References using CQUniversity approved system of referencing for this course in all instances.

Written Assessment

Communication Techniques (Techniques should not just be listed but expanded on eg. What you would do and how you would achieve it in this given situation.) - Applies extensive (in excess of 10) culturally sensitive verbal and non-verbal communication techniques to gain meaningful interaction with the patient and those around him.AND The communication techniques applied are grounded in the recovery based framework and relate to the given situation.