First Year Paramedic Science Student PAD Review

The Practice Assessment Document (PAD) will rule your life during your 10 weeks of placement in your first year of uni.

Here are my tips for passing your PAD, and how to make it easier. Enjoy!

What is the PAD and what does it include?

The PAD is your evidence for completing certain skills whilst on placement which is pass or fail. Your mentor (or PED) has to fill it out identifying which jobs you have been exposed to, and how you handled them. They can grade you as assisted (needing help), minimal supervision (the odd prompt here or there) or independent (woo, go you! Did it safely all by yourself). It includes skills from your Skills Passport and adds in other essential skills too, such as: airway management, cervical spine immobilisation, fracture splinting, IM injections and signposting to alternative pathways. There is are patient assessment pages, which patients fill out about how they feel you treated them, and there is a personal review on your time on placement. Your mentor also has to match statements to you, such as 'you turned up on time', 'you treated patients with dignity' etc. There are pages in the back to log your hours, as by the end of your degree you have to have completed a certain number of hours on ambulance placement otherwise you will be unable to progress to registration.

The PAD is not hard to fill out. Some mentors need gentle encouragement to fill it out, especially if they are new or did not qualify through the uni route. You will have to get formative and summative sign offs to show you have attempted things more than once. Fortunately, in first year you only require the most basic pass in every skill to pass your PAD (assisted), although feel free to encourage them to sign you off higher if you think you did a good job. Your PAD is not just for the university to pass you, but it also shows your progress to yourself.

But what if I do not get exposed to every skill?!

Granny Down
You also will not be exposed to every skill in there, do not fret! Your university will put on skills sign-off days for you to be put in a situation where you must complete your skill. These are similar to the passport sign-offs and so long as you understand some of the underpinning knowledge behind why you are doing the procedure, you will pass easily. I had to sign off my paediatric and adult airway management, whilst I remember others having to sign off fractures, cervical spine immobilisation along with other bits. You will probably meet most skills many times, such as the system examinations and pathway referrals, however you will also meet skills where you may not expect at first. You will have to check your 'Granny Down' for cervical
Granny Getting Down
spine injury, and may have to immobilise her if you cannot rule it out. On my first day I used a pelvic binder! You never know what you will get.

Is it difficult to sign off?

The PAD does not need to be hard to sign off. The important thing is that it gets filled out everyday! There is lots of writing required and it is really easy to forget what jobs you have done during the day, especially when you have had a busy one! Get your mentor to fill it out during your 15 minute trolley clear time whilst you clean up and redress the bed. If you do a job and you think that they should sign you off on it, write it on a post-it note and stick it to your PAD so you do not forget. If nothing is written after your first week, you need to chase them up! If it is broken down into small chunks then it is very manageable to complete. If you have lots of different mentors then it is even more important to get them to sign it off before the end of your shift as there is a chance you will not see them again and you require their signature! Be mindful of letting them take it home as if they lose it or they end up on long-term sick leave. Your PAD is very precious as its completion determines whether or not you progress to the next year!

I'm forgetful / I lose things / the dog chews my homework on a regular basis

Your mentor does not have to take you out on the road with them if you do not have your PAD with you! Make sure you always bring it! I have not heard students being refused hours due to forgetting it, but do not make yourself the first one! If you are worried about losing your evidence, take a photo of each page completed after each shift. This may sound like overkill but having this evidence is also important if the university lose your PAD once you have handed it in. Also take a photo of your hours log, so you know how many hours you have completed to date and the university may ask for proof of your hours via email (as the placement team are separate to the marking committee and are unlikely to see your PAD). If you lose your PAD or it gets damaged, your photos can be printed off and stapled into your new PAD so you have not got to chase signatures and try and remember every job you have done!

Any tips for completion?

Get service user reviews nice and early on so you do not have to worry about it at the end, because typically your last day will end up with lots of 'big sick' patients and will end on a patient having a seizure (and no one speaks English) (true story)!
Ensure you get stuff signed off every day, and do not be afraid to jump in and get involved. If you see your mentor get out an OPA, ask if you can insert it! Or if you go to a cardiac arrest or drug overdose, jump in first and suggest it! They may not be thinking about your PAD but there will be no difference in patient outcome if you jump in.
Anything you do not understand, ask them lots of questions about it. They will most likely be flattered and communicating will improve your relationship with them. Ask every question you can think of.
Gently encourage your mentor to fill out your PAD, however if you do not get anything filled out a couple of weeks in, ask nicely but stronger. If after that, they still are not taking an interest, go to your university. You need it signed off, your mentor probably gets paid more to have you as their student so it is part of their job. If the university does not know you are having problems, you will not have a leg to stand on if you finish placement and nothing is completed.

I hope this has been of use! I am off on placement in November so look out for a Second Year PAD Review! If there you have any questions, send me a message or if I think of anything else I will release a Part 1. Thanks for reading :)


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