SAQA

All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.

SOUTH AFRICAN QUALIFICATIONS AUTHORITY

REGISTERED QUALIFICATION:

Higher Certificate in Emergency Medical Care

SAQA QUAL ID	QUALIFICATION TITLE
109960	Higher Certificate in Emergency Medical Care
ORIGINATOR
Cape Peninsula University of Technology
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY			NQF SUB-FRAMEWORK
CHE - Council on Higher Education			HEQSF - Higher Education Qualifications Sub-framework
QUALIFICATION TYPE	FIELD		SUBFIELD
Higher Certificate	Field 09 - Health Sciences and Social Services		Rehabilitative Health/Services
ABET BAND	MINIMUM CREDITS	PRE-2009 NQF LEVEL	NQF LEVEL	QUAL CLASS
Undefined	120	Not Applicable	NQF Level 05	Regular-Provider-ELOAC
REGISTRATION STATUS		SAQA DECISION NUMBER	REGISTRATION START DATE	REGISTRATION END DATE
Reregistered		EXCO 0821/24	2019-07-25	2027-06-30
LAST DATE FOR ENROLMENT		LAST DATE FOR ACHIEVEMENT
2028-06-30		2031-06-30

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.

This qualification does not replace any other qualification and is not replaced by any other qualification.

PURPOSE AND RATIONALE OF THE QUALIFICATION

Purpose:
This qualification will develop the foundational knowledge, skills applied competencies and professional attributes required for rendering quality emergency care to the community within the Emergency Care Assistant (ECA) scope of practice. The qualification will enable further personal and professional development for lifelong learning.

The purpose of the qualification is to produce an entry-level health worker qualification, with learners who are able to work primarily under supervision but who will make independent decisions according to their capabilities when the situation requires it. The entry-level worker will be able to work in a variety of contexts. This qualification will be particularly useful for:

Individuals wishing to enter the emergency care profession.

Existing basic ambulance assistants.

Existing ambulance emergency assistants.

Existing operational emergency care orderlies.

Holders of this qualification will operate mainly in and around the ambulance, within wide-ranging contexts, including rural, urban, military, coastal, corporate, mass gatherings, homes, and workplaces.

Rationale:
This qualification is developed following a proposal from the national Department of Health (DoH) and the Health Professions Council of South Africa (HPCSA), Professional Board for Emergency Care (PBEC) and creation of the corresponding category of professional registration by the Health Professions Council of South Africa.

This qualification is an entry-level qualification in the three-tier Emergency Care Qualification Framework, as proposed by the DoH in the National Emergency Care Education and Training (NECET) policy. This three-tiered system has been determined to best meet the emergency care needs of the country and aligns emergency care education and training. The qualification provides the key competencies required of Emergency Care Assistants (ECAs) who will work under the guidance of Emergency Care Technicians, Emergency Care Practitioners and Medical Officers in a variety of contexts and provide assistance to these more advanced emergency care providers.

This qualification is designed to produce entry-level emergency care providers who are clinical assistants within the emergency medical care and rescue environment thereby replacing the Basic Ambulance Assistant Course as the entry qualification into the emergency medical services. There were 54 749 Basic Ambulance Assistants registered with the HPCSA in 2013 that could potentially want to upgrade their qualification to become an ECA.

The qualification provides an entry point into the career pathway of emergency medical services thereby creating access and an opportunity for employment within emergency care. This qualification primarily has a vocational orientation, which includes professional, vocational, and industry specific knowledge that provides a sound understanding of general theoretical principles as well as a combination of general and specific procedures and their application and will develop the necessary foundational knowledge; skills and attitudes needed to form the basis for further study in the field of emergency care and will provide access to other qualifications.

Qualifying learners will practice basic and intermediate emergency care primarily on ambulances within South Africa in rural and urban contexts that range from sophisticated emergency medical care facilities to remote primary health care settings. This qualification also aims to promote an understanding of the multi-disciplinary approach to effective, efficient patient care. In addition, this qualification aims to produce an emergency care provider that will take cognizance of South African history and will be able to adapt to the unique circumstances of a changing South Africa with emphasis on equity in health care, social upliftment, and reduction of the burden of disease. The qualification is also designed to enable learners to pursue further personal and professional development and to promote lifelong learning.

Employment opportunities for ECA's exist with the public and private emergency medical services, the South African Military Health Services, the mining industry and Fire and Safety services.

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING

Recognition of Prior Learning (RPL):
Prospective learners who are currently employed in emergency medical services and who previously only had access to short course training are given the opportunity to undergo an RPL process that allows them a point of entry to higher education.

Recognition of Prior Learning (RPL) is an alternative route of access into the qualification and this is in keeping with other emergency services qualifications. The field of emergency medical care is undertaking a massive change in the education and training system and needs to ensure that access in widened to deserving learners.

RPL for access is aimed at enabling persons who have not met formal entrance criteria to demonstrate that they have met entrance criteria through other means. There may be occasions where prospective learners can apply for exemptions if they have completed similar qualifications or parts of qualifications and these will be considered on a case by case basis, aligned to the institution's RPL policy.

The institution has a RPL policy in place that allows learners access to higher education by recognising their prior learning (short courses and work experience).

Entry Requirements:
The minimum requirements for this qualification is:

Senior Certificate with English, Mathematics, Biology and/or Physical Science, NQF Level 4.
Or

National Senior Certificate (Higher Certificate endorsement) with English, Mathematics or Mathematical Literacy, Life Sciences, and/or Physical Sciences, NQF Level 4.
Or

National Certificate (Vocational) with Mathematics, Life Sciences and/or Physical Sciences NQF Level 4.
And

The Medical Fitness and Physical Fitness Evaluations.

RECOGNISE PREVIOUS LEARNING?

QUALIFICATION RULES

The qualification consists of compulsory modules at Level 5 totalling 122 Credits.

Compulsory Modules:

Foundations of Professional Practice, 18 Credits.

Rescue Safety and Practice, 16 Credits.

Physical Sciences, 10 Credits.

Anatomy and Physiology, 16 Credits.

Primary Emergency Care, 16 Credits.

Emergency Care Practice, 16 Credits.

Emergency Care Skills, 16 Credits.

Clinical Emergency Care, 14 Credits.

EXIT LEVEL OUTCOMES

1. Demonstrate effective communication and apply the principles of medical ethics, professional behaviour and the legal framework to the context within which Emergency Care Assistants operate while maintaining personal health, physical preparedness, wellness, and safety.
2. Demonstrate an understanding of the structure and function of Emergency Medical Service (EMS) systems in South Africa and how they relate to the broader healthcare structures within the country.
3. Demonstrate knowledge and understanding of human and basic sciences underpinning emergency care.
4. Provide emergency medical care within an emergency medical service environment to all sectors of the community within the Emergency Care Assistant's scope of practice.
5. Demonstrate the rescue, extrication or retrieval of a patient from simple emergency situations during the normal course of emergency medical care and maintain personal and patient safety on a rescue scene.

ASSOCIATED ASSESSMENT CRITERIA

Associated Assessment Criteria for Exit Level Outcome 1:

Communicate effectively and accurately with patients, colleagues, and other stakeholders in a manner which is appropriate for the modality, whether it be verbal, written or electronic. The terminology used must be consistent with professional usage.

Interact with others in a manner which promotes human dignity and is sensitive to ethnic, cultural, linguistic, and religious and gender diversity.

Correctly apply ethical principles of beneficence, autonomy and justice, truth-telling, promise-keeping and confidentiality in all contexts.

Maintain the Professional Board for Emergency Care Provider's provisions, rules and code of ethics during all clinical interactions and related practices and seeks guidance when uncertainty surrounding a situation arises.

Maintain and control patient care records and drug registers in accordance with prescribed legislation.

Provide an accurate overview of the legal framework within which an Emergency Care Assistant operates.

Comprehensively discuss the importance of mental health and wellness on the part of the emergency care provider, highlighting their role and importance, with particular reference to the impact on job effectiveness.

Describe the impact of lifestyle, diet and exercise on personal and job performance and demonstrate suitable methods for achieving and maintaining a level of physical health and fitness which enables the performance of the duties and activities of the Emergency Care Assistant (ECA) in an operational context.

Demonstrate a level of physical fitness which enables the performance of the duties and activities of the ECA in the operational context.

Demonstrate a level of swimming proficiency which will allow the removal of a single drowning victim from a residential swimming pool while maintaining personal safety.

Identify, demonstrate and apply methods of risk assessment and decision making in the normal operational context, which maintain personal safety and the safety of immediate bystanders.

Demonstrates safe and effective lifting, carrying and movement of patients.

Comprehensively describes the safe and effective use of emergency service vehicles and emergency response driving.

Correctly conduct operational routines in an Emergency Medical Service (EMS) environment, by correctly and comprehensively conducting kit inspections and completing vehicle checklists.

Associated Assessment Criteria for Exit Level Outcome 2:

Describe the structure, role and function of both the public and private Emergency Services within the South African Context.

Explain the interdependence and interrelationships occurring between Emergency Medical Service (EMS) and other Allied Emergency and Health Care structures.

Correctly explain the role of the healthcare team in terms of key responsibilities of each role and discuss the relationships between each role.

Correctly identify and explain aspects of national legislation as applicable to emergency medical care and rescue services.

Provide and explain an example of a multi-disciplinary approach to common emergency medical care and rescue scenarios.

Correctly identify the broad operational needs of a South African Emergency Service.

Use general problem-solving and decision making techniques to identify and address operational problem areas in the context of ambulance operations.

Identify and discuss aspects of labour legislation and labour practice applicable to the Emergency Medical Services.

Explain and demonstrate the principles of disaster management as applicable to the Emergency Care Assistant.

Associated Assessment Criteria for Exit Level Outcome 3:

Accurately describe the general composition, form, spatial orientation, and position of structures within the regions of the human body and integrate these within a clinical context.

Correctly describe basic physiological functioning of the human body and explain how physiology integrates into patient care.

Explain key principles of chemistry and how they apply to emergency medical care.

Explain key principles of physics and how they apply to emergency medical care.

Describe the drugs used within the scope of practice of the Emergency Care Assistant accurately and comprehensively, in terms of class, schedule, trade name, and generic name, mechanism of action, indications, contra-indications, precautions, side effects, packaging, dosage and administration and route of administration.

Associated Assessment Criteria for Exit Level Outcome 4:

Correctly identify potential hazards within the emergency service environment in terms of their origins, impact and means of management or mitigation.

Demonstrate scene and incident management aligned with local best practice and established procedures.

Accurately describe Emergency Medical Care equipment in terms of function, storage, maintenance and safe use.

Discuss and implement established methods of infection within the framework of an approved policy.

Correctly integrate clinical skills and procedures into patient care, according to the ECA scope of practice.

Describe and demonstrate the principles of primary health care, disease prevention, health promotion and counselling within the context of Emergency Medical Care.

Discuss the promotion of Acquired immunodeficiency syndrome (AIDS) and Human Immunodeficiency Virus (HIV) awareness among people in the immediate environment.

Describe the general role of an Emergency Care Assistant within the primary health care system.

Perform clinical assessment and clinical decision-making aligned with the scope of practice of an Emergency Care Assistant.

Provide management and treatment for minor injuries and ailments in specific controlled and supervised circumstances.

Show due consideration to evidenced informed practice in the provision of emergency care support to sick or injured individuals, groups and communities.

Correctly demonstrate all the clinical skills listed within the Emergency Care Assistant scope of practice, in a simulated environment.

Differentiate between an emergency care and primary health care situation and apply contextually appropriate knowledge, skills and equipment in the management of the situation, within the ECA scope of practice and capabilities.

Demonstrate and effective and accurate verbal patient handover aligned to local protocols and procedures.

Demonstrate the keeping of accurate medical records which provide detailed patient information and information concerning emergency care treatment. Concerning.

Demonstrate and ability to reflect on and critique own practice and to reach a fair and realistic conclusion regarding own clinical competence using Gibbs cycle reflective framework.

Demonstrate the ability to offer appropriate and contextually relevant clinical advice that will enhance prevention of further injury or ill health, within the confines of the ECA scope of practice.

Associated Assessment Criteria for Exit Level Outcome 5:

Demonstrate an effective and rapid retrieval of either a conscious or unconscious drowning victim from a residential swimming pool while maintaining personal safety.

Demonstrate the ability to effectively extricate victims from motor vehicle wreckages where rescue tools are not required, while maintaining accepted emergency care best practice conventions.

Safely carry a patient without the use of a stretcher, either alone or in tandem with another rescuer, using a variety of accepted methods.

Move patients from a supine position in a multi-story building to the ambulance while maintaining personal and patient safety and maintaining accepted emergency care best practice conventions.

Correctly don, doff and use personal protective equipment to maintain personal and patient safety in the context of technical medical rescue.

Correctly use a Breathing Apparatus to maintain personal safety in the context of a hazardous atmosphere.

Assist in properly packaging a patient in a variety of stretchers, under expert direction, in the context of rope rescue, trench rescue or confined space rescue.

Correctly maintain personal safety while providing emergency medical care at a height.

Safely access and egress from a vertical rescue scene using personal, single person rope rescue techniques.

Integrated Assessment:
Work Integrated Learning underpins the design of the teaching and learning strategy and relevant workplace concerns are integrated into both the classroom contexts and workplace learning. Assessments, being aligned with teaching reflect this integration. Extensive formative assessments will be used during the program through the use of orthodox class tests as well as electronically administered tests on the Learner Management System, which provide immediate feedback. The nature of the questions addresses specific problems related to clinical algorithms and protocols prescribed by the professional body.

Summative Assessments mirror the types of questions asked in the formative phase. Extensive use of practical laboratory based learning also provides extensive opportunity for teaching, learning and immediate feedback, and non-formal formative assessment through both facilitator and peer feedback forms part of the teaching and learning strategy. Laboratory work is based on simulation of clinical cases using high fidelity manikin simulators. Simulations are designed around standardised clinical cases. Simulation is also used for summative assessment. Candidates spend time in the workplace as part of the formal, credit-bearing programme and are required to submit portfolios and logbooks as for assessment.

Formative Assessment is provided in the workplace by mentors and preceptors during work placements. The assessments involve the management of authentic clinical cases. Summative Clinical Case management assessments are conducted by lecturers on University affiliated ambulances.

Opportunities for integrated assessment between subjects are as follows. Case studies of actual clinical cases encountered during workplace placements are marked as written submissions in the Subject Emergency Care Practice and as oral presentations in the subject Clinical Emergency Care. The subject Clinical Emergency Care has a focus on applied competence and assessed through reflective reports, preceptor reports and lecturer evaluations of observed case management as well as logging of hours worked and skills performed.

The subjects Primary Emergency Care and Emergency Care Practice integrate extensively with the subject Emergency Care Skills which is a laboratory based subject, as the practical application of theoretical knowledge and concepts is taught and assessed through simulations in this subject. Foundations of Professional Practice (FOP) is also cross assessed as submission of case details follows the outcomes of ethics and confidentiality presented in this subject. Foundations of Professional Practice has physical fitness requirements which need to be attained if outcomes in the subject Rescue Safety and Practice and health and safety outcomes, also in FOP, are applied and assessed in Rescue Safety and Practice. Approximately 80% of the learning time involves work-directed theoretical learning, practical application or theory or workplace experience. The authentic nature of the teaching, learning and assessment activities inherently require integration of outcomes across subjects.

INTERNATIONAL COMPARABILITY

It is increasingly evident that there is a worldwide need for formally trained health care providers to be included in the Emergency Medical Services.

A Certified First Responder is a term used internationally to denote an entry-level health career in emergency medical services. In the United States of America (USA) there are several Health Schools and Colleges that provide training resulting in a similar qualification. Generally, a high school Diploma is required to enter the training programmes. Workers must complete a formal training and certification process. Training is offered at progressive levels. The Emergency Medical Technician -Basic qualification is the entry level for employment within an Emergency Medical Service. At this entry level, the procedures and skills performed are generally non-invasive and this type of training will be very similar to the type of training that the Emergency Care Assistant (ECA) will be exposed to.

In the United Kingdom, an Ambulance Aid qualification is offered and these individuals once qualified will work alongside a Paramedic. In the United Kingdom (UK), this entry level qualification is on the decline as a greater emphasis is being placed on the University based Paramedic qualifications. These courses are designed to equip the student with the skills required by the National Health Services (NHS) ambulance service. Emergency Care Assistants (ECAs) are a new role in the frontline staff on NHS emergency ambulances within the United Kingdom, introduced as part of the modernisation of the NHS ambulance services to cut costs. Having only been created in 2006, the role is evolving rapidly, and has not been standardised over the country, but will usually consist of assisting qualified paramedics and emergency medical technicians with their duties, although this is not always the case in exceptional circumstances. In Canada, this qualification compares with that of an Emergency Medical Responder (EMR). This is a level of practice recognised under the National Occupational Competency Profile (NOCP). There are a high number of EMRs in Canada as they play a critical role in the chain of survival. The level of practice of an EMR is not very comprehensive clinically. The skills within the EMRs scope align to those in this curriculum and the scope of practice is regulated.

In Ireland, an Emergency First Responder (EFR) is trained in extensive first aid, BLS training and the EFR is able to assist higher trained practitioners with patient care. This level of training is very basic and does not lead to employment within an emergency service.

In Australia, a Certificate IV is the basic life support level, which is recognised as the minimum entry level qualification for emergency work in an ambulance service.

This qualification has been compared to similar qualifications offered in several other countries around the world. Because there is a great deal of similarity in the curricula offered in several other countries it implies that these curricula reflect best practice. The duration of these programmes differ and literature reviewed reflects examples where there is a range of 100 hours to 1 year. More advanced programmes reflect duration periods from six months to three years.

ARTICULATION OPTIONS

This qualification allows for horizontal and vertical articulation possibilities.

Horizontal Articulation:

Higher Certificate in Auxiliary Nursing, NQF Level 5.

Higher Certificate in Dental Assistance, NQF Level 5.

Vertical Articulation:

Diploma in Emergency Care, Level 6.

Advanced Certificate in Medical Rescue, Level 6.

MODERATION OPTIONS

N/A

CRITERIA FOR THE REGISTRATION OF ASSESSORS

N/A

NOTES

N/A

LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION:

NONE

PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS QUALIFICATION:

This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.

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