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Updated: May 31, 2026

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High-Frequency Simulation-Based Assessment to Improve Clinical Competence in Paramedicine Education.

Jean-Paul Veronese, Nancy Jakstas, Malcolm Boyle

    Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
    |May 29, 2026
    PubMed
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    High-frequency simulation with performance-based assessment (PBA) tracking significantly enhances paramedicine students' clinical competence and exam performance over time. This evidence-informed strategy supports accreditation standards.

    Area of Science:

    • Paramedicine Education
    • Medical Simulation
    • Competence Assessment

    Background:

    • Clinical competence is critical for paramedicine graduates facing high-stakes decisions.
    • Structured, evidence-informed assessment is needed to ensure practice-readiness.
    • The impact of high-frequency simulation with performance-based assessment (PBA) tracking on long-term competence development is under-explored.

    Purpose of the Study:

    • To evaluate the effect of high-frequency simulation and formative assessment on clinical competence.
    • To determine the impact on summative practical exam outcomes in paramedicine education.

    Main Methods:

    • Secondary analysis of 2024 performance data from undergraduate paramedicine courses.
    • Utilized high-frequency simulation with graded formative PBAs and the Clinical Competence Assessment Tool (CCAT) for weekly assessments.
    Keywords:
    clinical competenceparamedicineperformance-based assessmentsimulation training

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  • Analyzed associations between formative performance and summative outcomes using statistical methods including paired t tests, mixed ANOVA, and hierarchical regression.

    • Main Results:

    • Students averaged 4.6 simulations, showing significant improvement in practice scores over time.
    • Higher final exam scores were observed in both cohorts (P<0.05).
    • Simulation frequency incrementally improved performance and independently predicted exam outcomes (B=3.46, P<0.05).

    Conclusions:

    • High-frequency simulation coupled with structured PBA tracking demonstrably enhances clinical competence and exam performance.
    • This scalable formative assessment strategy effectively supports paramedicine accreditation standards.