The impact of simulation with debriefing on developing clinical competence and performance in paramedicine students

Introduction Paramedics handle diverse medical and trauma cases, where any lapse in competency can compromise patient safety. Student paramedics must meet high standards set by oversight bodies to protect both the profession and the public. Growing evidence indicates that simulation facilitates attainment and reinforcement of clinical competencies. However, limited evidence explores the impact of simulation and debriefing on developing clinical competence in undergraduate paramedicine students. Aim This study aimed to evaluate the association between weekly practice session performance and summative practical exam outcomes, assessing how simulation-based practice supports the development of clinical competence among paramedicine students. Methods A retrospective analysis of performance-based assessment data (2019–2024) in a university paramedicine program evaluated the role of high-frequency simulation. Second-year students participated in weekly three hour simulated practice sessions and a summative practical exam, with performance assessed using the Clinical Competence Assessment Tool (CCAT). Practice session data were grouped into tertiles to assess trends. Pearson’s correlation measured the association between practice frequency and exam outcomes, paired samples t-tests evaluated performance progression, and hierarchical regression identified significant predictors of exam outcomes. Results Data from 305 students and 1,251 practice scenarios revealed a significant positive correlation between practice frequency and exam performance (rs = 0.257, p < 0.001). Clinical competence scores improved progressively across the trimester, with the strongest correlation observed in the final tertile (rs = 0.229, p < 0.001). Earlier tertiles showed weaker but statistically significant correlations (p < 0.05). A performance dip in 2020 due to reduced simulation exposure during COVID-19 further highlighted the critical role of consistent, high-frequency practice in fostering competence and exam success. Conclusion This study demonstrates the value of structured, high-frequency simulation and debriefing in enhancing clinical competence and exam performance. The findings underscore the importance of consistent practice, particularly in the final trimester weeks, supporting its integration into paramedicine curricula to ensure readiness for real-world practice and sustained competence.