Student Paramedics Research Articles

G30(P) Enhancing the preparedness of paramedic students for managing children presenting with congenital cardiac conditions in the pre-hospital setting through an online multimedia educational package

Paramedics are the front line clinicians in the delivery of prehospital emergency and urgent care in the UK and they face multiple challenges due to the unpredictability of their workload and the diversity of calls. Recently, proposed changes to children’s cardiac services have prompted concerns that paramedics may attend an increasing number of children with congenital heart disease (CHD) at home, although CHD may not be taught in pre-registration paramedic courses. Aim: This study set out to explore how much knowledge student paramedics have surrounding CHD; how prepared they feel for managing children with CHD and the extent to which an online multimedia educational package could enhance the preparedness of paramedic students for managing children with CHD. Method: An action research approach was adopted that firstly identified what paramedic students already knew and how confident they felt in managing these children and their families through a Focus Group (n = 8). An online multimedia learning tool was then developed and made available for the students, who were asked to provide feedback via an online questionnaire after completing the activities. Results: The focus group participants were concerned that they did not know where best to take a child with CHD during an emergency. The group expressed that they had very little knowledge about CHD and what knowledge they did have had generally been derived from lay sources. Students also expressed concern about interacting with parents in relation to the parent’s expectations, the parents’ knowledge of their child’s condition and transportation issues. All of the focus group participants completed the online multimedia educational package. However only 4 of the participants (50%) responded to the online evaluation questionnaire despite reminder emails; the results may not therefore be representative of the entire group of participants. Factors impacting upon the completion of the questionnaire will be discussed. Conclusion: There is clearly a need to address paramedic students’ knowledge and preparedness for managing children with complex CHD in the pre-hospital setting and communicating effectively with their families. Implications for future development of the educational tool will be discussed.

Student paramedics' perceptions of action learning: a mixed-method study

Paramedic education programmes must draw upon a wide range of teaching, learning and assessment techniques in order to ensure that graduating students possess the necessary skills and qualities for their profession ( Quality Assurance Agency (QAA), 2013 ). Theory and practice must come together as part of a reflective learning process at a number of points within the education cycle, in order to identify crucial learning points, and areas for self-improvement from the practice setting. One way of achieving this is via action learning (AL). This small-scale study uses a mixed methods approach to investigate whether or not student paramedics from a UK university, as participants within action learning sets (ALS), felt that that they were a useful educational tool to use within a Foundation Degree in Paramedic Science. Students reported many benefits to their educational experience having participated in ALS, including developments in personal, academic and professional areas. The research also showed how the AL process could be improved in areas such as AL induction, providing AL members with team working skills as well as supporting students with communication and leadership challenges during ALS.

We're Play-Acting: Simulation and Dramaturgical Sociology

BackgroundSimulation or scenario learning is an integral part of health care student development, and despite the increasing amount of research, very little is known about how students and facilitators experience it. MethodsThis compressed time mode, ethnographic approach study incorporated data from student paramedics during and immediately after simulation learning events, and facilitator views of facilitating the simulation experience. This provided an overview of simulation in the student paramedic development pathway. ResultsThe performance aspect of scenarios is echoed in the dramaturgical language used when talking about simulation learning events. ConclusionsThemes such as script, cast, role, and costume were explored, as were media portrayal of paramedics. Usual paramedic settings were also discussed.

Student perceptions in relation to Paramedic Educator (PEd) roles

This article examines student paramedics' perspectives of the Paramedic Educator (PEd) role, focusing on specific mentoring qualities that impact upon their learning. Furthermore, it aims to identify ‘mentoring’ issues specific to the paramedic profession. The study used semi-structured interviews with university paramedic students. The key attributes of a ‘mentor’ as identified in the nursing and healthcare literature were found to be relevant to the paramedic profession. Participants identified current challenges in practice specific to the paramedic profession. Questions are raised regarding the extent to which the culture of mentorship within ambulance services is sufficiently established to support students and PEds; the status quo poses significant challenges for students wishing to join the profession.

Student Paramedic Attitudes towards the Elderly: A Cross-Sectional Study

Introduction It is well known that Australia has an aging population and that the elderly are disproportionately overrepresented in the patients seen by ambulance paramedics. While research to date has primarily focussed on the attitudes towards the elderly held by nursing and medical students, there is a current paucity of research about the perspective of paramedic students. The objective of this study was to identify the attitudes of paramedic students from a large Australian university towards the elderly. Methods In 2013, second year paramedic students from Monash University, Melbourne, Australia were invited to participate in this cross-sectional study and record their attitudes towards the elderly (age >65) using the Aging Semantic Differential (ASD) questionnaire. The ASD utilises a 7 point bipolar Likert scale questionnaire consisting of 32 items and three subscales: Instrument—Ineffective; Autonomous—Dependent; Personal Acceptability—Unacceptability. Results Fifty six second year paramedic students participated in the study. The participants were predominantly <26 years of age n=48 (85.7%) and female n=36 (64.3%). Subscale results produced the following mean scores: Instrument—Ineffective (mean=35.05, SD=5.01); Autonomous—Dependent (mean=34.25, SD=4.26); Personal Acceptability—Unacceptability (mean=49.47, SD=6.44). Conclusion These results suggest that while student paramedics possess a healthy respect for the elderly, they also harbour some preconceived negative ideas about them. Ultimately, these attitudes may impact on a paramedic's interaction with, and management of the elderly patient, which raises questions about whether students are being adequately prepared for clinical practice.

Perceptions of Student Paramedic Interpersonal Communication Competence: A Cross-Sectional Study

Introduction Interpersonal communication skills are essential to the healthcare practitioner aiding in high quality, effective and safe clinical practice. Effective communication exerts a positive influence on the patient's physical and emotional status resulting in better patient outcomes and satisfaction. By identifying strengths and weaknesses, self-assessment of interpersonal communication skills can be used as an intervention tool to inform future curriculum renewal. The objective of this study was to identify paramedic students’ perceptions of their interpersonal communication competence. Methods Second year paramedic students from Monash University (Victoria) were invited to participate in a survey that asked them to record perceptions of their interpersonal communication skills using the Interpersonal Communication Competence Scale (ICCS). The ICCS is a 30-item unipolar questionnaire using a Likert scale ranging from 1 (almost never) to 5 (almost always). Mean and standard deviations (SD) were used to report results. Results Fifty-six second year paramedic students participated in the study. Participants were predominantly aged less than 25 years (85.7%) and male n=36 (64.3%). Students reported ‘often’ or ‘almost always’ for the items: ‘I put myself in others’ shoes’, n=46 (82%), mean=3.98 (SD 0.59); and, ‘I let others know that I understand what they say’, n=45 (80%), mean=3.96 (SD 0.66). Students reported ‘sometimes’, ‘often’ or ‘almost always’, for the items: ‘I have trouble convincing others to do what I want them to do’, n=55 (98%), mean=3.5 (SD 0.63); and, ‘My mind wanders during conversations’, n=41 (73%), mean=3.05 (SD 0.88). Conclusion Preliminary results suggest that student paramedics self-report their interpersonal communication skills highly apart from areas related to assertiveness and listening skills. These results could be indicative of student age, personality or experience level and warrant further research with larger sample sizes.

Abstracts of the 2014 Student Paramedics Australasia Conference

These are posters from the Student Paramedics Australasia (SPA) Conference at the Gold Coast, Queensland, 2014.

Hands off: can paramedics be educated at a distance?

This article looks at the challenges and opportunities presented by the use of distance methods to teach student paramedics. It examines distance learning from the perspective of the employer, the student and the higher education provider, and shows that there are considerable benefits for student paramedics and their employers in adopting a distance teaching approach to paramedic education. There are no short cuts to a successful outcome, and it is important to adopt the highest quality distance education.

Spinal clearance guideline for out-of hospital providers

Introduction Unnecessary spinal cord immobilisation is a common problem in South Africa, even though out-of hospital spinal clearance is becoming standard of care in international emergency medical care (EMC) communities. Large numbers of unnecessary spinal immobilisations, in low risk trauma patients, result in an increased health and economic burden in both the in-hospital and out-of hospital settings. Currently, informal spinal clearance is being practiced in South Africa creating large practice variation, potential patient safety compromise and probable economic burden. An evidence-based out-of hospital spinal clearance algorithm would minimise the unnecessary hospitalisation of low risk spinal patients. Our objectives included: (i) To provide an accurate and reproducible algorithm to identify and correctly refer clinically relevant spinal injury in the out-of hospital setting and (ii) To inform policy makers of best practice for spinal cord clearance through evidence informed decision making and provide implementation and evaluation recommendations. This document provides recommendations for a spinal clearance guideline for South Africa and includes implementation strategies and evaluation criteria. Methods A Population, Intervention, Professionals, Outcomes and Health Context (PIPOH) research question was designed to answer the guideline topic. The literature was systematically searched for spinal clearance guidelines or recommendations. These were screened, appraised and adapted by a specialist emergency care review group using the Appraisal of Guidelines Research and Evaluation (AGREE II) and ADAPTE tools recommended for guideline adaptation and development. The results were filtered by the primary author using pre-defined selection criteria. Results A total of 8 guidelines met the inclusion criteria. Each guideline was independently assessed by two emergency care specialists using the AGREE II tool. A forum discussion was held to adapt the included guidelines to the local out-of hospital needs. Emergency care policy stakeholders and operational and student paramedics were asked to review and comment on the adapted algorithm. Conclusion An out-of hospital spinal clearance guideline was developed with evaluation and implementation strategies for the out-of hospital context. The author would like to acknowledge the South African Cochrane Centre and Dr Tamara Kredo for their support.

A study of emotion work in student paramedic practice

Student paramedics are exposed to the harsh reality of paramedic practice early within preregistration education (British Paramedic Association (BPA) 2006). Active involvement in the emergency assessment, management and treatment of potentially life threatening and traumatic incidents involves exposure to human suffering, pain, trauma and death. Managing their own and others' emotions would appear to be integral. There is however, a paucity of research evidencing the emotional aspects of paramedic practice and none which specifically captures the student perspective. A qualitative, exploratory design and semi-structured interviews were undertaken with eight second year undergraduate paramedic science students to explore their perceptions and experiences of emotion work and the strategies used to deal with it. Thematic content analysis revealed three main themes, 'getting on with the job', 'struggling with emotion' and 'talking it through'. This paper presents the findings on the first two themes. Emergency resuscitation and getting on with the job emerged as a priority in a number of the experiences and subthemes included control and suppression of emotion, 'got to deal with it' and 'don't see them as a person'. Students struggled to deal with patients' and relatives' emotions and their own in some situations and subthemes included 'not sure of what to say', 'stop myself crying', and 'personal links'. The findings provide evidence of the emotional demands of student paramedic practice and have important implications for the curriculum content which must prepare and support students to perform emotion work effectively.

London Ambulance Service: practice education course

The first group of London Ambulance Service staff to complete a pioneering training course have been recognized at a special ceremony. The 25 paramedics and emergency medical technicians have completed a three-module course for practice educators who provide support for university students and student paramedics on placements with the service. The 150-hour training programme, believed to be the first of its kind in the country, includes assessing staff, giving feedback and also dealing with more challenging students, as well as completing written assessments. The course attracts 15 higher educational credits from the University of Greenwich at two levels. To complete the course, practice educators attend 30 hours of taught lessons (three modules) and provide a portfolio that includes a written assignment of 1500 words. The service has now been approached by other ambulance services who are keen to follow its lead. It is vital that all student paramedics have a named practice educator, this is a requirement of the Health Professions Council (HPC). The service has over 800 student paramedics needing some form of developmental support and access to a practice educator. Each year the modules are reviewed and updated to take account of the feedback received from staff who complete the courses. Paramedic, Caroline Woodward, who has completed the course, said:

Emotion work in paramedic practice: The implications for nurse educators

Contemporary paramedic practice involves the emergency assessment, management, treatment and transport of the public with minor and major; potentially life threatening conditions (Caroline, 2008). Paramedics are exposed to a myriad of human emotions related to suffering, pain, devastating trauma and death. Managing their own and others emotions appears to be a crucial component of their work, however there is a paucity of evidence relating to this aspect of the role. The movement of preregistration paramedic education into higher education has impacted on nurse educators in some settings, who are undertaking key administrative, managerial, teaching and personal tutoring roles. This is a valuable opportunity for nurse educators to contribute to the education of student paramedics in the crucial area of emotion work as part of interprofessional health care education. This paper examines emotional labour in health care, historical influences on paramedic education, the limited empirical research and the impact of gender, which provide insights into this profession crucial for nurse educators. The implications of emotion work for the educational curriculum and the support of student paramedics are discussed and strategies such as counselling, reflection and personal tutoring are suggested. Mentorship selection and preparation are highlighted and the need for a cultural change in attitude towards emotion work.

I.F.E.A.R reflection: an easy to use, adaptable template for paramedics

Paramedics are required by the Health Professions Council, as a condition for maintaining their registration, to maintain high clinical standards and continuously engage in their own professional development. Similarly, student paramedics are required to provide a portfolio of evidence that demonstrates their development and eventual competency. One means of engaging with this process is to apply a formal reflection process to emergency calls attended. Reflection is a hot-topic in paramedic education. However, it is known that for some, reflection can be daunting. Concerns about the academic process, writing and knowing where to begin are often articulated by students attending higher education programmes. This article outlines a suggested reflective framework adapted from Gibbs (1985) reflective cycle. It outlines a series of applicable, sequential questions. Reflection is about using questions to retell a story; it’s about answering these questions critically and, in so doing, often results in a well structured, reflective case-study; as well as improving one’s own clinical understanding and practice. In practice, we have found that both experienced practitioners and student paramedics have been able to use these steps to shape their writing. For those new to writing reflective case studies, the questions help to provide the muse for overcoming the ‘blank-sheet-of-paper’ inertia that can accompany portfolio building.

Analysing Thurstone and Likert attitude scales as data collection methods

The development of the paramedic as a health care professional and the movement of paramedic education into the higher education setting has resulted in the need for paramedics and student paramedics to be aware of and understand research methods. This article does not explore or apply the entire research process, as it focuses on a specific part of the research. The article explores and contrasts two different data collection methods used to measure attitudes, one of which will be familiar to most healthcare professionals: the Likert Scale. Less frequently used is the Thurstone method and reasons for this are discussed. The author offers an example how these methods might be used to measure attitudes about the preparedness of paramedics to address end of life care issues.

Planning and writing an evidence-based critical reflection

The shift of training and education of technicians and paramedics towards an academic pathway in higher education Institutes has placed greater emphasis on the need for students to demonstrate clinical effectiveness through evidence– based practice (EBP) and critical reflection in and on practice. However, the health care literature highlights that students often find it difficult to grasp the elements involved in asking questions about their practice, searching the literature and applying their findings to their critical reflections on practice. Evaluation of the learning needs of a group of nursing students reflected these findings. As a result, a guide was formulated to support student nurses in the development and application of these skills when using the Gibbs' model of reflection and this has been adapted for student paramedics. This article presents a set of guidelines which incorporate the Lenburg competency, outcomes and performance assessment (COPA) model (2002); a patient intended outcome, paramedic intervention (PIP) model, and an adapted Gibbs' reflective cycle model ( Figure 1 ) which paramedic students can use to develop the skills required to systematically plan and write evidence based critical reflections on practice.

Are current feedback methods optimal for student understanding and learning?

Student feedback provided to paramedic students is often a contentious issue, with tutors and student paramedics not always agreeing upon the best techniques to employ. It is identified that feedback provided to students should be a learning tool, therefore it should be meaningful. It is also identified that meaning can be lost in the written form, and that face-to-face verbal and visual feedback is the best methods of giving feedback. A research project was undertaken take to elicit the views and opinions on feedback methods, from a group of student paramedics who were new to higher education. the research was undertaken with a view to changing current practice, and improve the experience of student paramedics. Most of the student paramedics opted for tutorial feedback, although one student requested feedback via email. All students were provided with their choice of feedback method and the standard feedback method usually employed. It became obvious during the tutorial time allocated, that time management was going to be largest issue, as the tutorials took a considerable amount of time. The students were then asked how useful each method was to them. Most students stated that the tutorial feedback was where they learnt the most and therefore was the most beneficial. A number of issues were raised during the research, for example: how best to use tutorial time, and how much time should be allocated per student.

014 Learning effect of repeat clinical skill performance in a CBRN suit

IntroductionDue to an increasing risk of hazardous chemical terrorist attack and the need for rapid emergency medical care to be provided to the victims, the NHS is expecting frontline emergency...

Intubation using the Miller and Airtraq™ laryngoscopes: A paediatric manikin study

To see if the Airtraq™ paediatric laryngoscope is easier and faster for paramedic students to use than the traditional Miller (straight blade) laryngoscope. A randomised cross-over study involving 72 paramedic students. Each student intubated a Laerdal ALS baby™ manikin (Laerdal Medical Limited) representative of an 8 kg infant, once with the Airtraq™ and once with a Miller blade laryngoscope. The manikin was intubated with a size 3.5 endotracheal tube and a rigid stylet was used with the Miller blade but not with the Airtraq™. The Airtraq™ resulted in a 100% intubation success rate compared with 74% using the Miller laryngoscope. There were 14 oesophageal and five abandoned intubation attempts all in the Miller group. There was no statistical significance in median intubations times (P = 0.464) between the Miller and Airtraq™ groups. Participants rated both laryngoscopes easy to use and when asked which device they preferred, 46.5% selected the Miller laryngoscope (citing familiarity) and 53.5% preferred the Airtraq™ (citing ease of use). The Airtraq™ resulted in a 100% of all intubation attempts being successful and over half of all student paramedics believed it to be easier to use. The Airtraq™ was no faster that traditional intubation but intubation speed may have been affected by student familiarity with the Airtraq™. L’objectif était de déterminer si l’utilisation, par des étudiants ambulanciers paramédicaux, du laryngoscope Airtraq™ est plus facile et plus rapide que celle du laryngoscope de Miller (lame droite classique). Il s’agit d’une étude randomisée croisée impliquant 72 étudiants ambulanciers paramédicaux. Chaque étudiant a intubé un mannequin Laerdal ALS baby™ (Laerdal Medical Limited) simulant un nourrisson de 8kg et ce, en utilisant les deux différentes techniques, l’Airtraq™ et le laryngoscope de Miller. Une sonde endotrachéale de taille 3.5 était utilisée pour l’intubation du mannequin. De plus, un mandrin rigide était également utilisé, mais uniquement lors de l’intubation avec la lame de Miller. Le taux de réussite à l’intubation était de 100% avec l’Airtraq™ comparé à 74% avec le laryngoscope de Miller. Lors des intubations à l’aide du laryngoscope de Miller, on a noté 14 intubations oesophagiennes et 5 abandons. En ce qui concerne le temps médian d’intubation, il n’y avait pas de différence statistiquement significative entre les groupes Miller et Airtraq™. Les participants ont évalué les deux laryngoscopes comme étant faciles à utiliser. Interrogés sur leur technique préférée, 46,5% choisissent le laryngoscope de Miller (mentionnant l’habitude de la technique) et 53,5% choisissent l’Airtraq™ (mentionnant la facilité d’utilisation). Les tentatives d’intubation avec l’Airtraq™ ont montré un taux de réussite de 100% et plus de la moitié des étudiants estiment que l’Airtraq™ est plus facile à utiliser que le laryngoscope de Miller. L’intubation à l’aide de l’Airtraq™ n’était pas plus rapide que la technique d’intubation classique, mais la rapidité d’intubation pourrait être influencée par le manque d’habitude de l’utilisation de l’Airtraq™ par les étudiants.

Top up course for paramedics at Teeside University

Since 2007, Teesside University has been successfully running a foundation degree in paramedic science for pre-registration student paramedics. The programme is run in conjunction with both the North East Ambulance Service and Yorkshire Ambulance Service NHS Trusts and is now well established with over two hundred students graduating since its conception.

Cardiac arrest scripts: Measuring the retention of the skills required to manage out-of-hospital cardiac arrest following a new training intervention

Purpose of the study: Practitioners involved in resuscitation education are always looking for innovative and effective ways of teaching advanced life support (ALS) skills. The Cardiac arrest scripts (CAS) have been developed as a means to helping student paramedics learn how to manage out-of-hospital cardiac arrest.