Academic literature on the topic 'Paramedicine education'

Near-peer teaching (NPT) has been identified as a contemporary and valued pedagogical approach in higher education health programs, and it has recently gained momentum in paramedicine education. The objective of this study was to investigate the perceived experience of student paramedics involved in a near-peer teaching program over two academic trimesters. A cross-sectional study design was utilised in the form of an online questionnaire. The questionnaire contained a variety of questions that related to the experience of student paramedics involved in paramedicine near-peer programs. Of the 65 students enrolled, 34 completed the questionnaire (52.3% response rate). The results indicated that NPT was overwhelmingly considered a valuable and positive pedagogical method for use in paramedicine education.

The reality of paramedicine can cause students emotional distress, especially if this tests their values or beliefs. Therefore, educating students to be resilient and prepared for unpredictable, distressing events should be considered. The need to increase professional longevity in paramedicine has shifted employers' focus from road readiness to road resilience, which presents a complex challenge for educators. This article is the first of a series to discuss the use of supporting sciences to build road resilience in undergraduate paramedicine programmes. A review of the literature on paramedic education demonstrates there is new knowledge, based on experience in clinical practice and research, that paramedic educators can draw on to develop their discipline. Paramedics with postgraduate qualifications can shape the future of their professional discipline when their research produces a new discourse that informs a curriculum which can meet contemporary challenges. Discussion of a fictional case study illustrates how an emotional crisis could provide a platform for reflective learning and make a student more effective as a paramedic, and the educational environment needed to facilitate this.

While altruism has been studied in healthcare professions such as nursing and medicine, the exploration of the characteristics of altruism, as related to paramedicine and emergency care in Australia, is limited. This scoping review explores altruism in paramedicine from the perspective of the paramedic as practitioner, learner, and educator as seen through the lens of the paramedic and the patient. Also discussed is the positive impact of altruism on the patient experience of care. A scoping review was used to assess the availability of data related to altruism in paramedicine. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used to guide the process. Search categories were orientated around the subject (altruism) and discipline (paramedicine). A total of 27 articles are included in this scoping review. Initial searching identified 742 articles; after duplicate removal, 396 articles were screened with 346 excluded. Fifty articles were full-text reviewed and 23 excluded. The final 27 were extracted following full-text screening. None of the articles are specific to altruism in paramedicine. The data related to the practice of altruism in paramedicine are extremely limited. The preponderance of data arise from Europe and North America which, due to crewing and service differences, may impact the practice of altruism in different regions. Recent changes to the scope of paramedic practice, workload, education, and case acuity may influence behaviour regarding altruism, compassion, caring, and associated caring behaviours. The practice and education of paramedics including altruism, compassion, caring and caring behaviours in the Australasian setting warrants further research.

The department of Paramedicine at Auckland University of Technology is committed to establishing informed evidence and strategies representative of all ethnicities. The MESH360 team propose that immersive mixed reality (XR) can be employed within the learning environment to introduce critical elements of patient care through authentic environmental and socio-cultural influences without putting either students, educators, practitioners or patients at risk. Clinical simulation is a technique that replicates real-world scenarios in a controlled and non-threatening environment. However, despite the legal and moral obligations that paramedics have to provide culturally competent care, a lack of evidence and guidelines exist regarding how to adequately integrate simulation methods for cultural competence training into paramedicine education. In our curriculum, clinical simulation has been used mainly to teach the biomedical aspects of care with less focus on the psychological, cultural, and environmental contexts. A potential, therefore, exists for high-fidelity clinical simulation and XR as an effective teaching strategy for cultural competence training by providing learners with the opportunity to engage and provide care for patients from different cultural backgrounds, ethnic heritages, gender roles, and religious beliefs (Roberts et al., 2014). This is crucial preparation for the realities of professional practice where they are required to care for patients that represent the entirety of their community. This presentation explores the MESH360 project and the development of a theoretical framework to inform the design of critical thinking in enhanced culturally diverse simulation clinical scenarios (ResearchGate, n.d.). The project aims to develop a transferable methodology to triangulate participant subjective feedback upon learning in high stress environments within a wide range of cultural-responsive environments. The implications for practice and/or policy are the redefinition of the role of simulation in clinical health care education to support deeper critical learning and paramedic competency within cross-cultural environments within XR. The aim of the research is to develop simulation based real-world scenarios to teach cultural competence in the New Zealand paramedicine curriculum. Using a Design-Based Research framework in healthcare education the project explores the impact of culturally-responsive XR enhanced simulation for paramedicine students through the triangulation of participant subjective feedback, observation, and participant biometric data (heart rate) (Cochrane et al., 2017). Data analysis will be structured around the identification and description of the overarching elements constituting the cultural activity system in the study, in the context of XR in paramedicine education (Engeström, 1987). Our research objective focuses upon using XR to enable new pedagogies that redefine the role of the teacher, the learner, and of the learning context to: Develop clinically appropriate and contextually relevant simulation-based XR scenarios that teach students how to respect differences and beliefs in diverse populations whose world view may be different from ones’ own. Inform culturally-responsive teaching and learning in paramedicine education research and practice. Implementation of pedagogical strategies in paramedicine critical care simulation to enhance culturally-responsive understandings and practice.

ABSTRACTObjectivesThe aim of this study is to identify the types of community paramedicine programs and the training for each.MethodsA systematic review of MEDLINE, Embase, grey literature, and bibliographies followed a search strategy using common community paramedicine terms. All studies published in English up to January 22, 2018, were captured. Screening and extraction were completed in duplicate by two independent reviewers. The Mixed Methods Appraisal Tool (MMAT) was used to assess studies’ methodological quality (full methodology on PROSPERO: CRD42017051774).ResultsFrom 3,004 papers, there were 64 papers identified (58 unique community paramedicine programs). Of the papers with an appraisable study design (40.6%), the median MMAT score was 3 of 4 criteria met, suggesting moderate quality. Programs most often served frequent 911 callers (48.3%) and individuals at risk for emergency department admission, readmission, or hospitalization (41.4%); and 70.7% of programs were preventive home visits. Common services provided were home assessment (29.5%), medication management (39.7%), and referral and/or transport to community services (37.9%); and 77.6% of programs involved interprofessional collaboration. Community paramedicine training was described by 57% of programs and expanded upon traditional paramedicine training and emphasized technical skills. Study heterogeneity prevented meta-analysis.ConclusionCommunity paramedicine programs and training were diverse and allowed community paramedics to address a spectrum of population health and social needs. Training was poorly described. Enabling more programs to assess and report on program and training outcomes would support community paramedicine growth and the development of formalized training or education frameworks.

The Multiple Environments Simulation Hub (MESH360) research cluster was established in 2016 to explore ways of making critical care simulation environments more authentic learning experiences for students (Cochrane et al., 2016). Since its establishment, three cycles of data collection have occurred exploring immersive mixed reality (XR) to enhance traditional clinical simulation methodologies in Paramedicine education (Aguayo et al., 2018; Cochrane et al., 2020). Using a design-based research (DBR) methodology focused on prototyping in practice to generate design principles (Cochrane et al., 2017; McKenney & Reeves, 2019), along with a mixed-methods and multimodal approach to data collection and analysis in educational research (Cohen, Manion & Morrison, 2011; Lahat, Adali & Jutten, 2015), led the MESH360 team to develop a framework for designing immersive reality enhanced clinical simulation (Cochrane et al., 2020). Building upon this work, a set of design principles permitted to augment the immersive experience of participants through a case study involving an XR enhanced rescue helicopter simulation experience. Two key components of this enhanced simulation are: (1) a focus on combining XR design principles merging real environment elements with digital affordances (possibilities offered by digital tools and platforms) to provide a range of ‘learning points’ for different types of learners (i.e., from novice to experienced participants) (Aguayo, Eames & Cochrane, 2020); and (2) a focus on the embodiment of the experience (Aguayo et al., 2018) to maximize the interactivity, authenticity, and realism of the enhanced immersive reality through a sequence of experiences including virtual reality (VR) helicopter ride, simulated manikin work, and critical environmental soundscapes. Findings from the third cycle indicate an increase in spatial and context awareness across all types of participants, in relation to the authenticity of the XR environment when compared to traditional Paramedicine simulation training. Furthermore, participants also reported an enhanced realism of the ‘emergency response’ helicopter VR ride, as the sequence of experiences permitted participants to plan their response based on audio cues and information updates while virtually ‘traveling to the scene’. This iterative research work has led the MESH360 project to validate the set of transferable design principles and implementation framework for the design of authentic critical care simulation environments in Paramedicine education. Here we present and discuss a series of implications and benefits from the third MESH360 cycle in Paramedicine education emerging from the framework for designing XR enhanced clinical simulation. Anecdotic yet relevant data in relation to participant demographics and VR anxiety has led the MESH360 team to explore culturally-responsive practice in XR simulation in Paramedicine education (see Aiello et al., 2021). Future directions and transferability to other health and medical contexts are also discussed.

Background: Paramedics experience a range of ethical dilemmas in the course of their work. To date, ethical dilemmas by Australian paramedics have not been documented. With the scope of practice becoming increasingly complex, paramedic education may not have evolved to meet holistic professional demands. Aim: To describe the ethical dilemmas experienced by contemporary Australian paramedics. Methods: An online survey, based on a previous instrument, was used to explore a range of ethical dilemmas. Findings: Paramedics face a range of ethical dilemmas in their everyday practice. While several demographic variables were associated with different perceptions, the results of this study highlight that a paramedic's years of experience is most consistently associated with their perception of ethical dilemmas. Conclusion: Australian paramedics experience a range of ethical dilemmas consistent with previous international findings. Years of experience in the profession features heavily and is relied upon more so than education, suggesting that educational approaches to ethics education in paramedicine need to be reconsidered.

Background: Paramedics experience a range of ethical dilemmas in the course of their work. To date, ethical dilemmas by Australian paramedics have not been documented. With the scope of practice becoming increasingly complex, paramedic education may not have evolved to meet holistic professional demands. Aim: To describe the ethical dilemmas experienced by contemporary Australian paramedics. Methods: An online survey, based on a previous instrument, was used to explore a range of ethical dilemmas. Findings: Paramedics face a range of ethical dilemmas in their everyday practice. While several demographic variables were associated with different perceptions, the results of this study highlight that a paramedic's years of experience is most consistently associated with their perception of ethical dilemmas. Conclusion: Australian paramedics experience a range of ethical dilemmas consistent with previous international findings. Years of experience in the profession features heavily and is relied upon more so than education, suggesting that educational approaches to ethics education in paramedicine need to be reconsidered.

Background: In Australia, accrediting body competencies reflect paramedic professional practice rather than informing curriculum development for higher education institutions. Purpose: This article will investigate frameworks that can be used to design curriculum development. Method: An initial focused discourse analysis of the grey literature was undertaken followed by a systematic review. Findings: Three of the 18 institutions in Australia and New Zealand that offer paramedic education identified some form of framework. Two theories were identified as applicable in supporting the development of curricula that are focused on the expanded scope of practice of paramedicine. Discussion: The current and future scope in paramedicine will define the development of curricula, especially in relation to a more primary-focused healthcare model. Conclusion: Further research is required to establish a consensus on what constitutes the essential core knowledge and skills required by graduate paramedics so that they are able to deliver patient care proficiently.

Purpose Paramedics increasingly attend to mental health-related emergencies; however, there has been little evaluation of the mental health training for paramedics. This study aims to analyze the fit between paramedicine pedagogy, patient needs and the conditions for paramedics’ skill development. Design/methodology/approach Data were collected in a single, qualitative, critical ethnographic case study of pre-hospital mental health and psychosocial care in paramedicine in Ontario, Canada. Transcripts from interviews (n = 46), observation (n ∼ 90h) and document analysis were thematically analyzed using a constant comparative method. The study is theoretically grounded in a feminist political economy framework. Findings Tensions are explored in relation to the pedagogy of paramedicine and the conditions of work faced by paramedics. The paper presents challenges and insufficiencies with existing training, the ways in which certain work and training are valued and prioritized, increased emergency care and training needs and the limitations of training to improving care. Research limitations/implications Recommendations include more comprehensive didactic training, including the social determinants of health; scenario training; practicum placements in mental health or social services; collaboration with mental health and social services to further develop relevant curriculum and potential inclusion of service users. Originality/value This paper addresses the lack of mental health pedagogy in Ontario and internationally and the need for further training pre-certification and while in the workforce. It presents promising practices to ameliorate mental health training and education for paramedics.

Experiential learning (EL), whereby students are able to integrate theory with practice, is an essential component of learning for health professionals. Traditionally, EL in the health education context has been achieved through clinical placements (CPs) that see students ‘apprentice’ in real clinical settings. The literature suggests there are a number of factors that diminish a student’s ability to learn in such environments, including limited opportunities to practice, being confined primarily to observation roles as opposed to participate in tasks, being exposed to skills/procedures outside their level of learning/understanding, and institutional learning objectives being secondary to workplace goals. Simulation-based learning environments (SLEs) have been espoused as an effective alternative to traditional CPs, as they provide EL opportunities void of patient risk, and can be targeted to suit the needs of both teacher and learner. While many advocate that SLEs are the logical teaching modality for preparing students to practice in real clinical environments, the fast adoption of SLEs in health education has far exceeded evidence of its effectiveness in comparison to learning occurring via CPs. Research investigating SLEs to date has, for the most part, relied upon subjective measures of student satisfaction, confidence and competence and has utilised single-group analyses providing no yardstick for comparison. The present research sought to explore the value of SLEs for undergraduate health students in comparison to CPs, as well as investigate methods of improving the educational benefit of SLEs. This thesis is presented as a series of papers (i.e. PhD by publication) addressing the role of SLEs in health education. Study One investigates how social evaluation anxiety (SEA) impacts on performance amongst a sample of final-year nursing students. It was found that through increasing the number of professional actors in a simulation-based clinical scenario, social evaluation anxiety increased to an extent sufficient to detrimentally affect student performance. Thus, the study concluded that students would likely benefit from additional authentic exposures to EL opportunities earlier throughout their curriculum, so as to acclimatise them to real patient and person interaction. Studies Two and Three explore the differences and relationship between SLEs and CPs amongst first-year paramedicine students. The extent to which SLEs provide additional learning benefit in subsequent CPs was first established, followed by evidence suggesting this is most likely attributable to the increased opportunity for repetitive and targeted practice meant and why I did it. To my father, Rick Mills, unexpectedly losing you in December last year was unquestionably the most tragic time of my life, but the life lessons you embedded so strongly within me saw this thesis through to completion. I cannot thank you enough, and dedicate this accomplishment to you.

Evidence-based practice (EBP) is a core skill of all health professionals and a professional registration requirement for paramedics in Australia, NZ, and the UK. Paramedic Academics (PAs) have a key role in teaching EBP to paramedic undergraduates. However, only limited literature exists to assess the preparedness of PAs to do so. The current research is conducted under the paradigm of constructivism using the mixed methods of a phenomenological guided multiple repeated individual case studies using sequential semi-structured interviews incorporating vignettes and a positivist-based survey. The Evidence-Based Practice Profile-Paramedic (EBP2 -P) survey assesses the domains of relevance, terminology, practice, confidence, and sympathy to EBP. Demographic data was also collected. Data analysis was Cronbach’s alpha coefficient, descriptive statistics, Welch’s unequal variances t-test and Factorial AVOVA. A total of 106 PAs from Australia (61), NZ (20) and the UK (25) responded to the survey. Most respondents had a paramedic background (89%) and >10 years clinical experience (68%). Only 11% held a PhD while 12% held a Master’s by Research and 30% a Master’s by coursework. Under half of respondents had any EBP education (48%) or published an academic paper or presented at a conference (43%). Mean academic experience was four years with 22% reporting less than one year. EBP2 -P scores for the PAs were statistically significantly superior (p < .05) to other allied health professional academics in the domains of practice and sympathy and not significantly different in relevance, terminology, and confidence. The themes of variable EBP training levels, academic, and clinical use, inexperienced PAs, lack of higher degrees, resistance to students practicing EBP from clinical supervisors were detected in the qualitative phase. Student paramedics’ attitudes to EBP were influenced strongly by early clinical placements and they disliked being taught by non-paramedic staff that did not understand the paramedic environment and used irrelevant examples. The pattern of the EBP2 -P scores demonstrated that the PA cohort is at least as capable as the Allied Health Academics regarding the EBP characteristics evaluated. Differences between Australian PAs and their UK and NZ counterparts may be due to variation in years professional registration programs began. Some academics, in-service educators, and clinical managers require EBP education. Further support is needed for PAs to publish, present, and remain in academia. Paramedic EBP education should be themed through each unit of an undergraduate course with an explicit teaching of the five steps early, integrated into practical clinical situations and featuring prominently in a capstone project. Key recommendations for practice include retaining and developing paramedic academics with appropriate mentors; facilitating research and training opportunities; and monitor wages to align with ambulance industry. Furthermore, recommendations for higher education delivery focus on ensuring EBP is integrated into all units in the paramedic undergraduate curricula and implementing a EBP education program for clinical supervisors. Recommendations for further research involve conducting a EBP2 -P study of paramedic students transiting into the workforce, development, and evaluation of assessing EBP competency using OSCEs in undergraduate paramedicine and developing a paramedic signature pedagogy consensus statement based on a systematic review and Delphi survey. This work has provided insights regarding the key role paramedic academics have in teaching EBP to paramedic undergraduates. Findings from the current study reinforce that progression has been made in developing the professional culture to support the integration of EBP as a critical component of paramedicine education and practice.