Aim This study aimed to examine the quality of published paramedic scoping reviews against pre-existing frameworks to assess the extent to which they fulfil the requirements of this methodological approach. Subsequently, recommendations will be presented regarding improvements for future paramedic scoping reviews. Methods A scoping review was conducted guided by the PRISMA Extension for Scoping Reviews. A literature search was performed in six electronic databases as well as the grey literature to identify previous scoping reviews that focussed on paramedic or emergency medical service personnel. Relevant data were extracted from included articles and presented in narrative and tabular formats. Results The literature search initially identified 475 articles, of which 20 remained after title/abstract and full-text screening. There was a general increase in the number of studies published over time, the majority of articles (80%) had conducted their scoping review utilising published frameworks, and 75% of first authors were paramedics. Although many areas of these reports comply with published guidelines, there was an overall lack of consistency in the specific information included, the level of detail of that information, and the location of information within the reports. Conclusion All paramedic scoping studies should be reported with the use of a published framework to enable standardisation in the reporting, thus facilitating understanding, reproducibility, and utility. The PRISMA Extension for Scoping Reviews provides a checklist and thorough explanations of each step in the reporting process and is recommended for use with all future paramedic scoping reviews.
{"title":"An Assessment of Scoping Review Reporting within Paramedicine: A Scoping Review","authors":"B. Williams, Bronwyn Beovich","doi":"10.33151/ajp.17.834","DOIUrl":"https://doi.org/10.33151/ajp.17.834","url":null,"abstract":"Aim This study aimed to examine the quality of published paramedic scoping reviews against pre-existing frameworks to assess the extent to which they fulfil the requirements of this methodological approach. Subsequently, recommendations will be presented regarding improvements for future paramedic scoping reviews. Methods A scoping review was conducted guided by the PRISMA Extension for Scoping Reviews. A literature search was performed in six electronic databases as well as the grey literature to identify previous scoping reviews that focussed on paramedic or emergency medical service personnel. Relevant data were extracted from included articles and presented in narrative and tabular formats. Results The literature search initially identified 475 articles, of which 20 remained after title/abstract and full-text screening. There was a general increase in the number of studies published over time, the majority of articles (80%) had conducted their scoping review utilising published frameworks, and 75% of first authors were paramedics. Although many areas of these reports comply with published guidelines, there was an overall lack of consistency in the specific information included, the level of detail of that information, and the location of information within the reports. Conclusion All paramedic scoping studies should be reported with the use of a published framework to enable standardisation in the reporting, thus facilitating understanding, reproducibility, and utility. The PRISMA Extension for Scoping Reviews provides a checklist and thorough explanations of each step in the reporting process and is recommended for use with all future paramedic scoping reviews.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129411535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The Western Cape is a province in South Africa – known for the port city of Cape Town – surrounded by the Indian and Atlantic oceans. The transport of high-risk neonates between neonatal intensive care units in the Western Cape of South Africa is performed by advanced life support (ALS) providers. The implications of this practice have not been documented. This study will evaluate the preparedness of ALS providers to undertake intensive care of critically ill neonates during interfacility transfers. Methods Data collection was performed using a questionnaire with a response rate of 81% (n=145). The data analysis encompassed descriptive statistics using tables and figures. Inferential statistics was done using the chi-square test with a significance reported for p<0.05. Reliability was determined using Cronbach's alpha. Results The respondents highlighted that their initial ALS training was not adequate to prepare them for managing critically ill neonates. This view was expressed by the greater majority (n=63, 43.4%) when asked about their combined neonatal theory and practical training notional hours of their curriculum which focussed on managing critically ill neonates. Conclusion There is an urgent need to improve the training programs of ALS providers with regards to neonatology. Numerous factors affecting the preparedness of ALS providers to manage critically ill neonates have been highlighted.
{"title":"Preparedness of Western Cape Advanced Life Support Providers to Provide Clinical Stabilisation and Intensive Care for Neonatal Interfacility Transfers","authors":"E. Ismail, R. Naidoo, D. Prakaschandra","doi":"10.33151/ajp.17.781","DOIUrl":"https://doi.org/10.33151/ajp.17.781","url":null,"abstract":"Introduction The Western Cape is a province in South Africa – known for the port city of Cape Town – surrounded by the Indian and Atlantic oceans. The transport of high-risk neonates between neonatal intensive care units in the Western Cape of South Africa is performed by advanced life support (ALS) providers. The implications of this practice have not been documented. This study will evaluate the preparedness of ALS providers to undertake intensive care of critically ill neonates during interfacility transfers. Methods Data collection was performed using a questionnaire with a response rate of 81% (n=145). The data analysis encompassed descriptive statistics using tables and figures. Inferential statistics was done using the chi-square test with a significance reported for p<0.05. Reliability was determined using Cronbach's alpha. Results The respondents highlighted that their initial ALS training was not adequate to prepare them for managing critically ill neonates. This view was expressed by the greater majority (n=63, 43.4%) when asked about their combined neonatal theory and practical training notional hours of their curriculum which focussed on managing critically ill neonates. Conclusion There is an urgent need to improve the training programs of ALS providers with regards to neonatology. Numerous factors affecting the preparedness of ALS providers to manage critically ill neonates have been highlighted.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121518758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly Mackinnon, Timothy Everett, L. Holmes, Erin C. Smith, B. Mills
Introduction Paramedics are exposed to significant and cumulative stressors that contribute to poor mental health. The provision of effective and engaging mental health support is essential in improving overall wellbeing. Many ambulance services have adapted their available support services to reflect this need. However, there remains limited research into the perceived efficacy of these services and barriers that limit uptake from paramedics. Methods Paramedics and ambulance volunteers from Australia and New Zealand were invited to complete an online survey consisting of a series of Likert-scale and open-ended response questions. The well-validated Kessler Psychological Distress Scale was also incorporated into the online survey. Results A total of 184 participants completed the survey. A total of 50 (27%) participants reported high/very high levels of psychological distress. Participants exposed to at least one adverse event while working reported higher psychological distress scores than those that had not. Just over half (51%) of all participants disagreed/strongly disagreed there was no stigma associated with seeking mental health support from paramedic colleagues and 54% of participants disagreed/strongly disagreed there was no stigma from managerial staff. Conclusion These findings suggest paramedics are at a greater risk of psychological distress than the general population. This is particularly problematic given there is a clear perception of ongoing stigma among paramedics associated with the utilisation of mental health support services. Future research should explore methods for reducing stigma and encouraging help-seeking behaviours in this vulnerable population throughout all phases of an emergency service workers career.
{"title":"Risk of Psychological Distress, Pervasiveness of Stigma and Utilisation of Support Services: Exploring Paramedic Perceptions","authors":"Kelly Mackinnon, Timothy Everett, L. Holmes, Erin C. Smith, B. Mills","doi":"10.33151/ajp.17.764","DOIUrl":"https://doi.org/10.33151/ajp.17.764","url":null,"abstract":"Introduction Paramedics are exposed to significant and cumulative stressors that contribute to poor mental health. The provision of effective and engaging mental health support is essential in improving overall wellbeing. Many ambulance services have adapted their available support services to reflect this need. However, there remains limited research into the perceived efficacy of these services and barriers that limit uptake from paramedics. Methods Paramedics and ambulance volunteers from Australia and New Zealand were invited to complete an online survey consisting of a series of Likert-scale and open-ended response questions. The well-validated Kessler Psychological Distress Scale was also incorporated into the online survey. Results A total of 184 participants completed the survey. A total of 50 (27%) participants reported high/very high levels of psychological distress. Participants exposed to at least one adverse event while working reported higher psychological distress scores than those that had not. Just over half (51%) of all participants disagreed/strongly disagreed there was no stigma associated with seeking mental health support from paramedic colleagues and 54% of participants disagreed/strongly disagreed there was no stigma from managerial staff. Conclusion These findings suggest paramedics are at a greater risk of psychological distress than the general population. This is particularly problematic given there is a clear perception of ongoing stigma among paramedics associated with the utilisation of mental health support services. Future research should explore methods for reducing stigma and encouraging help-seeking behaviours in this vulnerable population throughout all phases of an emergency service workers career.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132011060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction University-led higher education for paramedics has been in place for over 20 years, with students in these programs required to complete supervised clinical placements with an experienced paramedic mentor. This investigation aims to establish whether the non-rotation of paramedic students between paramedic mentors while on ambulance-based placements aids or hinders the undergraduate paramedic student's development of competencies. Methods Purposive and convenience sampling methods were used, with semi-structured group interviews conducted with second year undergraduate paramedic students for data collection. Thematic analysis was used to draw meaning from the collected data. Results Five key themes emerged from within the data. Students reported difficulties in maintaining relationships with their assigned mentors, particularly in situations where conflicting schedules and role changes necessitated frequent rotation between mentors. Students reported feeling there was great variety in the way competency-based learning is managed by paramedic mentors, leading to inconsistencies in assessment. Students also described comparing their own personality and clinical practice against mentors, in order to self-identify more appropriate mentors during the placements. Conclusion This research provides an initial insight into how paramedic students perceive the effects of non-rotational ambulance-based placements on the development of competencies. Based on the findings of this research it is not possible to draw firm conclusions as to whether the non-rotation of ambulance-based placements aids or hinders undergraduate student paramedics’ development of competencies. Further research is required in this area across a variety of settings in order to understand the applicability of these results.
{"title":"Do Non-Rotational Ambulance-Based Placements Affect the Development of Paramedic Competencies from a Student Perspective? A Qualitative Study","authors":"L. Baranowski, R. Armour","doi":"10.33151/ajp.17.703","DOIUrl":"https://doi.org/10.33151/ajp.17.703","url":null,"abstract":"Introduction University-led higher education for paramedics has been in place for over 20 years, with students in these programs required to complete supervised clinical placements with an experienced paramedic mentor. This investigation aims to establish whether the non-rotation of paramedic students between paramedic mentors while on ambulance-based placements aids or hinders the undergraduate paramedic student's development of competencies. Methods Purposive and convenience sampling methods were used, with semi-structured group interviews conducted with second year undergraduate paramedic students for data collection. Thematic analysis was used to draw meaning from the collected data. Results Five key themes emerged from within the data. Students reported difficulties in maintaining relationships with their assigned mentors, particularly in situations where conflicting schedules and role changes necessitated frequent rotation between mentors. Students reported feeling there was great variety in the way competency-based learning is managed by paramedic mentors, leading to inconsistencies in assessment. Students also described comparing their own personality and clinical practice against mentors, in order to self-identify more appropriate mentors during the placements. Conclusion This research provides an initial insight into how paramedic students perceive the effects of non-rotational ambulance-based placements on the development of competencies. Based on the findings of this research it is not possible to draw firm conclusions as to whether the non-rotation of ambulance-based placements aids or hinders undergraduate student paramedics’ development of competencies. Further research is required in this area across a variety of settings in order to understand the applicability of these results.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115237315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Ensuring undergraduate healthcare students are work ready graduates who possess real-world experiences and realistic expectations of their professional environment is essential for Australian universities. This is becoming increasingly more difficult to accomplish with ongoing difficulties on sourcing appropriate clinical placement learning opportunities. We developed and piloted a simulated paramedic night shift investigating if undergraduate paramedic students perceived the experience to be realistic and to what extent they felt it contributed toward their learning. Methods A total of 24 undergraduate paramedic students were recruited to participate in a simulated 13-hour paramedic night shift held on university campus. Student satisfaction and perceived value towards learning was measured using an online survey the day after the simulation. Results 23 of 24 participants completed the online survey. Survey data suggested 22 participants felt the simulated night shift to be realistic of real-life paramedic practice, provided a valuable learning experience and should be made a mandatory component of undergraduate paramedicine curricula. Conclusion Given the difficulties associated with providing clinical placement opportunities for students and the perception among health professionals that on entering the workforce many graduates often lack the adaptability required to undertake shift-work and the professional role of a paramedic, educators should consider the merits of providing overnight simulated experiences to undergraduate students to better prepare and acclimatise students to overnight shift work.
{"title":"A Simulated Night Shift for Undergraduate Paramedicine Students: Lessons Learnt and the Perceived Value towards Learning","authors":"Alecka Miles, Sara Hansen, B. Mills","doi":"10.33151/ajp.17.732","DOIUrl":"https://doi.org/10.33151/ajp.17.732","url":null,"abstract":"Background Ensuring undergraduate healthcare students are work ready graduates who possess real-world experiences and realistic expectations of their professional environment is essential for Australian universities. This is becoming increasingly more difficult to accomplish with ongoing difficulties on sourcing appropriate clinical placement learning opportunities. We developed and piloted a simulated paramedic night shift investigating if undergraduate paramedic students perceived the experience to be realistic and to what extent they felt it contributed toward their learning. Methods A total of 24 undergraduate paramedic students were recruited to participate in a simulated 13-hour paramedic night shift held on university campus. Student satisfaction and perceived value towards learning was measured using an online survey the day after the simulation. Results 23 of 24 participants completed the online survey. Survey data suggested 22 participants felt the simulated night shift to be realistic of real-life paramedic practice, provided a valuable learning experience and should be made a mandatory component of undergraduate paramedicine curricula. Conclusion Given the difficulties associated with providing clinical placement opportunities for students and the perception among health professionals that on entering the workforce many graduates often lack the adaptability required to undertake shift-work and the professional role of a paramedic, educators should consider the merits of providing overnight simulated experiences to undergraduate students to better prepare and acclimatise students to overnight shift work.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127564327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Reid, Moira Sim, Shelley Beatty, H. Grantham, Mike Gale
Introduction There is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines a curriculum for ALS resuscitation education for providers working in the pre-hospital or resource-limited settings. The focus on pre-hospital ALS education is important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival. Methods The pre-hospital ALS curriculum developed in this research was derived from a survey and interviews with pre-hospital healthcare professionals and first responders, and input from resuscitation, medical and education experts. Following completion of the interviews an expert panel of resuscitation experts was consulted. Results Information collected indicated that a pre-hospital ALS course should follow current recommendations of the Australian Resuscitation Council and that the course should be delivered in a mixed mode comprising of online pre-reading and a quiz followed by one day of face-to-face teaching. Equipment should reflect that used in the pre-hospital environment and a pre-hospital ALS course should include scenarios relevant to the pre-hospital setting involving varying numbers of interprofessional healthcare teams as well as first responders and lay persons. Candidates should be assessed on a continual basis and certificates of participation be valid for 2 to 3 years. Conclusion To improve pre-hospital resuscitation education and maximise the likelihood of patient survival, ALS education for pre-hospital providers should follow Australian Resuscitation Council guidelines, include pre-course reading, case studies and practical simulation in situations that are likely to be encountered by pre-hospital professionals.
{"title":"Pre-Hospital Advanced Life Support Resuscitation – a Curriculum for Pre-Hospital Education","authors":"David Reid, Moira Sim, Shelley Beatty, H. Grantham, Mike Gale","doi":"10.33151/ajp.17.757","DOIUrl":"https://doi.org/10.33151/ajp.17.757","url":null,"abstract":"Introduction There is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines a curriculum for ALS resuscitation education for providers working in the pre-hospital or resource-limited settings. The focus on pre-hospital ALS education is important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival. Methods The pre-hospital ALS curriculum developed in this research was derived from a survey and interviews with pre-hospital healthcare professionals and first responders, and input from resuscitation, medical and education experts. Following completion of the interviews an expert panel of resuscitation experts was consulted. Results Information collected indicated that a pre-hospital ALS course should follow current recommendations of the Australian Resuscitation Council and that the course should be delivered in a mixed mode comprising of online pre-reading and a quiz followed by one day of face-to-face teaching. Equipment should reflect that used in the pre-hospital environment and a pre-hospital ALS course should include scenarios relevant to the pre-hospital setting involving varying numbers of interprofessional healthcare teams as well as first responders and lay persons. Candidates should be assessed on a continual basis and certificates of participation be valid for 2 to 3 years. Conclusion To improve pre-hospital resuscitation education and maximise the likelihood of patient survival, ALS education for pre-hospital providers should follow Australian Resuscitation Council guidelines, include pre-course reading, case studies and practical simulation in situations that are likely to be encountered by pre-hospital professionals.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"170 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122963574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Willis, S. Lawn, L. Roberts, L. Couzner, L. Mohammadi, Elizabeth Goble
Background Over the past decade there has been significant focus on the mental health and wellbeing of emergency service workers in Australia, evidenced by the 2018 Senate Inquiry into the role of Commonwealth, state and territory Governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers. Call-takers as an occupational group within this domain are at risk of cumulative and vicarious trauma, yet there is little research on their work-related mental illness. This systematic thematic narative literature review of qualitative articles reports on the mental health and wellbeing of emergency call-takers. Methods Both published peer review (2000–2018) and grey literature (2009–2018) that examined the impact of emergency work on call-takers was retrieved. Papers that focussed on call-takers’ psychological and psychosocial health were selected. Databases included Ovid Medline, CINAHL, Ovid EMcare, PsychInfo, Scopus as well as Google Scholar. Results Fourteen articles met the eligibility criteria; five peer review and nine grey literature studies. Thematic analysis identified issues around surveillance versus lack of supervision; role denial versus advocacy; and failure to acknowledge vicarious trauma. Suggestions for improvement required recognition of the stressful nature of the work, improvements in workplace culture and the provision of support and counselling services. Conclusion Workplace stressors for call-takers arise from their work in dealing with trauma related communication with the public as well workplace culture, particularly the response of management to issues such as shift work, poorly managed rosters and long hours of work with little time for recovery. Compounding these issues is the invisibility of call-taker work.
{"title":"The Impact of Emergency Call Taking on the Mental Health and Wellbeing of Ambulance Call-Takers: A Systematic Thematic Narrative of Qualitative Research","authors":"E. Willis, S. Lawn, L. Roberts, L. Couzner, L. Mohammadi, Elizabeth Goble","doi":"10.33151/ajp.17.801","DOIUrl":"https://doi.org/10.33151/ajp.17.801","url":null,"abstract":"Background Over the past decade there has been significant focus on the mental health and wellbeing of emergency service workers in Australia, evidenced by the 2018 Senate Inquiry into the role of Commonwealth, state and territory Governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers. Call-takers as an occupational group within this domain are at risk of cumulative and vicarious trauma, yet there is little research on their work-related mental illness. This systematic thematic narative literature review of qualitative articles reports on the mental health and wellbeing of emergency call-takers. Methods Both published peer review (2000–2018) and grey literature (2009–2018) that examined the impact of emergency work on call-takers was retrieved. Papers that focussed on call-takers’ psychological and psychosocial health were selected. Databases included Ovid Medline, CINAHL, Ovid EMcare, PsychInfo, Scopus as well as Google Scholar. Results Fourteen articles met the eligibility criteria; five peer review and nine grey literature studies. Thematic analysis identified issues around surveillance versus lack of supervision; role denial versus advocacy; and failure to acknowledge vicarious trauma. Suggestions for improvement required recognition of the stressful nature of the work, improvements in workplace culture and the provision of support and counselling services. Conclusion Workplace stressors for call-takers arise from their work in dealing with trauma related communication with the public as well workplace culture, particularly the response of management to issues such as shift work, poorly managed rosters and long hours of work with little time for recovery. Compounding these issues is the invisibility of call-taker work.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116240149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The ability to critically self-evaluate is fundamental to professional health roles. Reflective practice is now a recognised feature of the professional capabilities of registered paramedics in Australia, which has implications for both education and industry when determining competency. Reflective practice currently receives little priority in teaching, often appearing late in curriculum and not usually linked to high stakes assessment. It is argued that sustainable reflective practice skills should appear earlier and include opportunities for active student involvement in decisions regarding their learning. Student-tutor consensus assessment (STCA) is a reflection-in-practice technique providing a structured approach for critically appraising practice, while calibrating judgement with assessors. We evaluated the experiences of a cohort of newly commencing undergraduates within a fundamentals of paramedic practice subject. Methods Students were invited to complete a questionnaire relating to their perceptions and experiences after participating in the STCA approach. Results 88 responses were collected which indicated broad agreement regarding the value to learning and recognition for the importance of reflective practice skills to future professional roles. Conclusion Students readily embraced the principles of reflective practice and were able to effectively contribute to high level decisions regarding their work despite having only recently commenced the program. In addition, the high levels of broad agreement for the value of the STCA approach, suggest reflective practice and critical thinking-based assessments have a more important role to play in paramedic education.
{"title":"Assessment Partnerships from the Start: Building Reflective Practice as a Beginning Paramedic Student Competency","authors":"James Thompson, L. Couzner, D. Houston","doi":"10.33151/ajp.17.750","DOIUrl":"https://doi.org/10.33151/ajp.17.750","url":null,"abstract":"Introduction The ability to critically self-evaluate is fundamental to professional health roles. Reflective practice is now a recognised feature of the professional capabilities of registered paramedics in Australia, which has implications for both education and industry when determining competency. Reflective practice currently receives little priority in teaching, often appearing late in curriculum and not usually linked to high stakes assessment. It is argued that sustainable reflective practice skills should appear earlier and include opportunities for active student involvement in decisions regarding their learning. Student-tutor consensus assessment (STCA) is a reflection-in-practice technique providing a structured approach for critically appraising practice, while calibrating judgement with assessors. We evaluated the experiences of a cohort of newly commencing undergraduates within a fundamentals of paramedic practice subject. Methods Students were invited to complete a questionnaire relating to their perceptions and experiences after participating in the STCA approach. Results 88 responses were collected which indicated broad agreement regarding the value to learning and recognition for the importance of reflective practice skills to future professional roles. Conclusion Students readily embraced the principles of reflective practice and were able to effectively contribute to high level decisions regarding their work despite having only recently commenced the program. In addition, the high levels of broad agreement for the value of the STCA approach, suggest reflective practice and critical thinking-based assessments have a more important role to play in paramedic education.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127190932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This commentary aims to provide an overview of the current state and territory ambulance service cardiac arrest management recommendations to paramedics during the COVID-19 pandemic and highlight relevant risks to personnel.
{"title":"Responding to a Cardiac Arrest: Keeping Paramedics Safe during the Covid-19 Pandemic","authors":"S. Whitfield, A. MacQuarrie, M. Boyle","doi":"10.33151/ajp.17.809","DOIUrl":"https://doi.org/10.33151/ajp.17.809","url":null,"abstract":"This commentary aims to provide an overview of the current state and territory ambulance service cardiac arrest management recommendations to paramedics during the COVID-19 pandemic and highlight relevant risks to personnel.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125598292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To identify the patient and case characteristics associated with emergency department (ED) suitability of cases referred for emergency ambulance dispatch following ambulance-based secondary telephone triage. Methods A retrospective cohort analysis was conducted of secondary telephone triage cases transported to an ED by emergency ambulance between September 2009 and June 2012 in Melbourne, Australia. Patients were considered ED suitable if they were triaged as a category 1, 2 or 3 according to the Australian Triage Scale, were admitted to hospital or referred to another hospital for admission, or died in the ED. Descriptive statistics and multivariable binary logistic regression analysis were used to identify the variables associated with ED suitability. Results There were 2694 (21.2%) cases classified as ‘not ED suitable’. The mean age of this group was 51.7 years (SD 23.7 years) and 56.5% were female. Those that were ED suitable were older, with a mean age of 59.1 years (SD 22.6 years) and 53.6% were female. After adjusting for confounders the age (p<0.001), pain (p<0.001) and triage guideline groups (p<0.001) variables had statistically significant relationships with ED suitability. Gender (p=0.108), time of day (p=0.118), secondary triage call-taker qualification (p=0.237) and comorbidities (p=0.182) showed no association with ED suitability, and income status was approaching significance (95% CI 0.85–1.02, p=0.055). Conclusion There are patient and case characteristics associated with ED suitability that could be used to improve patient triage to better match patients with care pathways appropriate to their needs.
目的确定与急诊部(ED)在基于救护车的二级电话分诊后转介紧急救护车调度的病例的适宜性相关的患者和病例特征。方法回顾性队列分析2009年9月至2012年6月在澳大利亚墨尔本由急诊救护车转运至急诊室的二次电话分诊病例。如果患者根据澳大利亚分诊量表被分类为1、2或3类，入院或转诊到另一家医院入院，或在急诊科死亡，则认为患者适合急诊科。使用描述性统计和多变量二元逻辑回归分析来确定与急诊科适宜性相关的变量。结果2694例(21.2%)为“不适宜ED”。本组患者平均年龄51.7岁(SD 23.7岁)，56.5%为女性。适合ED的患者年龄较大，平均年龄59.1岁(SD 22.6岁)，女性53.6%。在调整混杂因素后，年龄(p<0.001)、疼痛(p<0.001)和分诊指南组(p<0.001)变量与ED适宜性有统计学意义的关系。性别(p=0.108)、一天中的时间(p=0.118)、二级分诊接诊员资格(p=0.237)和合并症(p=0.182)与ED适宜性无关，收入状况接近显著(95% CI 0.85-1.02, p=0.055)。结论与ED适宜性相关的患者和病例特征可用于改进患者分诊，以更好地为患者匹配适合其需求的护理路径。
{"title":"Characteristics Associated with Emergency Department Suitability in Low-Acuity Ambulance Cases","authors":"K. Eastwood, A. Morgans, Karen Smith","doi":"10.33151/ajp.17.782","DOIUrl":"https://doi.org/10.33151/ajp.17.782","url":null,"abstract":"Objective To identify the patient and case characteristics associated with emergency department (ED) suitability of cases referred for emergency ambulance dispatch following ambulance-based secondary telephone triage. Methods A retrospective cohort analysis was conducted of secondary telephone triage cases transported to an ED by emergency ambulance between September 2009 and June 2012 in Melbourne, Australia. Patients were considered ED suitable if they were triaged as a category 1, 2 or 3 according to the Australian Triage Scale, were admitted to hospital or referred to another hospital for admission, or died in the ED. Descriptive statistics and multivariable binary logistic regression analysis were used to identify the variables associated with ED suitability. Results There were 2694 (21.2%) cases classified as ‘not ED suitable’. The mean age of this group was 51.7 years (SD 23.7 years) and 56.5% were female. Those that were ED suitable were older, with a mean age of 59.1 years (SD 22.6 years) and 53.6% were female. After adjusting for confounders the age (p<0.001), pain (p<0.001) and triage guideline groups (p<0.001) variables had statistically significant relationships with ED suitability. Gender (p=0.108), time of day (p=0.118), secondary triage call-taker qualification (p=0.237) and comorbidities (p=0.182) showed no association with ED suitability, and income status was approaching significance (95% CI 0.85–1.02, p=0.055). Conclusion There are patient and case characteristics associated with ED suitability that could be used to improve patient triage to better match patients with care pathways appropriate to their needs.","PeriodicalId":340334,"journal":{"name":"Australian Journal of Paramedicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129581984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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