Academic literature on the topic 'Paramedical education Curricula'

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.

Introduction: Ultrasonography (US), performed in the Emergency Department (ED) by Emergency Physicians, is well established. Educational studies have shown some promise in training paramedics in US use. We have developed and piloted a novel curriculum for paramedic US education. Methods: Based on an informal needs assessment, an US curriculum for paramedics was developed to include: Basic principles, Focused assessment with sonography for trauma (FAST), cardiac, and vascular access. Participants included ED-based and pre-hospital paramedics including all paramedics with critical care training who routinely perform vascular access and procedural sedation within our ED. Comparisons were made using paired non-parametric tests (GraphPad). Results: Participants (N=9) were provided pre- reading materials prior to completing a 6-hour course, consisting of a mix of didactic and practical sessions with live models and vascular access phantoms. Each module was introduced with a 30 minute didactic session, led by an Emergency Physician trained in US, followed immediately by a 1 hour hands-on session lead by either an Emergency Physician or an Emergency Medicine Resident at a learner to instructor ratio of 3:1. At the end of the course, participants were asked to complete a short 10 minute survey that included (1) an assessment of the course quality with regard to preparatory material and course content/delivery (4 point Likert scale; excellent, good, fair, poor); (2) self reported US knowledge pre and post course on a scale of 1-10 (10 high, 1 low); (3) general yes/no questions related to the future of ECCU paramedical and (4) a subjective written section for additional comments. All participants rated the content favourably: 97% scoring it as excellent, and 3% as good. The participants median self-reported US knowledge score increased from 2/10 (IQR 2-3) to 8/10 (IQR 7.25-8; p=0.009) post- course. All comments from the text field were positive in nature. Conclusion: We report a paramedic US course curriculum, which when piloted resulted in high learner satisfaction and a high rate of self reported improvement in US knowledge. Further study will include an assessment of knowledge acquisition and practical performance. Future modifications in our curriculum will be based on needs assessment and may include additional modules.

Introduction:Evidence-based training and curriculum are seen as vital in order to be successful in preparing paramedics for an effective disaster response. The creation of broadly recognized standard core competencies to support the development of disaster response education and training courses for general health care providers and specific health care professionals will help to ensure that medical personnel are truly prepared to care for victims of mass casualty events.Aim:To identify current Australian operational paramedic’s specific disaster management education and knowledge as it relates to disaster management core competencies identified throughout the literature and the frequency of measures/techniques which these paramedics use to maintain competency and currency.Methods:Paramedics from all states of Australia were invited to complete an anonymous online survey. Two professional bodies distributed the survey via social media and a major ambulance service was surveyed via email.Results:The study population includes 130 respondents who self-identified as a currently practicing Australian paramedic. Paramedics from all states except South Australia responded, with the majority coming from Queensland Ambulance Service (N= 81%). In terms of experience, 81.54% of respondents report being qualified for greater than 5 years. Initial analysis shows that despite the extensive experience of the practitioners surveyed when asked to rate from high to low their level of knowledge of specific disaster management core competencies a number of gaps exist.Discussion:Core competencies are a defined level of expertise that is essential or fundamental to a particular job, and serve to form the foundation of education, training, and practice for operational service delivery. While more research is needed, these results may help inform industry, government, and education providers to better understand and to more efficiently provide education and ongoing training to paramedics who are responsible for the management of disaster within the Australian community.

The paramedic service responds to emergency calls for a variety of reasons, many relating to mental health concerns. This qualitative study aims to explore the views and experiences of student paramedics in relation to clinical decision making for mental health calls. Focus groups were used to investigate the participants' perspectives. Thematic analysis was used to organise data and identify key issues. Findings suggested some disparity between what paramedic students were prepared for and the reality of public need. Clinical decision making in relation to those with mental health problems was significantly influenced by the current provision of mental health services and the lack of mental health-specific education for student paramedics. Current changes to the paramedic programme make this an opportune time for a review of curriculum content.

AbstractThe purpose of this paper is to present approaches to foster critical thinking skills within the context of the current paramedic curriculum. It reviews some of the definitions and concepts of critical thinking from selected adult education and nursing literature in an attempt to formulate a workable definition as it applies to paramedics. From that definition, elements are identified and incorporated to form a teaching model for use in presenting the curriculum content. Some sample teaching strategies based on revised objectives of the airway/ventilation section also are included.

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.

AbstractIntroductionParamedics rely on establishing a health provider-patient relationship with patients that promotes two-way communication, patient satisfaction, and facilitates appropriate patient assessment and treatment. Paramedics also must have an ability to empathize with patients and their family members in order to develop a successful health provider-patient relationship. The objective of this study was to assess paramedics’ empathy and attitudes toward patients with specific conditions.MethodsThis was a cross-sectional study using a convenience sample of first-, second-, and third-year, Australian undergraduate paramedic students. Student empathy levels were assessed using two standardized self-reporting instruments: the Jefferson Scale of Physician Empathy (JSPE) Health Professional (HP) version and the Medical Condition Regard Scale (MCRS).ResultsA total of 94 paramedic students participated in the study. The JSPE demonstrated that male paramedic students had higher mean empathy scores than did female paramedic students (113.25 and 107.5, respectively; P = .042). The JSPE empathy level scores were lowest among first-year paramedic students (mean = 107.53); age was not found to be a significant variable on empathy scores. The Medical Condition Regard Scale revealed lowest scores in compassion towards substance abuse (mean = 46.42).ConclusionsThe results of this study provide the discipline of paramedic health care with useful data, and provide students, academics, and other educators with important information regarding the improvement of the health provider-patient relationship and paramedic education curriculum development.WilliamsB, BoyleM, EarlT. Measurement of empathy levels in undergraduate paramedic students. Prehosp Disaster Med. 2013;28(2):1-5.

The clinical examination is an important part of any patient consultation. After the primary survey and taking the patient history, a more in-depth examination is sometimes required to aid making a working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, clinical examination is an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Education on clinical examination concerning each of the main body systems is now an integral part of undergraduate paramedic curricula. This clinical examination series provides a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians to maintain and to demonstrate that they are staying up to date and advancing in their roles. This series gives an overview of each type of examination to support students, newly qualified paramedics and paramedics wishing to use these articles as a CPD development activity and an aide-memoire for clinical practice. This article, which explores the the neurological examination, gives an overview of initial examination considerations, and assessment of the upper limbs.

The clinical examination is an important part of any patient consultation. After the primary survey and taking the patient history, a more in-depth examination is sometimes required to aid making a working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, clinical examination is an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Education on clinical examination concerning each of the main body systems is now an integral part of undergraduate paramedic curricula. This clinical examination series provides a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians to maintain and demonstrate that they are staying up to date and advancing in their roles. This series gives an overview of each type of examination to support students, newly qualified paramedics and paramedics wishing to use these articles as a CPD development activity and an aide-memoire for clinical practice. This article, which explores the cardiovascular system, gives an overview of initial examination considerations, including first impressions.

The clinical examination is an important part of any patient consultation. After the primary survey and taking the patient history, a more in-depth examination is sometimes required to aid making a working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, clinical examination is an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Education on clinical examination concerning each of the main body systems is now an integral part of undergraduate paramedic curricula. This clinical examination series provides a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians to maintain and demonstrate they are staying up to date and advancing in their roles. This series gives an overview of each type of examination to support students, newly qualified paramedics and paramedics wishing to use these articles as a CPD development activity and an aide-memoire for clinical practice. This article, which explores the peripheral vascular system, gives an overview of initial examination considerations, including first impressions.

This interpretive study investigated the process of radical change for a collaborative team of investigators in an allied health school at the University of South Australia. Specifically, it investigated the process of developing and implementing a fully-integrated problem-based learning curriculum across the entire undergraduate curriculum for the School of Medical Radiation. The study examined the richness and complexity of the change process for this team of educators over a two year time period. The research builds on understandings of change derived from three main bodies of literature: the school-based educational change literature; the problem-based learning literature; and the organisational change literature. It interweaves knowledge gained from each of these areas to develop a new perspective from which to consider radical educational change in higher education. Much of the previous research into change ignores the participant experience, and particularly the emotional dimension of this experience. This study redresses that gap by exploring the human dimension of the change process. This study has provided an authentic and inclusive representation of participants' experience of radical educational change. It has shown that participants not only undergo considerable cognitive dissonance when implementing major change, they also undergo significant emotional dissonance. Thus, if we are to improve the outcomes of educational innovation, we need to develop change management practices that not only recognise but also support the emotional dimension of the change process.

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.

Less than 15 years ago the National Heart, Lung and Blood Institute surveyed physicians in the United States in order to characterize the demographics of hemophilia. The average age of persons with hemophilia in the United States was found to be 11.5 years old. By 10 years later, the life expectancy was predicted to be normal, and indeed the average age of persons with hemophilia in the U.S. is now in the early twenties. Early, intensive and predictably efficacious control of hemorrhage has made this result possible, and the therapeutic product which has allowed such control is commercial clotting factor concentrate.We now know that starting in 1978, and with great frquency during 1982 and 1983, the majority of U.S. hemophiliacs were infected with human immunodeficiency virus (HIV). It is estimated that as of January, 1987, approximately two thirds of the 20,000' persons with hemophilia in the United States have been infected with HIV. Among those with severe factor VIII deficiency, more than 9056 are seropositive. As of 1/5/87, there were 288 cases of AIDS among U.S. hemophiliacs, for an AIDS rate of approximately 2.256 of those with HIV infection. This number included 185 with severe, 32 with moderate and 28 with mild hemophilia A; 12 with severe, 6 with moderate and 1 with mild hemophilia B; 9 with vWD, and 4 others. A disproportionate number were older patients: 55 were ages 1-19; 62 ages 20-29; 85 ages 30-39, and 86 age 40 or older. Although the AIDS attack rate is no longer climbing logarhythmically, new cases are certainly still occurring.A variety of other HIV-related syndromes have emerged. Of great concern is immune thrombocytopenia, which is now relatively common; among a group of 209 carefully followed HIV-positive patients at our center, 31 (1556) are or have been thrombocytopenic. Progressive failure to normally gain height and weight in children with hemophilia has recently been shown by our group to correlate with HIV antibody positivity, and also with decreased T4/T8 ratio, decreased T4 cell count, decreased skin test reactivity, and subsequent development of ARC or AIDS in some such children. Finally, a picture of progressive fall in T4 count associated with recurrent non-specific infections and increased likelihood of positive viral culture, may predict an increased risk of developing AIDS.We know that the immune dysfunction in hemophilia is complex, and not wholly explained by HIV infection. One important factor may be the many foreign proteins contained in commercial clotting factor concentrates, and their ability to stimulate T cells. It is known that latent HIV infection in cultured T4 lymphocytes can be induced to enter the proliferative, viral secretory phase by the addition of soluble foreign antigens to the cell culture. Recent data of Brettler and colleagues, to be presented at this meeting, suggest that the use of highly purified VI!I:C (specific activity >3000 u/mg) in place of the present extremely impure products, may improve the immune dysfunction in hemophilia. This observation offers a new hypothetical approach to the prevention of progressive T4 cell depletion in HIV infected hemophiliacs, and requires immediate and extensive further study.The psychosocial burden of HIV infection is immense. The need for extensive, formal education and support programs is largely unmet in most parts of the world. Such programs are best run out of hemophilia treatment centers in most cases, and must include an active program on prevention of sexual transmission, provision of HIV testing before and during pregnancies, provision for maintenance of confidentiality, etc. Education concerning HIV is like all other forms of education. It requires formal organization, a curriculum, active rather than passive learning in which there is interaction between the teacher and the pupil, time for planned repetition, reinforcement with written materials, and assessment of goals achieved. For all of these reasons it is inappropriate to assume that the physician at the hemophilia center will be able to provide an adequate education program. Adquate paramedical personnel will need to undertake this effort, under the directjon of the physician.