To adequately prepare graduates for the dynamic demands of paramedic practice, adopting a contemporary educational approach is essential. This involves collaborating to identify crucial competencies through input from industry stakeholders, experienced practitioners, and discipline-specific experts. Accreditation assumes a central role within this framework, serving as a cornerstone to ensure that paramedicine curricula align with paramedics' diverse and evolving professional roles. Methods A narrative review of the literature and a directed search of grey literature were performed to identify specific developments in paramedicine competencies and scope of practice and mapped to the professional capabilities published by the Paramedicine Board of Australia. In determining a competency map and accreditation’s role in a competency framework specific to current and evolving paramedic practice, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents, countries and other professions. Results The review process identified 278 themes that were further allocated to 22 major analytical groupings. These groupings could further be mapped to previously reported cognitive, technical, integrative, context, relationship, affective/moral competencies and habits of mind. At the same time, the highest-rated groupings were key competencies of intellectual skills, safety, accountability, clinical decision-making, professionalism, communications, team-based approach and situational awareness. Two groups were represented in the literature but not in the professional capabilities, namely Health and Social continuum and self-directed practice. Conclusions This review highlights the importance of measuring and validating the professional capabilities of Paramedicine Practitioners. The study explores various metrics and competency frameworks used to assess competency, comparing them against national accreditation schemes' professional capability standards. The findings suggest that accreditation frameworks play a crucial role in improving the quality of paramedicine practice, encompassing intellectual skills, safety, accountability, clinical decision-making, professionalism, communication, teamwork, and situational awareness.
Scoping review of literature to determine if there is any evidence supporting the PICO question directly and indirectly. Research evidence supporting the intervention of POCUS at a timeline within a patient care episode that would predict or rule in/rule out the need for CT head before clinical signs and symptoms of raised ICP due to mild to moderate TBI manifest.
Background and rationales: Recognising that someone has deteriorating health can be a trigger for a change in their care plan, and potentially for advance care planning and introducing palliative care. While there are tools that can provide an objective measure of someone’s health status (for example scales designed to measure functional status), changes in a patient’s general appearance may be the first sign that their health is deteriorating. For example, people with white skin may look ‘grey’ or ‘sallow’ as their illness advances. For people with advanced and life-limiting illness, these subtle cues can be a trigger for health care professionals to discuss goals of care, the risks and benefits of further treatment, or to refer to specialist palliative care teams. We know that people from minoritised ethnic groups are less likely to access specialist palliative care and more likely to have frequent Emergency Department visits towards the end of life, though the reasons for this are not clear. We also know that identification of a diverse range of skin signs (such as rashes, pressure damage) can be challenging among people of colour. If health professionals are less able to identify deteriorating health among people of colour, this could lead to higher rates of Emergency Department attendance near the end of life, or delay in referral to palliative care. Whether and how skin colour influences how health professionals make judgements about people’s health in advancing illness is unclear, but is a potential source of racial bias. Research Questions: 1/ What are the skin changes that are used by health and care professionals as an indication that someone with advanced illnesses is deteriorating? 2/ How confident and competent are health and care professionals in identifying these skin changes in people of colour? Method: Two workstreams will occur in parallel. WS1: A rapid review will be undertaken to identify published evidence on (i) changes in skin and appearance that may indicate that someone with advanced illness is deteriorating, (ii) whether these changes are as readily identifiable among people of colour, and (iii) health and care professionals’ confidence in identifying these changes. Using guidance on literature searching for rapid reviews from the Cochrane Rapid Reviews Methods Group, we will perform focused searches on MEDLINE and Embase databases via OVID and utilise citation searching of known relevant references to supplement. Based on scoping searches, we anticipate that the rapid review will identify relatively little evidence. Therefore, in WS2 we will draw on health and care professionals’ experiential knowledge. WS2 Expert consultations will be held with health and care professionals to explore their experience in using skin and appearance changes to identify deterioration in health for people with advanced illnesses. At least two expert consultations will be held online, each lasting 90-120 minutes, and each including 6-10 health and care professionals who regularly care for people with advanced illness. Professional groups will include GPs, geriatricians, community nurses, care home professionals and specialist palliative care professionals. One expert consultation will be for professionals who practice in the UK, selecting those who practice in areas with high levels of ethnic diversity. Another will be for professionals who practice outside the UK in countries where the majority of the population are people of colour. A facilitated conversation will explore professionals’ experience in identifying deteriorating health in people who have advanced illness, their confidence to identify these changes, and whether there are differences for people of colour. Findings from the rapid review will be used to guide questions. PPI: We will convene a group of patients and public members who represent diverse ethnicities to guide the research, meeting with them regularly to discuss the research questions and emerging findings. As part of WS2 we will invite PPI members to observe (with their cameras off) the expert consultations and feed back their reflections about the discussions to the research team, to guide interpretation. In the expert consultations, we will aim to explore: 1/ health and the professionals’ experience in identifying changes in skin that may indicate that someone with an advanced illness is deteriorating; 2/ whether these changes are as readily identifiable among people of colour; and 3/ health and care professionals’ confidence and competence in identifying these changes among people of all skin tones Eligibility of taking part in the online expert consultation includes all of the following (for UK-based professionals): 1/ Health and care professionals who regularly care for adults with advanced illnesses 2/ GPs, geriatricians, community nurses, care home professionals, paramedics, or specialist palliative care professionals 3/ practice in the UK and in areas with high levels of ethnic diversity The online expert consultation meeting will last 90 minutes and involve 6-10 health and care professionals who regularly care for adults with advanced illnesses. We are planning to hold the consultation for health and care professionals based in the UK on Thursday, 13 February 2025, 11.00-12.30 (GMT) on Microsoft Teams.
art of patient care. Medical documentation prevents the loss of information and contributes towards improved ongoing medical care and can be referred to if there is a complaint regarding patients care, for research purposes and quality assurance. The purpose of this research, therefore, is to develop a framework, which can be used to improve the quality of medical documentation completed by PHECPs. This will require the identification of the information and knowledge gaps that PHECPS have regarding medical documentation and the manner in which they complete medical documentation. Solutions to the identified gaps will be provided by interviewing industry experts and reviewing current literature. The identified solutions will be used to create a clinical framework, which can be implemented to improve the quality of medical documentation recorded by PHECPs. This research will utilise a four-phase sequential explanatory mixed methodology. Phase one- quantitative phase: The PHECPS knowledge and perceptions of medical documentation will be assessed using a questionnaire with a quantitative design. Phase two, quantitative phase - Common problems and trends in medical documentation will be identified and quantitatively analysed on completed PRFs using a previously developed tool. Phase three - qualitative phase: Qualitative, semi structured interviews will be conducted to gain a greater understanding of the points identified in phase one and two of the research. Phase four: Assimilation of the data collected in phases 1,2 and 3 will be used to develop a proposed framework to improve MD. Phase four: A Delphi survey will be used to for additional expert input and consensus on the content and design of the framework
The study investigates paramedics’ coping actions for sustainable long-term work performance and burnout prevention. The research focuses on what individuals are doing to cope with their day-to-day stressors and the actions they take that may contribute to recovery and be protective against burnout. The research will involve short interviews to collect the data which should take 30 minutes. The interview will be conducted online (e.g. via Microsoft Teams). During the interview, the participant will be asked a series of questions about their experience of their job as a paramedic. Specifically, we will ask about day-to-day responsibilities, how individuals cope with these and if there are any challenges to applying coping strategies. With permission, the interview will be recorded, but participants can choose to keep their cameras off if they wish. Inclusion criteria: current or former practising paramedics, aged 18 and over, who can give informed consent. Exclusion criteria: Paramedic Students or individuals currently diagnosed with and receiving treatment for mental health disorders, such as burnout, mood and anxiety disorders.
Paramedicine is a constantly evolving field, with paramedic education programmes needing to be adaptable to keep up with changes in the scope of practice. Regulatory frameworks are crucial in guiding university programmes, providing students with the knowledge, skills, and professional attributes necessary to be safe and competent practitioners. This study aimed to identify variations in regulatory structures, the factors that influence those variations, and how they influence curricula. A descriptive-comparative approach was taken to examine paramedic accreditation processes, curricula, and syllabi across five countries using a modified Brady's model and extending the Comparative Education model. The findings suggest that paramedic services, regulatory authorities, and tertiary institutions must adopt a multilateral approach to recognise paramedicine's evolving scope of practice. All three stakeholders are responsible for aligning regulatory frameworks with industry needs and providing curricula guidance to tertiary institutions. This approach will enable paramedic education programmes to remain relevant and adaptable to changes in the field, ensuring that graduates are safe and competent practitioners. In conclusion, this study highlights the need for a collaborative effort between paramedic services, regulatory authorities, and tertiary institutions to recognise paramedicine's evolving scope of practice. The need for recognition of this evolution in both regulatory frameworks and curricula is a significant concern, and a multilateral approach is required to address this issue. This study provides valuable insights into the factors that influence variations in regulatory structures and their influence on curricula.
A multicentre, explanatory sequential mixed methods study. Phase 1 consists of an online survey and phase 2 involves semi-structured interviews with key stakeholders from UK NHS ambulance services in order to explore the perceptions and views of ambulance service staff on research culture and capacity building.
When faced with children paramedics (and other healthcare professionals) may have to estimate weight which can be used as a basis for administering drugs. Many estimation techniques rely on the patient’s chronological age however this has been shown to be unreliable (Black et al., 2002; Marlow et al., 2011; Charlton, Capsey and Moat, 2020), and in some cases a patient’s age may be unknown. Other techniques include parental estimation (Krieser et al., 2007) and measuring systems based on height and size (e.g. Braselow tape). Anecdotally paramedics may use a child’s clothing size to estimate age, and thus weight, when this is unknown. It is expected that the findings of this study will be used to improve the safe and effective treatment of children treated by paramedics by informing methods to estimate weight. This study will use a combination of face-to-face and online questionnaires to compare parental estimation, age-based formulae, and clothing size based formulae to establish their accuracy. The reference standard will be that 70% of estimations are within 10% of the actual weight, and 95% are within 20% (Wells et al., 2017).
It is a legal requirement for NHS ambulance trusts to collect patient ethnicity data, and improvements are needed as current adherence is poor. This study aims to interview frontline NHS ambulance staff in England, like paramedics or technicians, who complete ambulance call out documentation to explore the perceived barriers in this specific staff group to collecting this information. It is important to understand these barriers because the lack of patient ethnicity data in ambulance call-out documentation makes it difficult to monitor if health inequalities due to ethnicity exist. Health inequalities are unfair and avoidable difference in health, like when it was reported during the covid19 pandemic that black, Asian and minority ethnic groups were at higher risk of infection, severe symptoms, and death. This link was only found due to routine collection of patient ethnicity data. This study will look for volunteers across up to 10 NHS ambulance services in England who work in frontline roles, specifically those who have face-to-face contact with patients calling 999 and complete ambulance call-out documentation as a result. The study will aim to recruit 20 participants between February and July 2025. Participants will be asked to attend a 60- minute interview online using MS Teams.
This qualitative study is exploring stakeholder perspectives with experience of paramedics working in primary care, on the education and training required to work effectively as a paramedic in primary care settings, establishing whether paramedics have the appropriate education, training, and skills and whether this model is sustainable.
This research seeks to understand the links between the culture in ambulance trusts, management decision making and the support provided to Disabled staff. The study will look at the understanding of the term disability, how it is viewed and what is involved in the decision-making process when a request for support is made.
This project is in partial fulfilment of a PhD that is exploring the relationship and impact of ethnic diversity and diversity training on cultural competence in frontline ambulance service staff. The first study in this PhD was a review of WRES data from all ten ambulance services in England, in order to gain an understanding of workforce equality. The second study was a scoping review of factors impacting cultural competence in healthcare personnel. This was conducted as the third study (this project) aims to survey frontline ambulance service staff diversity demographics, life experiences, training and cultural competence. However, to understand the relationship between these factors and cultural competence, the other factors impacting cultural competence need to be known and accounted for. The fourth and final study in this PhD (also part of this project), aims to explore frontline service staffs’ acquisition of cultural competence, and their experiences and perspectives of cultural competence, its associated diversity training and importance on professional practice.