Overview Summary of Project
Paramedics are repeatedly exposed to traumatic and emotionally charged events, which can result in vicarious trauma (VT)—the enduring psychological impact of engaging empathetically with others’ trauma (McCann & Pearlman, 1990). VT has been linked to disruptions in core beliefs around trust, safety, and control, yet its cumulative impact in paramedicine is often overlooked (Meeker et al., 2025).
Alongside trauma exposure, paramedics are required to perform significant emotional labour—the management of feelings to display appropriate emotions in professional contexts (Hochschild, 2012). Research suggests that while emotional suppression is culturally ingrained in ambulance services, its role in exacerbating stress or enabling resilience has been underexplored (Wines et al., 2019; Alavi et al., 2023).
Despite growing recognition of mental health risks within the ambulance workforce (Faulkner, 2023), most research has focused on symptom measurement, stress, or burnout, neglecting how paramedics themselves construct meaning from these experiences. Importantly, exposure to trauma can also generate post-traumatic growth (PTG)—positive psychological change arising from adversity (Tedeschi & Calhoun, 2004). Evidence of secondary PTG in paramedics exists (Ogińska-Bulik et al., 2021), yet the relationship between VT, PTG, and professional identity remains largely untheorised.
To address these gaps, this project will use a qualitative design, employing semi-structured interviews and reflexive thematic analysis to explore how UK paramedics narrate and make sense of VT and emotional labour, and how these experiences shape identity and potential for growth. By focusing on paramedics’ lived experiences and narratives, the study seeks to inform more compassionate, context-sensitive approaches to supporting wellbeing.
This study will recruit 6 to 10 UK-registered paramedics who are currently working in frontline NHS ambulance services and have a minimum of three years’ operational experience. The requirement for a minimum of three years’ frontline experience ensures that participants are likely to have encountered sufficient exposure to vicarious trauma to provide meaningful reflections. Vicarious trauma is a common feature of sustained exposure to distressing incidents in this environment, and all eligible participants will have encountered such experiences. However, those no longer in a frontline ambulance role (e.g., working in primary care or education) will be excluded, as the study aims to explore how vicarious trauma and emotional labour are understood within the ongoing context of frontline emergency care.
In line with Braun and Clarke’s guidance for reflexive thematic analysis (RTA), smaller samples are acceptable where data are rich, detailed, and fit for purpose (Smith, 2024; Braun & Clarke, 2013, 2021). For a Masters-level project, 6–15 interviews are typically recommended; however, Braun and Clarke note that data quality, not quantity, is key. Studies using rich, experiential interviews often require fewer participants to develop meaningful themes across the dataset. Furthermore, realist concepts like saturation are not applicable to RTA (Braun & Clarke, 2021), and instead the goal is to ensure sufficient information power (Malterud et al., 2016).
Given the scope and time-limited nature of this MSc dissertation, a maximum of 10 participants has been set. This allows for deep engagement with each dataset while ensuring practical feasibility for recruitment, transcription, analysis, and write-up within the project’s timeframe.
This is a qualitative study using semi-structured interviews and analysed through reflexive thematic analysis (Braun & Clarke, 2019). An inductive, experiential approach will be adopted, meaning that themes will be developed from participants’ own accounts rather than from pre-determined frameworks. The analysis will explore how UK paramedics make sense of vicarious trauma, emotional labour, professional identity, and post-traumatic growth, situated within their social and organisational context.
The researcher is an experienced registered paramedic, and the project will be approached through a researcher-practitioner lens. This dual role will be critically reflected upon using a reflexive journal, acknowledging how professional experience informs, but does not dominate, interpretation of the data.
All interviews will be audio-recorded, transcribed verbatim, and manually coded by the researcher. Coding will be conducted iteratively, with meaningful units grouped into codes and then into broader candidate themes through a recursive, reflective process of engagement with the data. Transcripts will adopt an orthographic style that captures not only what was said, but also how it was said—for example, pauses, emphasis, and intonation—where relevant to meaning (Braun & Clarke, 2022). This allows for a richer interpretative analysis and ensures fidelity to participants’ lived experiences. Transcription conventions (e.g., underlining for emphasis, inverted commas for reported speech) will be used consistently and explained in the final report. No statistical analysis or outlier management is required. Transparency, supervision, and ongoing reflexivity will support the credibility and trustworthiness of the findings, with a clear audit trail documenting analytic decisions throughout.
The primary material is a semi-structured interview guide, structured around three phases: rapport-building openers, core reflective questions, and ethically framed closing prompts to support debriefing. The format is trauma-informed and flexible, designed to ensure consistency while allowing participants to focus on what matters most to them. Questions cover vicarious trauma, emotional labour, professional identity, and meaning-making, aligning closely with the project’s aims. All prompts are open-ended, emotionally attuned, and sensitively worded to reflect the emotive weight of the topic. Participants will also receive a participant information sheet, consent form, and debrief sheet.
Interviews will take place online using secure video conferencing software (e.g., MS Teams or Zoom). They will last approximately 40–60 minutes and will be audio-recorded using the platform’s built-in function, then downloaded and stored on the University’s password-protected OneDrive system. Interviews will follow a semi-structured format, beginning with rapport-building before exploring participants’ experiences of vicarious trauma, emotional labour, identity, and potential growth. Interviews will be conducted by the researcher (Jenny Honour).
Participants may choose to take part individually or in dyads (e.g., crewmates) and may withdraw at any time before data analysis begins, without giving a reason. Following the interview, participants will be emailed a debrief sheet and a list of relevant support organisations (e.g., Mind, TASC, Ambulance Staff Charity). Where multiple participants are interviewed together, ground rules for mutual respect and confidentiality will be established at the start.
Interviews will be transcribed verbatim by the researcher, and all identifiable details will be pseudonymised during transcription. Transcripts and audio files will be securely stored on OneDrive for a maximum of 5 years, accessible only to the researcher and supervisor. Participants may request to review their transcript prior to analysis.
Ethical approval was achieved from the University of Portsmouth on 3rd October 2025
