Influence and Inspire: Advancing the Paramedicine Research Agenda for Australasia

Work-integrated learning (WIL) and its assessment are prominent features within the curriculum of Australasian paramedicine tertiary education programs. However, research on the diversity and assessment of WIL in the context of paramedicine tertiary education is scarce. It remains unclear what WIL activities paramedicine students undertake and what assessment tools are used to evaluate outcomes. This study aimed to provide a comprehensive overview of WIL practices in Australasian tertiary paramedicine programs.

This study investigated paramedic perspectives on cross-border ambulance response, concentrating on non-technical skills (NTS) in high acuity trauma. It focused on the New South Wales (NSW) and Victorian border in Australia. Qualitative interviews with members of both ambulance services revealed various challenges in managing high-acuity trauma patients during collaboration. Further education, networking and debriefing is needed to improve work relationships between the services. A cross-border response guideline for paramedics may improve work practices and patient outcomes along the NSW and Victorian border region. Further research in this area is required. 

Paramedicine education lacks a nationally standardised assessment tool for evaluating students during work-integrated learning (WIL). The absence of a national harmonised assessment sets paramedicine apart from other health disciplines, risking patient safety and workforce competence.  In 2023, Executive Sponsor Australasian Council of Paramedicine Deans (ACPD) supported the development of the Australian Paramedicine Professional Capabilities Tool (APPCAT) project to meet program accreditation standards.  The APPCAT aims to develop a reliable method for assessing paramedicine students under direct observation during placement.   With HREC ethics approval, to date, two rounds of the modified Delphi process have been undertaken with the assistance of an Expert Reference Working Group (ERWG) with the results of a third round being analysed. 

This research investigates the seat belt utilisation and safety risks paramedics face during ambulance operations. Quantitative and qualitative data were collected using a convergent mixed methods approach to understand paramedic seat belt usage, ambulance accidents, and injuries. Preliminary findings from 311 paramedics reveal varying seat belt usage patterns based on patient acuity. While many paramedics wear seat belts as drivers (87.5%) and passengers (84.03%) in ambulances, usage decreases in rear-facing seats and further with stable or critical patients. Accident rates are concerning, with 40% of participants reporting involvement in accidents.

Introduction: Upon the transition to practice with the Queensland Ambulance Service (QAS), intern paramedics receive crucial mentorship from experienced practitioners. This study explored the mentoring strategies employed by experienced paramedics to facilitate interns’ seamless integration into the workforce. Methods: Employing a sequential mixed methods approach, this study examined the mechanisms underlying the induction and support of intern paramedics as they progress towards becoming proficient independent practitioners. Results: The study uncovered consistent themes central to effective paramedic mentoring practices. Notably, it identified primary techniques utilised by experienced paramedics to guide intern paramedics on-the-job. Conclusion: Findings underscored the imperative of instituting a robust mentoring model within QAS, emphasising the necessity of defining the paramedic mentor’s role and implementing a structured five-step mentoring process.

This study validated and tested the reliability of the Medication Safety in Paramedicine (MSiP) tool. The survey was developed directly from the qualitative outcomes of a systematic review and its themes, and assessed by a panel of industry experts for face validity. Reliability testing of the pilot revealed excellent internal consistency and confirmatory factor analysis revealed moderate correlation across the diverse factor categories. While designed for use in Australia and Aotearoa New Zealand, the tool can be modified for other EMS contexts.

Consensus-based studies appear to be increasingly common in paramedicine research. Recent analyses in other disciplines describe great diversity in methods characterised by frequent modifications. Despite its methodological amenability, rigour must be maintained to ensure meaningful robust outputs. This research involved a bibliographic analysis of published research reporting the use of a consensus methodology in the pre-hospital context. The findings of this research suggest that there may be a need for stronger methodological guidance within the paramedicine research space to ensure quality, and stronger engagement with reporting guidelines to ensure completeness and transparency. 

There is limited evidence mapping a relationship between the transferability of a paramedic’s leadership capability to that of their clinical skill set. With a lack of current evidence in this space, this research has been designed to explore the perceptions of paramedics as to the role of leadership within their clinical practice with specific reference to: 1) Investigating and describing the relationship between acquired leadership capability and clinical performance in the out of hospital environment; 2) Identifying and exploring those key themes that might influence an association between paramedic leadership aptitude and patient safety.

Despite the documented effects of shift work on health and performance, few studies have examined its impact on the paramedic population. This study explores the impact of shift work, on paramedics and their practice through analysis of decision making, work performance, communication, and individual physiology. In pairs, participants complete a simulated shift rotation, during which they engage in high fidelity paramedic scenarios and decision-making tasks. Biological measures are collected throughout the rotation to assess underlying physiological condition. To date, the study has recruited, screened, and obtained consent from 13 paramedics.

Frequent users of ambulance services are on the rise within ambulance services globally. While there has been increasing research exploring the characteristics of frequent users and interventions to reduce calls in multiple countries and services, little is known about how paramedics perceive frequent users. The main objective of the POFAS study is to explore Australian Paramedics’ perceptions of frequent users and inform further research, as well as identify strategies recommended by paramedics to reduce the impact of frequent ambulance users.

Mental rehearsal has been historically used in sports psychology to improve performance and reduce stress.  It is not known if these benefits transfer to the paramedicine domain.  We conducted an acceptability study using a mixed methods approach to determine the acceptability amongst undergraduate and postgraduate paramedic students.  Participants took part in a specifically designed workshop, describing the underlying theories of MR and practical application.  Participants then provided feedback via the Usage Rating Profile – Intervention Revised (URP-IR) and free-text response questions, immediately after the workshop.  Participants were followed up after two weeks to identify any change in key areas. Survey results showed that mental rehearsal was accepted by the study population, however further research is needed to determine what impact, if any, this method of education will have on clinical competency and patient safety. 

This research aimed to determine the influence of patients’ sex on paramedic administration of analgesia in cases of acute abdominal pain. A retrospective analytical cohort study including patients aged 16 to 65 with a complaint of abdominal pain who were seen by paramedics employed by an Australian jurisdictional ambulance service between July 2019 to June 2020 was undertaken. The research demonstrated that equity in pain management in relation to overall analgesic administration between the sexes existed. However, it was noted that females had lower odds of being administered an opioid than their male counterparts, therefore disparities in analgesia type existed between the sexes.

This study is a small part of a larger PhD program of research. There is a need for evidence-based pre-employment physical fitness assessment standards in paramedic organisations. This program of research has assessed the feasibility of implementing an existing, international, standardised pre-employment paramedic physical capacity test, the Ottawa Paramedic Physical Abilities Test (OPPAT™), in the Australian context. This abstract focusses on paramedicine students’ perceptions of physical preparation activities in an undergraduate paramedicine degree program. Paramedicine is an increasingly popular profession, with the main pathway into the role through the completion of a two to five-year bachelor’s degree program. This tertiary pathway presents some challenges for the physical preparation of students for the paramedic role. Student paramedic physical fitness is a safety concern for the student, patients and existing staff.

Neck of femur fractures are common, yet paramedic management of this injury is not well understood. Moreover, a review of clinical practice guidelines shows no evidence of specific treatment guidelines for this condition, revealing a potential knowledge gap. To address this, a customized online survey was administered to registered Australian paramedics (n=365). The survey explored demographics, education, training, patient assessment, fracture immobilisation, pain relief, cognitive assessment, and referral pathways. Understanding current practices can help inform guideline development, ensuring best-practice prehospital care for this common and potentially life-threatening condition.

This pilot study investigates the challenges Australian final-year student paramedics face in calculating weight-based medication dosages for paediatric trauma patients. Surveying 66 students from 13 universities, the study finds that over half of respondents encounter difficulties in medication calculations, particularly with adrenaline, fentanyl, and morphine. Confidence levels vary across patient age groups, underscoring the need for comprehensive training programs to address these challenges and ensure optimal treatment outcomes.

The study explores the adoption of point-of-care ultrasound (POCUS) in Australasian paramedic practice, highlighting its diagnostic and procedural benefits. However, issues such as inconsistent training, lack of standardised governance, and varied adoption rates across regions pose challenges. Through interviews with medical directors and clinical leads, five themes were identified, including the need for clear governance and supportive cultural changes within paramedicine. The research emphasizes creating a comprehensive framework to standardise POCUS training and governance to maximise its benefits and ensure safe, quality care in out-of-hospital settings. Future efforts should focus on developing these standards.

Despite increased female demographics in paramedicine, there remain unresolved female-specific issues in workforce planning, policies, and procedures. Participants (n=183) completed an anonymous online survey about their menstrual cycle and hormonal contraceptive history in relation to their occupation or clinical placement. Human research ethics were approved. Women working in paramedicine experience adverse effects because of their menstrual cycle, and many do not have access to basic menstrual support options. Findings from this study can be used to inform industry and to support women when menstruating and/or taking hormonal contraception. Female/women used to describe persons who are assigned female at birth.

Despite frequent use by paramedics, the prevalence and extent of occupational exposure (OE) to ketamine remain an understudied area of concern. Advancements in drug testing technologies, such as hair analysis, have enabled the detection of ketamine and its primary metabolite, norketamine, at very low levels of quantification. However, interpreting results is challenging without recognised cut-off values to differentiate between legitimate OE and intentional consumption of ketamine. To highlight any occupational risks and guide future research in this area, we conducted a scoping review to systematically map and synthesise all the available evidence on OE to ketamine among healthcare professionals.