Best practice for supporting students in the workplace.

We investigated the academic performance of distance-taught student Paramedics and the effect of workplace support measures offered by their employers. Using a combination of quantitative, qualitative and open text data, we identified factors important for student success and well-being. Dedicated study time was not a significant predictor of student success, but was related to the quality of achievement as measured by pass grade. More important for success were less tangible factors such as relationship with a mentor, and being part of a supportive peer group. It is important to accord prominence to these features, and to build them into new course design. Care must also be taken that placements elsewhere be well organised, and students proactively supported while undertaking them

Computer assisted assessment and advice for "non-serious" 999 ambulance service callers : the potential impact on ambulance despatch

Objective: To investigate the potential impact for ambulance services of telephone assessment and triage for callers who present with non-serious problems (Category C calls) as classified by ambulance service call takers. Design: Pragmatic controlled trial. Calls identified using priority dispatch protocols as non-serious were allocated to intervention and control groups according to time of call. Ambulance dispatch occurred according to existing procedures. During intervention sessions, nurses or paramedics within the control room used a computerised decision support system to provide telephone assessment, triage and, if appropriate, offer advice to permit estimation of the potential impact on ambulance dispatch. Setting: Ambulance services in London and the West Midlands. Subjects: Patients for whom emergency calls were made to the ambulance services between April 1998 and May 1999 during four hour sessions sampled across all days of the week between 0700 and 2300. Main outcome measures: Triage decision, ambulance cancellation, attendance at an emergency department. Results: In total, there were 635 intervention calls and 611 controls. Of those in the intervention group, 330 (52.0%) were triaged as not requiring an emergency ambulance, and 119 (36.6%) of these did not attend an emergency department. This compares with 55 (18.1%) of those triaged by a nurse or paramedic as requiring an ambulance (odds ratio 2.62; 95% CI 1.78 to 3.85). Patients triaged as not requiring an emergency ambulance were less likely to be admitted to an inpatient bed (odds ratio 0.55; 95% CI 0.33 to 0.93), but even so 30 (9.2%) were admitted. Nurses were more likely than paramedics to triage calls into the groups classified as not requiring an ambulance. After controlling for age, case mix, time of day, day of week, season, and ambulance service, the results of a logistic regression analysis revealed that this difference was significant with an odds ratio for nurses:paramedics of 1.28 (95% CI 1.12 to 1.47). Conclusions: The findings indicate that telephone assessment of Category C calls identifies patients who are less likely to require emergency department care and that this could have a significant impact on emergency ambulance dispatch rates. Nurses were more likely than paramedics to assess calls as requiring an alternative response to emergency ambulance despatch, but the extent to which this relates to aspects of training and professional perspective is unclear. However, consideration should be given to the acceptability, reliability, and cost consequences of this intervention before it can be recommended for full evaluation

Piloting mobile mixed reality simulation in paramedic distance education

New pedagogical methods delivered through mobile mixed reality (via a user-supplied mobile phone incorporating 3d printing and augmented reality) are becoming possible in distance education, shifting pedagogy from 2D images, words and videos to interactive simulations and immersive mobile skill training environments. This paper presents insights from the implementation and testing of a mobile mixed reality intervention in an Australian distance paramedic science classroom. The context of this mobile simulation study is skills acquisition in airways management focusing on direct laryngoscopy with foreign body removal. The intervention aims to assist distance education learners in practicing skills prior to attending mandatory residential schools and helps build a baseline equality between those students that study face to face and those at a distance. Outcomes from the pilot study showed improvements in several key performance indicators in the distance learners, but also demonstrated problems to overcome in the pedagogical method

Excellence in paramedic education

Not peer reviewedExploring the idea of competence and excellence in paramedic education is timely as stakeholders in Canadian EMS work with the Paramedic Association of Canada (PAC) to redevelop the National Occupational Competency Profile for Paramedics in Canada (NOCP).paramedic education; technical competence; clinical competence; excellence; expertis

UK Paramedic Rapid Sequence Intubation...Is it viable?

This report details the indications and drug requirements of Rapid Sequence Intubation (RSI), then proceeds to discuss the literature and evidence surrounding RSI with a view to answering the question: Can UK Paramedics perform RSI? And more importantly, should they? The literature reviewed is taken from a variety of sources, including searches of internet material, journal articles and relevant text books, and the information critically reviewed. The report details and critiques the information gleaned and discovers that there is little in the way of research relating to Paramedic RSI, and therefore uses other appropriate studies, for example MacKay [1]. It is soon realised that even the studies that are published are not as concise as they first appear to be, some leaving large breaches in the research, and other failing to answer the questions posed. The report concludes that at present, the data that has been collected is not in favour of Paramedic administered RSI, in fact it is overwhelmingly suggested that pre-hospital RSI is actually detrimental to patient outcomes. Therefore, it is concluded that whilst UK Paramedics would be capable of administering RSI, with the evidence bias, it would not be appropriate