The Developments in Paramedical Science and the implications of National and International Accreditation and Registration in Alliance with Ambulance Authorities

The School of Exercise, Biomedical and Health Sciences at Edith Cowan University established a new Bachelor of Science (Paramedical Science) degree in 2004. The program is a joint initiative between Edith Cowan University and St. John Ambulance and is the only Paramedical degree being taught within Western Australia. In preparing the graduates to work in the profession as qualified paramedics, it was essential to integrate the theoretical content taught by both the university and the ambulance corporation with significant practical experiences being delivered in the ambulance and hospital environments. The implications for this type of arrangement have been far reaching, as it involved the combining of the university resources with a corporate provider who had previously been involved in an education program in the VET system. From the beginning it was recognised that there were many issues that had to be addressed. These included: 1. the ownership of the intellectual property, 2. cost sharing arrangements between the university and the corporate partner, 3. quality control of all aspects of the program, 4. staffing implications for units taught outside the university, 5. legal liability associated with all aspects of conducting the program, 6. adherence to occupational safety and health standards, 7. duty of care for both patients and the trainee paramedics, 8. ownership of the program, 9. the identity of the university degree as opposed to the VET qualification, 10. conversion from the VET qualification, 11. development of postgraduate and research programs, 12. accreditation and registration. With the development of this program each of these issues has brought its own unique problems and forced similarly unique solutions. This has been an exciting challenge for all concerned. There was no template or guide to follow within the university system and this was the first time that the university has entered into an arrangement where a partner from the community has had such a significant input into a teaching program. The resulting agreement has provided a guide for others who may wish to establish similar partnerships in the future. Now that this degree is about to see its first graduates receive their parchments it is beneficial to reflect on the changes which have occurred both locally and nationally since the inception of the degree. It is clear that the effort that has gone into the careful development of this degree and its associated partnership has resulted in a quality program being delivered by the university in conjunction with its corporate partner

Preparing student paramedics for the mental health challenges of the profession by using the wisdom of the experienced

Given the significant mental health issues affecting our paramedics, there exists an urgent need to promote positive mental health and well-being among future cohorts of student paramedics.  This study investigated the preparedness of student paramedics for the mental health challenges of the profession and explored the coping strategies used by experienced paramedics.The study was conducted in two parts. Part A comprised of two surveys which were developed and administered to 16 course coordinators and 302 students of the 16 accredited undergraduate paramedicine courses across Australia and New Zealand. The survey aimed to identify the perceived need for preparation within the curriculum.  In addition, the anticipations, confidence and fears of student paramedics, Course Coordinators and paramedics were also collected as a means to explore the preparedness through self-evaluation, reflection and discussion.Part B included twenty semi-structured interviews with experienced paramedics, from Australia and New Zealand. The interviews were conducted to gain an understanding of their experiences and the mental health coping strategies they employed, as well as capture the advice they would give to student paramedics. Results from the interviews were validated by three focus groups comprised of six paramedics each, representative of the geographic spread.Results suggest there is widespread recognition for the need to include preparation for the mental health challenges of the profession, within accredited undergraduate paramedic courses, with 100% of course coordinators and 97% of students recognising this need.The interviews with paramedics provided valuable insights into the experiences and strategies used to aid the survival of the paramedics throughout their careers.  Within the interviews, 70% of participants expressed a sincere love for the paramedic role, and 70% identified black humour as the coping strategy most used by themselves and colleagues.  In addition, extensive advice was given to students based upon the paramedics’ lived experiences.  This advice comprised of three themes; support, health and the profession.   These findings were mapped against the aims of Australia’s current Mental Health Policy to provide evidence-based and policy-informed guidelines for the integration of positive mental health strategies into undergraduate paramedicine curricula.Preparing student paramedics for the mental health challenges of the profession could be advantageous.  One way to achieve this is through the inclusion of key content within the undergraduate curriculum by utilising the relatable data collected on anticipation, confidence, fears and the advice offered by the veteran paramedics can be integrated. These lived experiences are highly credible and an opportunity for veterans to contribute positively to the future of paramedicine

The influence of multimedia resources in and out of biomedical studies

With respect to the provision of learning support materials, it is generally accepted that enriched learning environments are better than simple didactic sessions and consequently improved resources ultimately lead to better learning, which in turn leads to improved grades. The use of a dedicated multimedia teaching room specifically set up to create a learning environment for biomedical science within a nursing program has been documented and correlated with the student’s final mark and course retention. The significance of this study is that the results and retention for biomedical science studies are further compared to studies in which the resource room would have been of no benefit. Failure rates and course retention rates were not significantly different between students who did not use the facility (n=237) and those who used it only once (n=47), however there were demonstrable differences between the first group and students who accessed the resource on multiple occasions (n=203). However the results of those students using the resource, show that they were significantly disadvantaged in non-biomedical studies where the availability of the resource did not assist them. Within the limitations of the study, the data does support the premise that access to dedicated teaching materials improves learning, which translates to better grades

The use of formative assessment and support materials to assist students in taking control of their own online learning

Traditionally, science instruction has focused on creating an interactive, intrinsically motivational approach to teaching, i.e., ‘delivery’, but there is a need to be paying just as much attention to empower students with the ability to ‘receive’ the science. Some of the keys to this recipe include the use of self-assessment tests; activities that require the interpretation of case studies; peer instruction interactions; online and multimedia lessons which encourage top down/bottom up science processing strategies to decipher meaning; and simulations that test all of the science skills in action. Online materials foster autonomous learners in a science practice. The end goal progresses students to function outside a passive classroom environment so they may, without the aid of an external evaluator, shift the process of learning from the teacher to the student. This paper addresses critical issues in Anatomy and Physiology education; how to better motivate students and help them make the connection to what is important to learn; how to get students to see the whole topic rather than minute details; how to help students who lack study skills and how to instill critical thinking skills from entry to the course so as to succeed in learning attribution to efficacy. Within this philosophical framework, formative assessment techniques provide students with the knowledge and detail that is needed to move forward in their careers, through an emphasis on critical thinking, conceptual understanding, and relevant application of knowledge. In doing so the resources provided help students to: • come to class better prepared for lectures • get immediate feedback and context-sensitive help on assignments and quizzes; and • track their progress throughout the cours

Inhaled methoxyflurane and intranasal fentanyl for prehospital management of visceral pain in an Australian ambulance service

Objective This study analysed the analgesic effect and changes in vital signs associated with administration of inhaled Methoxyflurane (MTX) and/or intranasal Fentanyl (INF) for prehospital management of visceral pain. Method A retrospective, observational study reviewing 1024 randomly selected records of patients with presumed visceral pain administered MTX (465), INF (397) or both (162) by the Western Australian Ambulance Service between January 2004 and February 2006. Clinical variables assessed included systolic blood pressure, pulse rate, respiration rate and Glasgow Coma Scale score. Pain was assessed utilising Visual/Verbal Analogue Scale pain scores. Results Overall effects on vital signs appeared favourable 5 min after use and at hospital arrival with either agent alone or in combination. As sole agents, MTX produced the greatest initial pain scores reduction (2.0 (1.7 to 2.2) vs 1.6 (1.4 to 1.8)) (mean (95% CI), and INF provided greater pain reduction by hospital arrival (3.2 (2.9 to 3.5) vs 2.5 (2.1 to 2.9)). While both agents were effective, INF provided a greater pain score reduction for cardiac (3.0 (2.6 to 3.4) vs 2.3 (1.8 to 2.8)), female (3.4 (2.9 to 4.0) v 2.5 (2.0 to 3.0)) and age 75+ patients (3.2 (2.5 to 3.8) vs 1.8 (1.0 to 2.5)). Combined use of agents was not advantageous. Conclusions MTX and INF are effective agents for providing visceral pain analgesia in the prehospital setting. While MTX provided a more rapid onset of pain relief, INF provided superior analgesia after subsequent doses and in female, cardiac and older patients

Parental anxiety and post-traumatic stress symptoms in pediatric food allergy

Objective: The purpose of this study was to explore anxiety, worry, and posttraumatic stress symptoms (PTSS) in parents of children with food allergies, and to evaluate whether these three psychological outcomes could be predicted by allergy severity, intolerance of uncertainty, and food allergy self-efficacy. Methods: Participants were 105 parents who reported their children to have medically diagnosed food allergies. Participants were recruited to a study on parent wellbeing through an allergy clinic and social media advertisements. Participants completed online questionnaires assessing anxiety, worry, PTSS, intolerance of uncertainty, food allergy self-efficacy, and demographic and allergy information. Results: In this sample, 81.0% of parents reported clinically significant worry, 42.3% met the clinical cut-off for PTSS, and 39.1% reported moderate-extremely severe anxiety. Greater intolerance of uncertainty and lower food allergy self-efficacy were associated with poorer psychological outcomes, with mixed results for allergy severity. However, intolerance of uncertainty was the only variable to consistently account for unique variance within regression models. Conclusions: This study highlights the need for greater awareness of mental health in parents of children with food allergy. The study also indicates that factors impacting on parents’ perception of threat may be most strongly predictive of psychological outcomes, warranting further research. Finally, the study indicates that intolerance of uncertainty may be a promising target for psychological interventions within this population

Student empathy levels across 12 medical and health professions: an interventional study

BackgroundEmpathy is a difficult characteristic to define, teach and assess; the &lsquo;nebulous&rsquo; properties of empathic behaviour often means that educators fail to incorporate the explicit teaching and assessment of empathy within the curriculum. One solution suggested is that teaching empathy in an interprofessional education setting is an effective educational approach in developing empathic behaviours.MethodStudent participants from Monash University, Deakin University, University of South Australia, and Edith Cowan University completed a self-reporting survey package pre and post two-hour empathy workshop consisting of the Jefferson Scale of Empathy &ndash; Health Profession &ndash; Student version (JSE-HP-S).ResultsA total of 293 students from 12 different medical and health care professions participated in the empathy workshops. The majority of participants were from Monash University n&thinsp;=&thinsp;230 (78 %), the nursing profession n&thinsp;=&thinsp;59 (20 %), &lt; 26 years of age n&thinsp;=&thinsp;215 (73 %) and enrolled in first year studies n&thinsp;=&thinsp;123 (42 %). Using a paired t-test repeated measure self-reported empathy levels improved at p&thinsp;&lt;&thinsp;0.0001, mean 114.34 vs. 120.32 (d&thinsp;=&thinsp;0.22).ConclusionThis project has shown that self-reported empathy levels have been shown to statistically improve following DVD simulation-based workshops.<br /

National health and medical research council statement on electronic cigarettes: 2022 update

Introduction: Electronic cigarette (e-cigarette) use in Australia has rapidly increased since the 2017 National Health and Medical Research Council (NHMRC) Chief Executive Officer (CEO) statement on e-cigarettes. The type of products available and the demographic characteristics of people using these products have changed. New evidence has been published and there is growing concern among public health professionals about the increased use, particularly among young people who do not currently smoke combustible cigarettes. The combination of these issues led NHMRC to review the current evidence and provide an updated statement on e-cigarettes. In this article, we describe the comprehensive process used to review the evidence and develop the 2022 NHMRC CEO statement on electronic cigarettes. Main recommendations: E-cigarettes can be harmful; all e-cigarette users are exposed to chemicals and toxins that have the potential to cause adverse health effects. There are no health benefits of using e-cigarettes if you do not currently smoke tobacco cigarettes. Adolescents are more likely to try e-cigarettes if they are exposed to e-cigarettes on social media. Short term e-cigarette use may help some smokers to quit who have been previously unsuccessful with other smoking cessation aids. There are other proven safe and effective options available to help smokers to quit. Changes in management as a result of this statement: The evidence base for the harms of e-cigarette use has strengthened since the previous NHMRC statement. Significant gaps in the evidence base remain, especially about the longer term health harms of using e-cigarettes and the toxicity of many chemicals in e-cigarettes inhaled as an aerosol

ParaMED Home: A protocol for a randomised controlled trial of paramedic assessment and referral to access medical care at home

<p>Abstract</p> <p>Background</p> <p>In Australia approximately 25% of Emergency Department (ED) attendances are via ambulance. ED overcrowding in Australia, as in many countries, is common. Measures to reduce overcrowding include the provision of enhanced timely primary care in the community for appropriate low risk injury and illness. Therefore paramedic assessment and referral to a community home hospital service, in preference to transfer to ED, may confer clinical and cost benefit.</p> <p>Methods/Design</p> <p>A randomised controlled trial. Consenting adult patients that call an ambulance and are assessed by paramedics as having an eligible low risk problem will be randomised to referral to ED via ambulance transfer or referral to a rapid response service that will assess and treat the patient in their own residence. The primary outcome measure is requirement for unplanned medical attention (in or out of hospital) in the first 48 hours. Secondary outcomes will include a number of other clinical endpoints. A cost effectiveness analysis will be conducted.</p> <p>Discussion</p> <p>If this trial demonstrates clinical non-inferiority and cost savings associated with the primary assessment service, it will provide one means to safely address ED overcrowding.</p> <p>Trial Registration</p> <p>Australian and New Zealand Clinical Trials Registry Number <a href="http://www.anzctr.org.au/trial_view.aspx?ID=335818">12610001064099</a></p