Do undergraduate paramedic students require prehospital placements?

I gave a presentation on this topic at the Paramedics Australasia conference in Hobart 3 November 2012 to discuss problems with undergraduate students securing prehospital placements.  There are many opportunities for paramedic students to gain the necessary knowledge, skills and experience to prepare them for work as a paramedic – much of which could be gained without prehospital placements at all (and in my view) could better prepare graduates for the reality of life as a paramedic.

Most employers of graduate ‘paramedics’ require a period of “internship” or postgraduate experience prior to recognising graduate paramedics as ‘qualified’ and able to work independently.  Industry is therefore committed to providing graduates with the necessary ‘orientation’ to the out-of-hospital setting where undergraduate learning can be consolidated once they are employed.  I feel that paramedics could benefit greatly by gaining much of their clinical experience in emergency departments embedded within a clinical school delivering medical programs.  This would enable undergraduate paramedic students to be more like undergraduate medical students in their latter years of training.  The emergency department setting mirrors the prehospital setting with respect to acuity and case mix but offers a more concentrated opportunity for learning as each emergency department has a catchment area of typically several ambulance branches.  The emergency department also offers more time for learning and reflection and the opportunity to determine the outcome of the patients prehospital course (what was the diagnosis, what did the paramedics do, would I have done the same – the basis for case based learning).

In this presentation I briefly introduced the defined roles of an emergency physician (according to the Australasian College of Emergency Medicine) and made comparisons between these roles and those of paramedics.  The clinical experiences graduate paramedics need during their training traverse across traditional professional boundaries including medicine, nursing and allied health – this is both a benefit and a challenge of the paramedicine ‘profession’.

Paramedics of the future will need to know more than paramedics now – accelerating the growth of the profession will require new ideas and new perspectives rather than more of the same.  Many challenges lay ahead (including resource implications on emergency departments if such a model was to be adopted).  Embedding paramedic education within clinical schools and considering the out-of-hospital setting (in an acute sense) an extension of the emergency department could make for an interesting model of paramedic education and for paramedic curriculum planning.  Food for thought…download presentation : Undergraduate placements Hobart PA 2012

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