ORCID Profile
0000-0001-6473-5397
Current Organisations
Queen's University
,
Fanshawe College
,
Charles Sturt University
,
Monash University
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Publisher: Cold Spring Harbor Laboratory
Date: 08-2019
DOI: 10.1101/19003491
Abstract: Previous research has suggested that stress may have a negative effect on the clinical performance of paramedics. In addition, stress has been demonstrated to have a negative impact the driving abilities of the general population, increasing the number of driving errors. However, to date no studies have explored stress and its potential impact on non-clinical performance of paramedics, particularly their driving abilities. Paramedic students underwent emergency driving assessment in a driving simulator before and after exposure to a stressful medical scenario. Number and type of errors were documented before and after by both driving simulator software and observation by two observers from the research team. The NASA Task Load Index (TLX) was utilised to record self-reported stress levels. 36 students participated in the study. Following exposure to a stressful medical scenario, paramedic students demonstrated no increase in overall error rate, but demonstrated an increase in three critical driving errors, namely failure to wear a seatbelt (3 baseline v 10 post stress), failing to stop for red lights or stop signs (7 v 35), and losing control of the vehicle (2 v 11). Self-reported stress levels also increased after the clinical scenario, particularly in the area of mental (cognitive) demand. Paramedics are routinely exposed to acute stress in their everyday work, and this stress could affect their non-clinical performance. The critical errors committed by participants in this study closely matched those considered to be contributory factors in many ambulance collisions. These results stimulate the need for further research into the effects of stress on non-clinical performance in general, and highlight the potential need to consider additional driver training and stress management education in order to mitigate the frequency and severity of driving errors. Paramedics are exposed to stressful clinical scenarios during the course of their work Many critical and serious clinical calls require transport to hospital Ambulance crashes occur regularly and pose a significant risk to the safety and wellbeing of both patients and paramedics This simulated clinical scenario followed by a simulated driving scenario has highlighted that stress appears to affect driving abilities in paramedic students The findings of this study, although conducted in paramedic students in simulated environments, highlight the need to further investigate the effects of stress on driving abilities among paramedics
Publisher: Medknow
Date: 2018
Publisher: The Association of Faculties of Medicine of Canada
Date: 22-03-2022
DOI: 10.36834/CMEJ.75002
Publisher: Springer Science and Business Media LLC
Date: 03-12-2020
DOI: 10.1007/S10459-019-09946-W
Abstract: Competency frameworks serve various roles including outlining characteristics of a competent workforce, facilitating mobility, and analysing or assessing expertise. Given these roles and their relevance in the health professions, we sought to understand the methods and strategies used in the development of existing competency frameworks. We applied the Arksey and O'Malley framework to undertake this scoping review. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) using keywords related to competency frameworks. We screened studies for inclusion by title and abstract, and we included studies of any type that described the development of a competency framework in a healthcare profession. Two reviewers independently extracted data including study characteristics. Data synthesis was both quantitative and qualitative. Among 5710 citations, we selected 190 for analysis. The majority of studies were conducted in medicine and nursing professions. Literature reviews and group techniques were conducted in 116 studies each (61%), and 85 (45%) outlined some form of stakeholder deliberation. We observed a significant degree of ersity in methodological strategies, inconsistent adherence to existing guidance on the selection of methods, who was involved, and based on the variation we observed in timeframes, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. We observed significant variation within the conduct and reporting of the competency framework development process. While some variation can be expected given the differences across and within professions, our results suggest there is some difficulty in determining whether methods were fit-for-purpose, and therefore in making determinations regarding the appropriateness of the development process. This uncertainty may unwillingly create and legitimise uncertain or artificial outcomes. There is a need for improved guidance in the process for developing and reporting competency frameworks.
Publisher: Irish College of Paramedics
Date: 27-09-2018
Abstract: strong Introduction /strong Every year, thousands of patients die and millions are harmed by medical care provision. Paramedics care for patients in dynamic, and challenging environments every day, which creates conditions that are ideal for mistakes to occur and for harm to be caused as a result. Knowledge of patient safety is recognised as a competency for paramedics in several jurisdictions, yet general awareness among paramedics of patient safety issues remains poor. The Institute for Healthcare Improvement (IHI) Open School courses were identified as a potential solution to this identified gap. These courses have been successfully integrated into various health professions education programs in other institutions however, no literature was discovered which discussed the integration of these courses into paramedic education. strong Methods /strong Eight online courses from the 13-course IHI Basic Certificate in Quality and Safety were embedded into the curriculum of a professional issues class in a paramedic diploma program in Ontario, Canada. Courses were completed outside of classroom time over one semester, and a percentage of activity marks for the class were awarded to students on the completion of the eight courses. Students provided a copy of certificates to prove completion of training. strong Results /strong In this pilot program, 41 paramedic students in the class (98%) completed all 13 courses, and were awarded the IHI Basic Certificate in Quality and Safety. Students described the courses as “ em highly applicable to paramedicine and pre-hospital care /em ”. In addition, students state that completing the certificate gave them knowledge of “ em the means by which change can be enacted /em ”. The completion of the courses outside of class time was achievable, and feedback from students has been overwhelmingly positive. An additional 43 students are currently enrolled in the courses, with completion expected by December 2018. strong Conclusion /strong The IHI Open School courses are an easy to implement strategy for paramedics looking to gain a brief, concise education on quality and patient safety. It is our goal to integrate the IHI Open School Basic Certificate across all classes in the two-year diploma program. We hope this will lay a foundation for professional practice that is based on safe, high-quality care provision.
Publisher: Irish College of Paramedics
Date: 03-09-2018
DOI: 10.32378/IJP.V3I2.91
Abstract: class="Pa2" strong Background /strong class="Pa2" To guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey. No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally. class="Pa2" strong Methods /strong class="Pa2" This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics. The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators. class="Pa2" strong Results /strong class="Pa2" The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”. class="Pa2" strong Conclusion /strong class="Pa2" The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context. Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.
Publisher: Irish College of Paramedics
Date: 26-09-2018
Abstract: strong Background /strong Empathy in healthcare delivery is an essential component to providing high-quality patient care. Empathy in paramedics and paramedic students has been subject to limited study to date. This study aimed to determine the empathy levels demonstrated by first year paramedic students over the course of their first year of study. strong Methods /strong This study employed a longitudinal design of a convenience s le of first year paramedic students in a community college program in Ontario, Canada. The Medical Condition Regard Scale (MCRS) was used to measure empathy levels across four medical conditions: intellectual disability, suicide attempt, substance abuse and mental health emergency. Surveys were conducted three times approximately 2-3 months apart before first semester field placements (Nov/17), after first semester field placements (Jan/18) and near the end of second semester field placements (Mar/18). strong Results /strong A total of 20 students completed all three surveys. Females, respondents aged 22-24, and participants with previous post-secondary education demonstrated higher mean empathy scores than their counterparts. Substance abuse was associated with the lowest mean empathy score for every demographic. Mean scores for intellectual disability, attempted suicide and mental health emergency decreased from the first survey to the last. Mean scores for substance abuse increased from 43.3 (SD±8.2) to 46.45 (SD±7.04). strong Conclusion /strong Results from this study suggest that in general, empathy levels among paramedic students decline over the course of their education. Male paramedic students are less empathetic than their female counterparts, and those with previous post-secondary education displayed higher mean empathy scores. The findings in this research support previous findings, and suggest that paramedic education programs may benefit from the inclusion of additional empathy training and education.
Publisher: Mark Allen Group
Date: 02-04-2019
DOI: 10.12968/JPAR.2019.11.4.CPD1
Abstract: Empathy is generally considered to be the understanding of another person's reactions, thoughts, feelings and problems, and being able to relay this sense of understanding back to the in idual. Empathy in healthcare is associated with improved communication, reduced stress, lower complication rates and better clinical outcomes. Low empathy is associated with decreased patient satisfaction and provider burnout. The burden of emotional work in paramedic practice and coping strategies may be contributory factors to lower empathy. Some evidence suggests that the empathy of paramedic students varies between patient groups and can decline over time. Empathy is an interpersonal skill that can be learned and improved upon. In paramedic practice, it is complex and inadequately studied. Its relationship to patient care, paramedic burnout and wellbeing require investigation. Several strategies to teach empathy should be considered by educators.
Publisher: Informa UK Limited
Date: 18-01-2021
Publisher: Irish College of Paramedics
Date: 09-09-2019
Abstract: In this wellbeing series we present practical advice for prehospital care providers, responders, and other shift workers. These articles are produced by experts in their field. Many of these topics were presented at the Irish College of Paramedics Wellbeing Symposium in University College Cork in May 2019.
Publisher: BMJ
Date: 23-08-2022
DOI: 10.1136/EMERMED-2022-999.19
Abstract: Already well situated in the community, paramedics work collaboratively with other community partners to ensure patients receive the services that they require and the high quality in-home and in-community care they deserve. The ongoing COVID-19 pandemic has highlighted the prevalence of social inequities in Canada, particularly in already marginalized groups, and the importance of social connectedness and caregiver wellbeing solutions. We sought to explore innovations in community paramedicine programs across Canada in response to COVID-19. We conducted a scoping literature review of community paramedicine publications since 2020, with a focus on Canadian context, and undertook semi-structured interviews with key informants to capture innovations that may not be well represented in the literature. A total of 22 studies, combined with 26 grey literature sources were identified through the literature search. We interviewed ten stakeholders from erse community care and community paramedicine settings across Canada to further explore each element of the conceptual framework. A conceptual framework (Figure 1) was developed to categorize the literature and findings into themes, namely: leveraging technology (e.g., virtual consultations, remote monitoring) responding to COVID-19 (e.g., mass testing and vaccination) addressing social needs (e.g., home visits, helping patients with groceries) caring for vulnerable populations (e.g., providing palliative care at home). These innovations were united in the idea of collaborating with other health care professionals and agencies, while facilitating care and case management coordination. The COVID-19 pandemic has highlighted the essential collaborative care role community paramedicine programs can provide to patients in their homes or communities. Community paramedicine programs have evolved to meet the needs of their communities. These programs have demonstrated their ability to support public health measures, provide home and community-based care, and most importantly, collaborate with other health care professionals in coordinating and providing care to Canadians regardless of social circumstances.
Publisher: Cold Spring Harbor Laboratory
Date: 11-12-2019
DOI: 10.1101/19014118
Abstract: Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality worldwide. Recent studies demonstrated low survival rates in Middle Eastern countries. Anecdotally there are unique demographic, cultural and logistical challenges in this region. However, there remains a paucity of data published on OHCA in the Middle East. In order to address OHCA in a meaningful manner in the region, we first need to quantify the issue. We conducted a scoping review of published and grey literature on OHCA in the Gulf Cooperative Council region that utilised Arksey and O’Malley’s framework. Electronic databases and grey literature sources were identified and searched. Subject matter experts in the region were consulted. All types of studies in English and Arabic were included. A total of 24 studies were included from Saudi Arabia, the UAE, Oman, Kuwait, and Qatar. No literature was identified from the state of Bahrain. OHCA victims in the region are younger, predominantly male, and more co-morbid than other international studies. We observed low Emergency Medical Service utilisation, low bystander cardiopulmonary resuscitation, return of spontaneous circulation, and survival to discharge rates across the region. There are differences in characteristics of OHCA among ethnic groups. We identified unique characteristics associated with OHCA in the region, variances in processes and outcomes, and a lack of coordinated effort to research and address OHCA. We recommend creating lead agencies responsible for coordinating and developing strategies such as community response, public education, and reporting databases.
Publisher: F1000 Research Ltd
Date: 23-05-2022
DOI: 10.12688/HRBOPENRES.13545.1
Abstract: Background : Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods : We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results : Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GP’s, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GP’s, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions : The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
Publisher: SAGE Publications
Date: 26-05-2023
Publisher: F1000 Research Ltd
Date: 12-08-2022
DOI: 10.12688/HRBOPENRES.13545.2
Abstract: Background : Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods : We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results : Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GPs, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GPs, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions : The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
Publisher: Irish College of Paramedics
Date: 22-12-2017
DOI: 10.32378/IJP.V2I2.67
Abstract: The National Prehospital Research Strategy was published in 2008, which aimed to gauge current levels of prehospital research activity in Ireland ascertain the research strengths that exist in the Irish prehospital community pinpoint the obstacles to high quality research in the prehospital arena determine the building blocks for a national prehospital research culture outline an implementation plan for the strategy and, identify expected and measurable short and long-term outcomes of implementing the strategy. The characteristics of systems that facilitate research productivity include: the promotion of a research culture mentoring by established scholars communication with a professional network rewards for research and brokered opportunities. Almost ten years later, the development of research capacity within the practitioner cohort has not progressed as much as hoped. A culture of research provides a supportive context in which research is uniformly expected, discussed, produced, and valued. We propose that a culture of research does not yet exist among Irish prehospital practitioners.
Publisher: Irish College of Paramedics
Date: 13-03-2019
Abstract: strong Background /strong Fatigue is a complex phenomenon that has effects on physical characteristics, cognition, behaviours, and physical and mental health. Paramedicine crosses the boundaries of many high-risk industries, namely medicine, transport and aviation. The effects of fatigue on paramedics thus need to be explored and considered in order to begin to identify appropriate interventions and management strategies. strong Aim /strong The aim of this article was to provide an overview of fatigue in paramedics and its potential effects on various areas of paramedic practice and paramedic health, and to outline potential solutions to assess and manage the risk of fatigue in paramedics as suggested by the literature. strong Methods /strong We conducted unstructured, non-systematic searches of the literature in order to inform an overview of the literature. An overview is a summary of the literature that attempts to survey the literature and describe its characteristics. We thematically structured the review under the following headings: defining occupational activity and health status clinical performance and patient safety shift length and time at work effects on paramedic health effects on driving abilities fatigue risk management and, fatigue proofing. strong Discussion /strong Fatigue should be considered in the context of overall paramedic health status and paramedic occupational activity. The nature of paramedic shift work, and the associated occupational activity place paramedics at increased risk from fatigue. Shift work may also contribute to sleep disorders among paramedics. Fatigue is associated with increased errors and adverse events, increased chronic disease and injury rates, depression and anxiety, and impaired driving ability. strong Conclusion /strong The issue of fatigue in paramedicine is complex and has serious consequences for patients and paramedics. Paramedic services and paramedics need to work collaboratively to identify and action appropriate measures to reduce the effects of fatigue on the wellbeing of the workforce and mitigate its effects on clinical performance and safety.
Publisher: Cold Spring Harbor Laboratory
Date: 11-10-2020
DOI: 10.1101/19008516
Abstract: Research indicates students of lower socioeconomic status (SES) are educationally disadvantaged. We sought to examine differences in paramedic student academic performance from counties with varying SES in the United States. Student performance data and SES data were combined for counties within the states of California, Mississippi, Louisiana, Texas and Virginia. Linear multiple regression modelling was performed to determine the relationship between income, high school graduation rate, poverty and food insecurity with first-attempt scores on the Fisdap Paramedic Readiness Exam (PRE) versions 3 and 4. Linear regression models indicated that there was a significant relationship between county-level income, poverty, graduation rate, food insecurity, and paramedic student academic performance. It remains unclear what type of relationship exists between in idual SES and in idual academic performance of paramedic students. These findings support the future collection of in idual student level SES data in order to identify issues and mitigate impact on academic performance.
Publisher: Irish College of Paramedics
Date: 12-06-2017
DOI: 10.32378/IJP.V2I1.53
Abstract: Abstracts for oral and poster presentations at the EMS Gathering 2017 held in Kinsale, Ireland from 3rd to 5th May 2017.
Publisher: SAGE Publications
Date: 07-09-2023
Publisher: MDPI AG
Date: 09-12-2022
DOI: 10.20944/PREPRINTS202212.0169.V1
Abstract: The National Occupational Competency Profile (NOCP) & ndash the competency framework for paramedics in Canada & ndash is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title and abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into eleven emerging concepts related to competencies: Inclusion, Diversity, Equity, and Accessibility (IDEA) in paramedicine Social responsiveness, justice, equity and access Anti-racism Healthy Professionals Evidence Informed Practice and Systems Complex Adaptive Systems Learning Environment Virtual Care Clinical Reasoning Adaptive Expertise and Planetary Health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, development group discussions, and competency identification.
Publisher: Irish College of Paramedics
Date: 07-06-2016
DOI: 10.32378/IJP.V1I1.5
Abstract: Background The impact of social media and online learning in health professions education has previously shown generally positive results in medical, nursing and pharmacy students. To date there has not been any extensive research into social media and online learning use by prehospital health care professionals such as paramedics. Aim & Methods We sought to identify the extent to which Irish pre-hospital practitioners make use of online learning and social media for continuous professional competency (CPC), and the means by which they do so. A cross-sectional online survey of practitioners was conducted to obtain both quantitative and qualitative data. The release of the survey was in a controlled manner to PHECC registrants via various channels. Participation was voluntary and anonymous. Results A total of 248 respondents completed the survey in full by closing date of 31 March 2015, representing 5.4% of all registrants (n=4,555). 77% of respondents were male, and the majority were registered as Emergency Medical Technicians (49%), followed by Advanced Paramedics (26%). Over 78% of respondents used a mobile device in the course of their clinical duties the majority used an iOS device. Social media and online learning were considered learning tools by over 75% of respondents, and over 74% agreed they should be further incorporated into prehospital education. The most popular platforms for CPC activities were YouTube and Facebook. The majority of respondents (88%) viewed self-directed activities to constitute continuous professional development activity, but 64% felt that an activity that resulted in the awarding of a certificate was better value. Over 90% of respondents had previous experience with online learning, but only 42% indicated they had previously purchased or paid for online learning. Conclusion Prehospital practitioners in Ireland in the population studied consider online learning and social media acceptable for CPC purposes. The main social media outlets used by PHECC registrants are YouTube and Facebook. Practitioners consider online learning that awards a certificate to be better value than self-directed activities. The majority have previous experience of online learning. The results of this study can be used to ensure educational interventions are targeted at practitioners through the correct channels.
Publisher: MDPI AG
Date: 12-12-2022
DOI: 10.20944/PREPRINTS202212.0169.V2
Abstract: The National Occupational Competency Profile (NOCP) & ndash the competency framework for paramedics in Canada & ndash is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title and abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into eleven emerging concepts related to competencies: Inclusion, Diversity, Equity, and Accessibility (IDEA) in paramedicine Social responsiveness, justice, equity and access Anti-racism Healthy Professionals Evidence Informed Practice and Systems Complex Adaptive Systems Learning Environment Virtual Care Clinical Reasoning Adaptive Expertise and Planetary Health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, development group discussions, and competency identification.
Publisher: Unpublished
Date: 2016
Publisher: Kent State University
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 18-05-2021
Publisher: Mark Allen Group
Date: 02-11-2018
Publisher: Springer Science and Business Media LLC
Date: 25-11-2019
DOI: 10.1017/CEM.2019.427
Abstract: Podcasts are increasingly being used for medical education. A deeper understanding of usage patterns would inform both producers and researchers of medical podcasts. We aimed to determine how and why podcasts are used by emergency medicine and critical care clinicians. An international interprofessional s le (medical students, residents, physicians, nurses, physician assistants, and paramedics) was recruited through direct contact and a multimodal social media (Twitter and Facebook) c aign. Each participant completed a survey outlining how and why they utilize medical podcasts. Recruitment materials included an infographic and study website. 390 participants from 33 countries and 4 professions (medicine, nursing, paramedicine, physician assistant) completed the survey. Participants most frequently listened to medical podcasts to review new literature (75.8%), learn core material (75.1%), and refresh memory (71.8%). The majority (62.6%) were aware of the ability to listen at increased speeds, but most (76.9%) listened at 1.0 x (normal) speed. All but 25 (6.4%) participants concurrently performed other tasks while listening. Driving (72.3%), exercising (39.7%), and completing chores (39.2%) were the most common. A minority of participants used active learning techniques such as pausing, rewinding, and replaying segments of the podcast. Very few listened to podcasts multiple times. An international cohort of emergency clinicians use medical podcasts predominantly for learning. Their listening habits (rarely employing active learning strategies and frequently performing concurrent tasks) may not support this goal. Further exploration of the impact of these activities on learning from podcasts is warranted.
Publisher: Center for Open Science
Date: 26-05-2023
Abstract: This abstract describes a mixed methods program of research undertaken in a single paramedic service in Ontario, Canada, following the introduction of a novel, point-of-event violence reporting process. Broadly, the research seeks to describe (1) the prevalence and characteristics of violence against paramedics (2) its contributing circumstances and (3) risk factors for development.
Publisher: Mark Allen Group
Date: 02-09-2019
Publisher: Hindawi Limited
Date: 05-09-2022
DOI: 10.1111/HSC.13985
Abstract: Community paramedic roles are expanding internationally, and no review of the literature could be found to guide services in the formation of community paramedicine programmes. For this reason, the aim of this restricted review was to explore and better understand the successes and learnings of community paramedic programmes across five domains being education requirements, models of delivery, clinical governance and supervision, scope of roles and outcomes. This restricted review was conducted by searching four databases (CENTRAL, ERIC, EMBASE, MEDLINE and Google Scholar) as well as grey literature search from 2001 until 28/12/2021. After screening, 98 articles were included in the narrative synthesis. Most studies were from the USA (n = 37), followed by Canada (n = 29). Most studies reported on outcomes of community paramedicine programmes (n = 50), followed by models of delivery (n = 28). The findings of this review demonstrate a lack of research and understanding in the areas of education and scope of the role for community paramedics. The findings highlight a need to develop common approaches to education and scope of role while maintaining flexibility in addressing community needs. There was an observable lack of standardisation in the implementation of governance and supervision models, which may prevent community paramedicine from realising its full potential. The outcome measures reported show that there is evidence to support the implementation of community paramedicine into healthcare system design. Community paramedicine programmes result in a net reduction in acute healthcare utilisation, appear to be economically viable and result in positive patient outcomes with high patient satisfaction with care. There is a developing pool of evidence to many aspects of community paramedicine programmes. However, at this time, gaps in the literature prevent a definitive recommendation on the impact of community paramedicine programmes on healthcare system functionality.
Publisher: Cold Spring Harbor Laboratory
Date: 08-2019
DOI: 10.1101/19003475
Abstract: Competency frameworks serve various roles including outlining characteristics of a competent workforce, facilitating mobility, and analysing or assessing expertise. Given these roles and their relevance in the health professions, we sought to understand the methods and strategies used in the development of existing competency frameworks. We applied the Arksey and O’Malley framework to undertake this scoping review. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) using keywords related to competency frameworks. We screened studies for inclusion by title and abstract, and we included studies of any type that described the development of a competency framework in a healthcare profession. Two reviewers independently extracted data including study characteristics. Data synthesis was both quantitative and qualitative. Among 5,710 citations, we selected 190 for analysis. The majority of studies were conducted in medicine and nursing professions. Literature reviews and group techniques were conducted in 116 studies each (61%), and 85 (45%) outlined some form of stakeholder deliberation. We observed a significant degree of ersity in methodological strategies, inconsistent adherence to existing guidance on the selection of methods, who was involved, and based on the variation we observed in timeframes, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. We observed significant variation within the conduct and reporting of the competency framework development process. While some variation can be expected given the differences across and within professions, our results suggest there is some difficulty in determining whether methods were fit-for-purpose, and therefore in making determinations regarding the appropriateness of the development process. This uncertainty may unwillingly create and legitimise uncertain or artificial outcomes. There is a need for improved guidance in the process for developing and reporting competency frameworks.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2020
Publisher: MDPI AG
Date: 13-04-2022
DOI: 10.20944/PREPRINTS202204.0127.V1
Abstract: Competency frameworks outline the perceived knowledge, skills and other attributes required for professional practice. Competency frameworks have gained in popularity, in part for their ability to inform health professions education, assessment, professional mobility, and other activities. Previous research has shown inadequate reporting within reports describing their development and that may jeopardize their use and application. We aimed to develop a set of minimum criteria that provides guidance to authors (and consumers) in an effort to improve reporting of the development of competency frameworks. The checklist was developed by a 35-member expert panel and a five-member research team following published guidance from the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network. The final checklist contains 20 essential reporting items including guidance on reporting title and abstract, framework development, the development process, testing and funding/conflicts of interest. The intent of the COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guideline is to help readers (including researchers, educators, regulators, health professionals, and patients) develop a greater understanding of relevant terminology, core concepts, and key items to report for competency framework development in health professions.
Publisher: World Health Organization Regional Office for the Eastern Mediterranean (WHO/EMRO)
Date: 29-07-2021
DOI: 10.26719/EMHJ.20.141
Abstract: Background: Published data are lacking on response to and outcomes of out-of-hospital cardiac arrest in the Middle East. What data there are have not been comprehensively analysed. Aims: This study aimed to assess the characteristics of people with out-of-hospital cardiac arrest in Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates) and the response to and outcomes of such incidents. Methods: This was a scoping review of published and grey literature on out-of-hospital cardiac arrest in GCC countries from 1990 to June 2019. Studies in English and Arabic were eligible for inclusion. MEDLINE, CINAHL, Web of Science and EMBASE were searched as well as relevant non-indexed journals. Google searches were also done. References of included studies were scanned for relevant articles. Experts on the subject in the region were consulted. Results: Of 647 citations retrieved, 24 studies were included for data extraction and analysis. No literature was identified for Bahrain. People with out-of-hospital cardiac arrest in the region were younger, predominantly male and had more comorbidity than reported in other regions of the world. Use of emergency medical services was low across the GCC countries, as was bystander cardiopulmonary resuscitation, return of spontaneous circulation and survival to discharge. Conclusions: A coordinated effort to address out-of-hospital cardiac arrest, including the generation of research, is lacking within and among GCC countries. Establishment of lead agencies responsible for developing and coordinating strategies to address out-of-hospital cardiac arrest, such as community response, public education and reporting databases, is recommended.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2016
Publisher: Saudi Medical Journal
Date: 06-2016
Publisher: Oxford University Press (OUP)
Date: 23-11-2023
DOI: 10.1093/BJS/ZNAC394
Abstract: Competency frameworks outline the perceived knowledge, skills, attitudes, and other attributes required for professional practice. These frameworks have gained in popularity, in part for their ability to inform health professions education, assessment, professional mobility, and other activities. Previous research has highlighted inadequate reporting related to their development which may then jeopardize their defensibility and utility. This study aimed to develop a set of minimum reporting criteria for developers and authors of competency frameworks in an effort to improve transparency, clarity, interpretability and appraisal of the developmental process, and its outputs. Following guidance from the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, an expert panel was assembled, and a knowledge synthesis, a Delphi study, and workshops were conducted using in iduals with experience developing competency frameworks, to identify and achieve consensus on the essential items for a competency framework development reporting guideline. An initial checklist was developed by the 35-member expert panel and the research team. Following the steps listed above, a final reporting guideline including 20 essential items across five sections (title and abstract framework development development process testing and funding/conflicts of interest) was developed. The COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guideline permits a greater understanding of relevant terminology, core concepts, and key items to report for competency framework development in the health professions.
Publisher: MDPI AG
Date: 22-08-2017
Abstract: Violence against paramedics has been described as a ‘serious public health problem’ but one that remains ‘vastly underreported’, owing to an organizational culture that stigmatizes reporting–hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between 1 February 2021 and 31 January 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n = 364) or sexual (n = 19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%) however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of the violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 h, being physically assaulted every 46 h, and injured every 9 days.
Publisher: MDPI AG
Date: 14-02-0100
DOI: 10.20944/PREPRINTS202103.0296.V2
Abstract: Competency frameworks are developed for a variety of purposes, including describing professional practice and informing education and assessment frameworks. Despite the volume of competency frameworks developed in the healthcare professions, guidance remains unclear and is inconsistently adhered to (perhaps in part due to a lack of organising frameworks), there is variability in methodological choices, inconsistently reported outputs, and a lack of evaluation of frameworks. As such, we proposed the need for improved guidance. In this paper we outline a six-step model for developing competency framework that is designed to address some of these shortcomings. The six-steps comprise [1] identifying purpose, intended uses, scope, and stakeholders [2] theoretically informed ways of identifying the contexts of complex, & lsquo real-world& rsquo professional practice, which includes [3] aligned methods and means by which practice can be explored [4] the identification and specification of competencies required for professional practice, [5] how to report the process and outputs of identifying such competencies, and [6] built-in strategies to continuously evaluate, update and maintain competency framework development processes and outputs. The model synthesizes and organizes existing guidance and literature, and furthers this existing guidance by highlighting the need for a theoretically-informed approach to describing and exploring practice that is appropriate, as well as offering guidance for developers on reporting the development process and outputs, and planning for the ongoing maintenance of frameworks.
Publisher: MDPI AG
Date: 11-03-2021
DOI: 10.20944/PREPRINTS202103.0296.V1
Abstract: The development of competency frameworks in healthcare professions is characterised by potentially inadequate descriptions of practice, variable developmental approaches, and inconsistent reporting and evaluating of outcomes. This may be in part due to limited existing guidance, which neglects broader contexts, lacks organising frameworks, and fails to provide guidance on selection of methods. To address such concerns, this paper first outlines a & lsquo systems thinking& rsquo conceptual framework by which to conceptualise and describe clinical practice when developing competency frameworks. This is achieved through combining Ecological Systems Theory and complexity thinking to identify, and explore the contexts and components of clinical practice. The & lsquo systems thinking& rsquo conceptual framework is then integrated into a six-step model for developing competency frameworks that synthesises and organises existing advice. The six steps include (1) identify practicalities (e.g. purpose, scope, detail, timeline), (2) identify influencing contexts and factors using & lsquo systems thinking& rsquo , (3) use aligned mixed-methods, (4) translate data into competency frameworks, (5) report processes and outcomes, and (6) plan to evaluate, update and maintain the competency framework. The model provides a logical organising structure of principles to guide assumptions and commitments when developing competency frameworks. Additionally, the model affords the flexibility required when exploring professional practice across varying contexts, and suggests employing mixed methodological approaches that are aligned with purpose and scope. The model acknowledges changing and complex contexts, considers existing guidance, and adds a unique and complementary means to conceptualise and improve the competency framework development process.
Publisher: Irish College of Paramedics
Date: 09-10-2018
Abstract: strong Background /strong Previous research has demonstrated that stress has a negative impact on the performance of paramedics while performing medical related tasks. Acute stress has also been shown to negatively impact the driving abilities of the general population increasing the number of critical driving errors performed. No literature was discovered that discussed the effects of stress on the driving abilities of paramedics. strong Methods /strong Paramedic students underwent a driving ability assessment in a driving simulator. We then exposed them to a stress inducing medical scenario. Another driving assessment was then conducted. The numbers, and types of errors were documented before and after the scenario. strong Results /strong students participated in the study. Paramedic students demonstrated no increase in overall error rate after a stressful scenario, but demonstrated an increase in three critical driving errors failure to wear a seatbelt (3 baseline v 10 post stress, p= 0.0087), failing to stop for red lights or stop signs (7 v 35, p= & .0001), and losing controlling of the vehicle (2 v 11, p= 0.0052). strong Conclusion /strong Paramedic students demonstrated an increase in critical driving errors after a stressful simulated clinical scenario. Paramedics are routinely exposed to acute stress during the course of their working day. This stress could increase the number of critical driving errors that occur. These results reinforce the need for further research, and highlight the potential need for increased driver training and stress management education in order to mitigate the frequency and severity of driving errors made by paramedics.
Publisher: Cold Spring Harbor Laboratory
Date: 06-08-2019
DOI: 10.1101/19003483
Abstract: When paramedics are dispatched, it is expected that every patient receives the same level of care regardless of variable factors. Homelessness is a growing social issue across Canada that is particularly prevalent in urban areas. The quality of healthcare delivered to in iduals experiencing homelessness may be influenced by negative attitudes held by healthcare professionals. There is an absence of literature quantifying the perspectives of paramedics towards homelessness therefore, the focus of this study was to identify the attitudes of paramedic students towards homelessness and to continue the conversation in regards to the evolving educational needs of paramedic students. This study employed a longitudinal design of a convenience s le of first year paramedic students in a college program in Ontario, Canada. The ‘Health Professional’s Attitude Towards the Homeless Inventory’ (HPATHI) was distributed to participants before and after placement and clinical exposure. The questionnaire includes 19 statements which participants respond to on a Likert scale. Mean scores were calculated, and statements were categorized into attitudes, interest, and confidence. Data were collected post-placement on interactions with persons experiencing homelessness. A total of 52 first year paramedic students completed the HPATHI pre-placement and 47 completed the questionnaire post-placement. Mean scores for attitudes (pre 3.64, SD 0.49 post 3.85, SD 0.38, p=0.032), interest (pre 3.91, SD 0.40 post 3.84, SD 0.39,p=0.51) and confidence (pre 4.02, SD 0.50 post 3.71, SD 0.67, p=0.004) were largely positive, but there was a demonstrated decreasing trend in confidence with, and interest in, working with those experiencing homelessness. Participants reported an average of 60 hours of placement, during which 15 participants (32%) reported interactions with people experiencing homelessness. First year paramedic students demonstrate overall positive attitudes towards those experiencing homelessness, and the mean score for attitudes improved over the surveys. However, there were demonstrable decreases in confidence and interest over time, which may be related to the type and frequency of interactions during clinical placement. Paramedic education programs may benefit from the inclusion of focused education on homelessness, specific clinical experiences, and education related to social determinants of health.
Publisher: Mark Allen Group
Date: 02-12-2018
DOI: 10.12968/IPPR.2018.8.3.42
Abstract: Empathy is an important factor in communication between healthcare provider and patient. Previous studies have shown that empathy benefits patient care in multiple ways. Empathy allows a space of decreased vulnerability and, as a result, builds trust in healthcare relationships. It fosters open communication that leads to improved patient care improves patient satisfaction and buffers healthcare provider burnout. This study aimed to determine the empathy levels demonstrated by paramedic students to patients with various medical conditions, and to compare these findings with those of previous studies. This study employed a cross-sectional design of a convenience s le of first and second year paramedic students in a community college programme in Ontario, Canada. The Medical Condition Regard Scale (MCRS) was used to measure empathy levels in these students across five medical conditions: physical disability, intellectual disability, suicide attempt, mental health emergency, and substance abuse. A total of 43 students participated in the study 27 males and 15 females (1 unknown). Males demonstrated a mean empathy score of 232.44 while females demonstrated a mean of 266.4. Across the five medical conditions, substance abuse had the lowest mean empathy score (42.88), followed by mental health emergency (49.58), suicide attempt (49.47), intellectual disability (50.42) and physical disability (53.0). Results from this study suggest that paramedic students demonstrated the lowest levels of empathy towards patients suffering from substance abuse issues, and the highest levels of empathy towards patients with a physical disability. Male paramedic students are less empathetic than their female peers, and second year paramedic students are less empathetic than their first year counterparts. These results provide an insight into paramedic student attitudes in Canada, and provide a foundation for further studies.
Publisher: Unpublished
Date: 2015
Publisher: Frontiers Media SA
Date: 26-07-2022
Abstract: Competency frameworks typically describe the perceived knowledge, skills, attitudes and other characteristics required for a health professional to practice safely and effectively. Patient and public involvement in the development of competency frameworks is uncommon despite delivery of person-centered care being a defining feature of a competent health professional. This systematic review aimed to determine how patients and the public are involved in the development of competency frameworks for health professions, and whether their involvement influenced the outcome of the competency frameworks. Studies were identified from six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Web of Science and ERIC). The database search yielded a total of 8,222 citations, and 43 articles were included for data extraction. Most studies were from the United Kingdom (27%) and developed through multidisciplinary collaborations involving two or more professions (40%). There was a large variation in the number of patients and members of the public recruited (range 1–1,398) recruitment sources included patients and carers with the clinical condition of interest (30%) or established consumer representative groups (22%). Common stages for involving patients and the public were in generation of competency statements (57%) or reviewing the draft competency framework (57%). Only ten studies (27%) took a collaborative approach to the engagement of patients and public in competency framework development. The main ways in which involvement influenced the competency framework were validation of health professional-derived competency statements, provision of desirable behaviors and attitudes and generation of additional competency statements. Overall, there was a lack of reporting regarding the details and outcome of patient and public involvement. Further research is required to optimize approaches to patient and public involvement in competency framework development including guidance regarding who, how, when and for what purposes they should be engaged and the requirements for reporting. www.crd.york.ac.uk rospero/ , identifier: CRD42020203117.
Publisher: MDPI AG
Date: 08-11-2021
DOI: 10.20944/PREPRINTS202103.0296.V3
Abstract: Competency frameworks are developed for a variety of purposes, including describing professional practice and informing education and assessment frameworks. Despite the volume of competency frameworks developed in the healthcare professions, guidance remains unclear and is inconsistently adhered to (perhaps in part due to a lack of organising frameworks), there is variability in methodological choices, inconsistently reported outputs, and a lack of evaluation of frameworks. As such, we proposed the need for improved guidance. In this paper we outline a six-step model for developing competency framework that is designed to address some of these shortcomings. The six-steps comprise [1] identifying purpose, intended uses, scope, and stakeholders [2] theoretically informed ways of identifying the contexts of complex, & lsquo real-world& rsquo professional practice, which includes [3] aligned methods and means by which practice can be explored [4] the identification and specification of competencies required for professional practice, [5] how to report the process and outputs of identifying such competencies, and [6] built-in strategies to continuously evaluate, update and maintain competency framework development processes and outputs. The model synthesizes and organizes existing guidance and literature, and furthers this existing guidance by highlighting the need for a theoretically-informed approach to describing and exploring practice that is appropriate, as well as offering guidance for developers on reporting the development process and outputs, and planning for the ongoing maintenance of frameworks.
Publisher: Saudi Medical Journal
Date: 11-2016
Publisher: Irish College of Paramedics
Date: 29-11-2016
DOI: 10.32378/IJP.V1I2.40
Publisher: BMJ
Date: 10-2019
DOI: 10.1136/BMJOPEN-2019-031956
Abstract: Community paramedicine programme are often designed to address repeated and non-urgent use of paramedic services by providing patients with alternatives to the traditional ‘treat and transport’ ambulance model of care. We sought to investigate the level of consensus that could be found by a panel of experts regarding appropriate health, social and environmental domains that should be assessed in community paramedicine home visit programme. We applied the RAND/UCLA Appropriateness Method in a modified Delphi method to investigate the level of consensus on assessment domains for use in community paramedicine home visit programme. We included a multi-national panel of 17 experts on community paramedicine and in-home assessment from multiple settings (paramedicine, primary care, mental health, home and community care, geriatric care). A list of potential assessment categories was established after a targeted literature review and confirmed by panel members. Over multiple rounds, panel members scored the appropriateness of 48 assessment domains on a Likert scale from 0 (not appropriate) to 5 (very appropriate). Scores were then reviewed at an in-person meeting and a finalised list of assessment domains was generated. After the preliminary round of scoring, all 48 assessment domains had scores that demonstrated consensus. Nine assessment domains (18.8%) demonstrated a wider range of rated appropriateness. No domains were found to be not appropriate. Achieving consensus about the appropriateness of assessment domains on the first round of scoring negated the need for subsequent rounds of scoring. The in-person meeting resulted in re-grouping assessment domains and adding an additional domain about urinary continence. An international panel of experts with knowledge about in-home assessment by community paramedics demonstrated a high level of agreement on appropriate patient assessment domains for community paramedicine home visit programme. Community paramedicine home visit programme are likely to have similar patient populations. A standardised assessment instrument may be viable in multiple settings.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2023
Publisher: SAGE Publications
Date: 27-04-2023
DOI: 10.1177/27536386231171813
Abstract: As the paramedic profession continues to grow and evolve, a shift from purely reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalised and under-served populations, the paramedic role and its potential future implications in caring for these patients need to be explored. The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit and controlled drugs. A scoping review of English language literature published since 2002 was conducted using CINAHL, Medline, Embase and Google Scholar. We used a previously published paramedic search term filter for sensitivity combined with search terms related to illicit and controlled drug use and addiction. Studies were selected based on relevance to the research question. A total of 104 peer-reviewed and 14 grey literature articles were selected for inclusion. The main finding of this scoping review is the notable lack of evidence base surrounding the contemporary paramedic role in the care provision of people who use drugs. The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to approach care in meaningful ways that extend past traditional drug poisoning response. The interface between the community of people who use drugs and the paramedic may be a highly influential encounter during a patient's journey through the healthcare system. The evolving role of the paramedic in this encounter requires focused study and should be viewed as a research priority in response to the ongoing drug poisoning crisis.
Publisher: Irish College of Paramedics
Date: 07-06-2016
DOI: 10.32378/IJP.V1I1.25
Abstract: Abstracts from oral and poster presentations at the 2016 EMS Gathering.
Publisher: Irish College of Paramedics
Date: 07-06-2016
DOI: 10.32378/IJP.V1I1.23
Abstract: Welcome to the first issue of the Irish Journal of Paramedicine (IJP). It gives me great pleasure to launch this journal, a first for Irish paramedics, and pre-hospital care in Ireland. I am also honoured to announce that the IJP has been adopted as the official journal of the Irish College of Paramedics, the professional body for prehospital emergency care practitioners in Ireland. A newly emerging profession, paramedicine is now poised at a crossroads. Previously alluded to with colleagues from around the globe, the role of the paramedic is one that is rapidly evolving, and yet paramedicine as a discipline has yet to figure out where it belongs.(1) Are we public safety professionals, first responders or healthcare professionals? Williams has previously stated that the road less travelled requires the paramedic profession to pursue identity as a healthcare profession and not as emergency responders, EMS workers, or ambulance drivers, which we are so commonly identified as.(2) Initiatives within Ireland such as the Centre for Prehospital Research national research agenda, the move to higher education for paramedics in University College Dublin and the University of Limerick, and the publication of high-quality peer-reviewed research, undertaken for paramedics, led by paramedics, and published in paramedicine journals are key components in this pursuit of professionalism. It is our hope that the Irish Journal of Paramedicine will play its part as a vehicle in this endeavour. It is important however to point out that the Irish Journal of Paramedicine is not exclusively for paramedics. Within Ireland, and around the world, there are many other prehospital care providers, including community responders, volunteer first responders, EMT practitioners, nurses, physicians and others who deliver high quality patient care and are as committed to their personal and professional development as any paramedic. This journal is for the entire prehospital care community, within Ireland and abroad. On behalf of the editorial board and the executive of the Irish College of Paramedics, I would like to outline our vision for this journal. We aim to deliver a high quality, freely accessible, peer-reviewed journal that will help to further the professionalisation of paramedicine and prehospital care provision both in Ireland and internationally. Our aim is to provide you with access to research, reviews, appraisals, clinical updates, case reports and opinions that will help you to provide the best quality service – whether you are a student, clinician, educator, manager or researcher. We aim to present a wide range of topics relating to clinical practice, professional issues, role development, education and training, policy and service delivery, thereby representing all aspects of paramedicine and prehospital care. Our editorial board consists of respected academics, researchers, clinicians and educators from Ireland and abroad who are committed to furthering the cause of paramedicine, and encouraging its future development of professional standing. I am indebted to them for the time they gave so freely in helping to establish this journal. We strongly encourage you to submit articles, reports, letters and other contributions to the journal. It is also our vision to publish abstracts of research activity undertaken by Irish prehospital care providers and practitioners, which has been presented at various conferences and scientific meetings, such as the EMS Gathering, and Irish College of Paramedics Scientific Days to name but two. Remember this is your journal and it will be as successful as you want it to be. This journal has been a long time in the making, and we look forward to helping it to develop into a true academic and clinical resource along with your assistance. Thank you. Alan M. Batt Editor Source of support/funding: None. Conflict of interest: AB is Editor of the IJP. Provenance and review: Commissioned, not peer-reviewed. References . Morton J, Kloepping K, Buick J, Todd J, Batt A. The evolution of the paramedic. Can Paramed. 2015 (5). . Williams B, Onsman A, Brown T. Is the Australian Paramedic Discipline a Full Profession ? J Emerg Prim Heal Care. 2010 (1):3. How to cite this article: Batt AM. Welcome to the Irish Journal of Paramedicine (Editorial). Irish Journal of Paramedicine, 2016 1(1). This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial-ShareAlike 4.0 International ( a href="icenses/by-nc-sa/4.0/" icenses/by-nc-sa/4.0/ /a ),which permits use, distribution, and reproduction in any medium, provided the original work and any attributes thereof are properly cited, are distributed under the same licence, and that the work is not used for commercial purposes. Content copyright remains with the authors, who grant the IJP a licence to reuse and distribute.
Publisher: SAGE Publications
Date: 20-09-2023
Publisher: SAGE Publications
Date: 02-06-2023
DOI: 10.1177/27536386231174097
Abstract: British Columbia Emergency Health Service trialled the use of intranasal (IN) ketamine given by Primary Care Paramedics (PCPs). Prior to this practice change, the PCPs had not performed weight-based drug calculations, given medications intranasally, nor been responsible for controlled and targeted substances. This study aimed to use the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domain Framework (TDF) to identify enablers and barriers to implementing IN paramedic administered ketamine analgesia (iPAKA) for PCPs. This was a parallel convergent mixed methods study with two phases. The quantitative phase consisted of longitudinal staff surveys to assess PCP knowledge and perceptions of ketamine and controlled and targeted substances policies. The qualitative phase involved staff focus groups on programme implementation. Descriptive statistics of survey results were integrated with coded focus group data and analysed using the COM-B model and TDF. Evidence-based behavioural change techniques were mapped to each TDF domain. Our analysis revealed barriers and enablers across several TDF domains. Implementing ketamine was enabled by quality education, strong organisational support and the availability of cognitive aides. Trial success was attributed in part to participant's feelings of optimism and their increased job satisfaction. Key barriers included a knowledge gap involving drug dosage calculations, negative emotions associated with performance anxiety and a lack of field education and supervision to monitor paramedic practice. The use of theoretical frameworks and models like COM-B/TDF serves to improve the sustainable implementation of behaviour and clinical practice change in paramedicine. When project teams use theory to guide design and implementation, they can systematically identify and target in idual and organisational enablers and barriers to adopting routine practices. The iPAKA study reveals key barriers and facilitators in several TDF domains and presents theory-linked targeted behavioural techniques to support on-going implementation of PCP-administered IN ketamine for analgesia.
Publisher: Irish College of Paramedics
Date: 07-06-2016
DOI: 10.32378/IJP.V1I1.27
Abstract: Welcome to the first issue of the Irish Journal of Paramedicine (IJP). Our editorial board consists of respected academics, researchers, clinicians and educators from Ireland and abroad who are committed to furthering the cause of paramedicine, and encouraging its future development of professional standing. This article introduces the members of the editorial board, and outlines their qualifications and experience in prehospital care and paramedicine.
No related grants have been discovered for Alan Batt.