Stewart, Scott ORCID: 0000-0002-9686-9100 (2022) Preparedness of Australasian and UK Paramedic Academics to Teach Evidence Based Practice. PhD thesis, Victoria University.

Abstract

Evidence-based practice (EBP) is a core skill of all health professionals and a professional registration requirement for paramedics in Australia, NZ, and the UK. Paramedic Academics (PAs) have a key role in teaching EBP to paramedic undergraduates. However, only limited literature exists to assess the preparedness of PAs to do so. The current research is conducted under the paradigm of constructivism using the mixed methods of a phenomenological guided multiple repeated individual case studies using sequential semi-structured interviews incorporating vignettes and a positivist-based survey. The Evidence-Based Practice Profile-Paramedic (EBP2 -P) survey assesses the domains of relevance, terminology, practice, confidence, and sympathy to EBP. Demographic data was also collected. Data analysis was Cronbach’s alpha coefficient, descriptive statistics, Welch’s unequal variances t-test and Factorial AVOVA. A total of 106 PAs from Australia (61), NZ (20) and the UK (25) responded to the survey. Most respondents had a paramedic background (89%) and >10 years clinical experience (68%). Only 11% held a PhD while 12% held a Master’s by Research and 30% a Master’s by coursework. Under half of respondents had any EBP education (48%) or published an academic paper or presented at a conference (43%). Mean academic experience was four years with 22% reporting less than one year. EBP2 -P scores for the PAs were statistically significantly superior (p < .05) to other allied health professional academics in the domains of practice and sympathy and not significantly different in relevance, terminology, and confidence. The themes of variable EBP training levels, academic, and clinical use, inexperienced PAs, lack of higher degrees, resistance to students practicing EBP from clinical supervisors were detected in the qualitative phase. Student paramedics’ attitudes to EBP were influenced strongly by early clinical placements and they disliked being taught by non-paramedic staff that did not understand the paramedic environment and used irrelevant examples. The pattern of the EBP2 -P scores demonstrated that the PA cohort is at least as capable as the Allied Health Academics regarding the EBP characteristics evaluated. Differences between Australian PAs and their UK and NZ counterparts may be due to variation in years professional registration programs began. Some academics, in-service educators, and clinical managers require EBP education. Further support is needed for PAs to publish, present, and remain in academia. Paramedic EBP education should be themed through each unit of an undergraduate course with an explicit teaching of the five steps early, integrated into practical clinical situations and featuring prominently in a capstone project. Key recommendations for practice include retaining and developing paramedic academics with appropriate mentors; facilitating research and training opportunities; and monitor wages to align with ambulance industry. Furthermore, recommendations for higher education delivery focus on ensuring EBP is integrated into all units in the paramedic undergraduate curricula and implementing a EBP education program for clinical supervisors. Recommendations for further research involve conducting a EBP2 -P study of paramedic students transiting into the workforce, development, and evaluation of assessing EBP competency using OSCEs in undergraduate paramedicine and developing a paramedic signature pedagogy consensus statement based on a systematic review and Delphi survey. This work has provided insights regarding the key role paramedic academics have in teaching EBP to paramedic undergraduates. Findings from the current study reinforce that progression has been made in developing the professional culture to support the integration of EBP as a critical component of paramedicine education and practice.

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