Bambini D, Washburn J, Perkins R Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nurs Educ Perspect. 2009; 30:(2)79-82

Boyle MJ, Williams B Listening and communication styles of undergraduate paramedic students. Journal of Paramedic Practice. 2011; 3:(9)504-9

Boyle M, Williams B, Burgess S Contemporary simulation education for undergraduate paramedic students. Emerg Med J. 2007; 24:(12)854-57

Flowers K, Gamble NSignapore2012

Joyce CM, Wainer J, Archer F, Wyatt A, Piterman L Trends in the paramedic workforce: a profession in transition. Aust Health Rev. 2009; 33:(4)533-40

Kitzinger J The methodology of focus groups: The importance of interaction between research participants. Sociol Health Illn. 1994; 16:(1)103-21

Lazarsfeld-Jensen A Starting young: The challenge of developing graduates’ road readiness. Journal of Paramedic Practice. 2010; 2:(8)368-72

Approaches that work: How authentic learning is transforming higher education. 2007. https// (accessed 22 October)

Meyer EC, Sellers DE, Browning DM, McGuffie K, Solomon MX, Truong RD Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med. 2009; 10:(3)352-9

Patrick CJ, Peach D, Pocknee C, Webb F, Fletcher M, Pretto G The WIL [Work Integrated Learning] report: A national scoping study [Australian Learning and Teaching Council (ALTC) Final Report].Brisbane: Queensland University of Technology; 2008

Searl KR, McAllister M, Dwyer T Little people, big lessons: An innovative strategy to develop interpersonal skills in undergraduate nursing students. Nurse Educ Today. 2014; 34:(9)1201-6

Seidman INew York: Teachers College Press; 2006

Von Wyl T, Zuercher M, Amsler F, Walter B, Ummenhofer W Technical and non-technical skills can be reliably assessed during paramedic simulation training. Acta Anaesthesiol Scand. 2009; 53:(1)121-27

Williams B, Onsman A, Brown T Australian paramedic graduate attributes: a pilot study using exploratory factor analysis. Emerg Med J. 2010; 27:(10)794-9

Williams A A study of emotion work in student paramedic practice. Nurse Educ Today. 2012; 33:(5)512-7

Williams B, Dousek S The satisfaction with simulation experience scale (SSES): A validation study. J Nurs Educ Pract. 2012; 2:(3)73-80

Willis E, Williams B, Brightwell R, O'Meara P, Pointon T Road-ready paramedics and the supporting sciences curriculum. Focus on Health Professional Education: A Multi-disciplinary Journal. 2010; 11:(2)1-13

A simulated wilderness exercise: the development of relational competence in paramedic students

02 April 2015
Volume 5 · Issue 1


The aim of this study was to assess the impact of a cognitively and physically challenging simulated wilderness exercise (SWE) on the development of relational competence in senior paramedic students. New paramedic graduates reportedly bring limited relational competence to their work role. The SWE, conducted in a wilderness landscape in Central Victoria, Australia was developed to address this limitation. Our study, an interpretative qualitative design, used a convenience sample of paramedic students who attended the three-day event (n=29). Qualitative data were collected through participant field diary and focus groups. Thematic analysis of study data identified four themes associated with relational competence, with each giving voice to participants’ new understandings of themselves in the work environment, namely: ‘interpersonal relating’, ‘maturity, respect and tolerance’, ‘self-awareness in the team environment’ and ‘belonging and professional identity’. It is clear that the challenge of working in teams in an unfamiliar and physically taxing environment prompted and/or extended relational competence in study participants. The practice implication of this finding is that these graduates will perform the relational aspects of their work role with greater ease, thus strengthening transition to normal work pressures in their first professional work role.

A pre-employment model of paramedic education is now the norm in Australia, where learning occurs predominantly in class-rooms and laboratories located in the university sector, complemented by on-road clinical placements in the industry sector (Joyce et al, 2009). New paramedic graduates have been found to have lower than desired clinical competence (Willis et al, 2010), and effort is expended in both sectors to remedy that deficit. However, an equally worrying deficit in this new group of health professionals is their low level of relational competence (Willis et al, 2010), namely, their interpersonal relating, maturity, ability to contribute to a team environment (Lazarsfeld-Jensen, 2010) and manage their own and others’ emotions (Williams, 2012). In terms of this aspect of their professional role, paramedic graduates are not work-ready.

Subscribe to get full access to International Paramedic Practice

Thank you for visiting International Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed