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How student paramedics navigate a changing UK healthcare landscape

02 September 2020
Volume 10 · Issue 3



Paramedics have witnessed a huge shift in their role as providers of prehospital emergency care, although little is known about how student paramedics manage the competing demands they face in practice.


To explore how student paramedics experience the changing healthcare landscape.


Semi-structured, focus groups and thematic content analysis was adopted. A purposive sample of student paramedics at different stages of their diploma preparatory training were invited to participate in focus group interviews.


Participants considered that other services and the public perceived the purpose of emergency paramedics as largely a traditional one, as a service to transport patients to hospital. This appears to influence how they manage complex clinical situations. Student paramedics' clinical decision-making is frequently influenced by the emotional environments in which they work, combined with difficult communication with patients and a lack of support from the various professional groups involved in patient care.


This study has highlighted the complexity of situations that student paramedics find themselves in while making decisions, which has important implications for paramedic educators and those supporting them in practice.

The role of the paramedic in the UK has changed over the past few decades (Smith, 2017). A once protocol-driven vocation, associated with limited clinical decision-making and responsibility, paramedicine has emerged as an autonomous profession involving an expanding scope of practice (National Institute for Health and Care Excellence (NICE), 2017). In part, this may have been driven by the shifting focus on models of care delivery, with increased attention paid to alternatives to hospital admission (Pollock, 2019).

Paramedics are required to demonstrate a higher level of clinical decision-making and judgement than was historically required (Simpson et al, 2017). While emergency care remains a fundamental part of the paramedic role, calls to less urgent or acute conditions have become a growing aspect of their job (NICE, 2017). New approaches to healthcare delivery, with more treatment being provided away from acute hospitals and closer to home, require different ways of working (Miller et al, 2016).

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