References
Obstetrics and birth: effects of experiences and gender bias on student test scores
Abstract
Objectives:
Paramedic education requires all students have the experience of attending childbirth. Obstetric (OB) experiences are limited for students in hospitals and even more so in the field. Gender bias may exist in hospital OB rotations for paramedic students but research on this is limited. This study is intended to examine whether a sex bias exists in field or hospital placements and if that bias correlates to OB test scores.
Methods:
Using data from Fisdap, numbers of OB experiences were analysed and compared to individual student sex and experience type (hospital clinical, field or skills laboratory). The number of experiences were compared to that student's score on the OB section of the Fisdap paramedic readiness examinations version 3 (PRE3) or version 4 (PRE4).
Results:
Of 12 090 paramedic students, male (n=5625) and female (n=2682) students who took the PRE3 had equal average scores of 0.76 and male (n=2498) and female (n=1285) students who took the PRE4 had average scores of 0.77 and 0.79 respectively. Students who took the PRE3 saw a mean of 4.32 births, a majority of which were in hospital (3.68); there was minimal difference in experiences between male and female students in field or skills laboratory settings, but women saw more births in hospital settings (3.92) than men (3.43). Students who took the PRE4 saw a mean of 4.54 births, a majority of which were in hospital (3.8) and there was minimal difference in experiences between male and female students in field or laboratory settings but women students saw more births in hospital (4.06) than men (3.54).
Conclusions
There is no correlation between the number of OB emergency encounters by paramedic students and their OB test scores. However, a potential gender bias exists as female students tend to have more labour and birth experiences in hospital settings than their male counterparts, while number of experiences in lab and field settings were similar.
Prehospital childbirth emergencies and deliveries are rare (Verdile et al, 1995) but can involve complications for both the mother and the newborn, leading to increased morbidity and mortality (McLelland et al, 2014; Flanagan et al, 2017).
To complete paramedic education each student has to participate in childbirth experiences through three supervised modes of formal instruction—clinical experience in hospital and prehospital settings, and simulation in the clinical skills laboratory. The total number of newborn deliveries that paramedic students must participate in, in any of these settings, is established through recommendations made by the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP).
It is mandatory for students to complete an accredited programme in obstetrics (OB) and childbirth before sitting the National Registry of Emergency Medical Technicians (NREMT, 2021) qualification examinations.
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