Shooting For Change In Paramedicine Research

· Lived Experience,Professional

Words By Alexandra Mair

 

What are your immediate thoughts when I say the word ‘research’?

Maybe, it is a scientist sitting in a laboratory researching cures for diseases. Perhaps a chemist mixing solutions?

But, did you think of this?

Imagine standing outside of a shipping container. You’re wearing a singlet that has the capability of tracking your stress in real time. You try to act cool, but you know that they’re watching. They can see your heart rate spike, your respiratory rate increase and stress slowly growing. There is no hiding. You talk to your partner. Make sure you have all the gear you need, not knowing what to expect.

Then, it starts. The military personnel run in front of you, guns rapidly firing, securing what is to be a dangerous scene. You’re standing outside, palms sweaty, reciting “ABC’s, ABC’s, ABC’s”. Then you hear, “Come in!” 

I sure didn’t think of that as research. But it was what my first experience of being included in a research project. A high-fidelity simulation assessing our stress response and much more.

There are two things that I have had challenged during my time as a student paramedic and nurse. Those being reflection and research. I was the cliché student who was disinterested in these topics and vowed I would never dip my toe into this aspect of the health profession. However, fast forward four years and surprise, I have an affinity for both. So, today I will be reflecting on my introduction into research. 

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During my studies at university, research was not actively advertised. It had not crossed my mind until my 3rd year when I heard that other students were involved in small research projects. As a result of this, I never got involved as I didn’t know where to start or who to ask. I remained the student whose attitude towards research was that it was boring.

The major part of my journey into research began with creating ‘The Student Paramedic Podcast’. During my 3rd year, I was at a loss. I shared many of the same questions as my cohort about the paramedic profession. A lot of these questions revolved around ‘Where can the paramedic profession take me?’ ‘How do I maintain my mental and physical wellbeing with shift work?’ ‘What does the transition from student to graduate and student to paramedic look like?’ ‘How can I be the best student and clinician I can be?’ This was during COVID-19, when a lot of CPD events were cancelled and it felt like students did not have access to many of the ‘real-world’ learning tools or opportunity to network with people to answer such questions. 

When exploring topics to discuss and people to interview on the podcast, I came across many currently practicing paramedics, who were also completing research projects. Areas that really piqued my interested and those that related to the questions I wanted to get answered on the podcast. I was surprised to find that there were many paramedicine related research projects1-3 relating to the importance of fitness and wellbeing for the job, students undertaking work in areas outside of traditional roles, as well as the impact of paramedic work on personal wellbeing. This showed me that anything was able to be researched.

As part of scoping out guests for the podcast, I asked Dr Sandy MacQuarrie, senior lecturer, researcher, and paramedic, to be a guest on the podcast. Much to my surprise, Sandy said yes and encouraged me to have the episode focussed on students engaging in research projects. 

I was intrigued at this point. I had begun to slowly change my attitude towards research due to interviewing and reading about how research can be utilised to answer the questions I was endeavouring to get answered. When I learnt that students were being encouraged to participate in and lead such incredible projects, I was hooked. 

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I was inspired by these students (Joel, Elise, Jasmin, and Chloe) who spoke about their projects on the podcast, especially whilst completing their paramedic studies simultaneously. I hadn’t seen this kind of professional culture before nor had I seen so many students in one university being encouraged to do so. To have a team of faculty leaders so passionate about involving students in this aspect of the profession is incredible and very much needed for the profession to evolve. 

So, we did the podcast episode and it was a hit. So many students who listened, did not realise that this was something that they could do whilst studying. 

One of the behaviour changes I recognised in myself after this discussion, was that some of these studies included utilising mindfulness techniques during simulations that could be utilised operationally and how to best prepare students for placement. I quickly realised that to create meaningful and tangible change within the profession and at an organisational level, evidence-based research is required. 

Research can be fun and interesting. You can study almost anything. If you want to change something, you can almost always study it to drive the change required.

This discussion with Dr. MacQuarrie and these students provided an answer for one of the questions that I endeavoured to explore on the podcast, ‘Where can the paramedic profession take you?’ Research can be undertaken during university, upon graduating, whilst waiting for employment, or in conjunction to working. It can be done informally with a team, or it can be a part of an honours, masters, or PhD. There are many avenues. 

Paramedicine only became a registered profession at the end of my first year in 2018. I didn’t understand the gravity of this at the time. However now looking at professions such as medicine and nursing, these professions have had years of research. Although students undertaking medical degrees are encouraged to partake in research as a component of the degree, evidence of student involvement in research within the paramedic field is limited4. It is suggested that students may gain personal benefit as well as enhance profession led research. The long-standing research in the medical and nursing fields have driven evidence-based practice and enhanced the scope of practice to drive positive patient outcomes. 

The paramedic profession is young. There is so much room for anyone to begin making a tangible change in this profession. Student involvement and contribution in research highlights the change from a vocational educational training towards tertiary education and the further progression of the profession in the future5.

My attitude has evolved to realise that this change and progression can only be done with evidence-based practice. For the pre-hospital environment to be considered equal to the medical and nursing professions it works so closely with, it needs a strong team of students, paramedics, and academics to navigate towards the same playing field. Building an interest and passion for research in students from their first year will take our profession to the next level. 

Our current academics and paramedics have gotten the profession to where it is today. Many students ask, ‘What will the profession look like in 10 years’ time?’ I think that as students and young clinicians, we get to decide the answer to that and it starts with research. 

So, have I completed a research project yet? Well, the answer is no. But I’m only just beginning. 

I was involved in a research project shortly after the episode about research aired. I was invited along to be the crash test dummy for a research project assessing the difference in stress responses between high and low fidelity studies (this is the study I refer to at the beginning of this reflection). 

This test day was a success, and I later came back to assist in the data collection in the real version of the study. This study utilised ‘Astroskins’ and ‘Hexoskins’ to collect all biometric data including, but not limited to, heart rate, heart rate variability, G-forces, temperature, blood pressure, oxygen saturations, respiratory rate etc. and plotted the R-R data on a ‘Poincare’ graph to show when sympathetic or parasympathetic nervous systems activation occurred. I wore one of these for the test day and it was an invaluable experience seeing numerical data about my stress response correlating to my perceived stress and how it impacted my clinical performance.

I never thought that research could ever look like this. This experience has proved to me that research can be both fun and challenging, yet an integral part to changing all aspects within the healthcare profession. 

So how do you start to get into research? 

Start talking to and networking with those who are undertaking research in the field. Reach out to your faculty staff, network with those who are conducting research, start looking at different studies that have been done that pique your interest and think about things that you’d like to change and how that could become a study.

The research world is extensive and if I have learnt anything, it is that there is a project for anyone to sink their teeth into.

 

References

1. Paakkonen H, Ring J, Kettunen J. Physical fitness of paramedic students during vocational training - a follow-up study. Irish Journal of Paramedicine [Internet]. 2018 [cited 27 February 2022]. Available from: http://www.irishparamedicine.com/index.php/ijp/article/view/49

2. Devenish A, Mckay G, Long D, Horrocks P, Smith M. Undergraduate paramedic student experiences working in snow resort medical clinics: a non-traditional interprofessional clinical placement model. Irish Journal of Paramedicine [Internet]. 2022 [cited 27 February 2022]. Available from: http://dx.doi.org/10.32378/ijp.v4i1.101

3. Lawn S, Roberts L, Willis E, Couzner L, Mohammadi L, Goble E. The effects of emergency medical service work on the psychological, physical, and social well-being of ambulance personnel: a systematic review of qualitative research. BMC Psychiatry [Internet]. 2020 [cited 27 February 2022];20(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332532/

4. Lim D, Grant-Wakefield C, Tippett V. Engaging paramedic students in research: A case report. Australasian Journal of Paramedicine [Internet]. 2014 [cited 27 February 2022];11(4):1-4. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/3/109

5. O'Meara P. Student research: the future of paramedicine. Australasian Journal of Paramedicine [Internet]. Vol. 11. 2014 [cited 2022Feb27]. p. 1–. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/60