Out of the silo: a qualitative study of paramedic transition to a specialist role in community paramedicine

PhD Thesis


Long, David N.. 2017. Out of the silo: a qualitative study of paramedic transition to a specialist role in community paramedicine. PhD Thesis Doctor of Philosophy. Queensland University of Technology. https://doi.org/10.5204/thesis.eprints.114997
Title

Out of the silo: a qualitative study of paramedic transition to a specialist role in community paramedicine

TypePhD Thesis
Authors
AuthorLong, David N.
SupervisorDevenish
Scott
Tippett, Vivienne
Clark, Michele
Institution of OriginQueensland University of Technology
Qualification NameDoctor of Philosophy
Number of Pages290
Year2017
Digital Object Identifier (DOI)https://doi.org/10.5204/thesis.eprints.114997
Web Address (URL)https://eprints.qut.edu.au/114997/
Abstract

Community paramedicine is an evolving specialist stream of paramedic practice comprising two dominant service delivery models; those aligned with an Extended Care Paramedic (ECP)-type model and those aligned with a Community Paramedic (CP)-type model. The underlying philosophy of community paramedicine is to provide patients in the community with options to navigate more efficiently the healthcare system and avoid unnecessary presentations to a hospital emergency department. Community paramedicine contrasts with 'traditional' paramedic practice by targeting non-urgent patients who may benefit from an expanded scope of practice in both scheduled and unscheduled out-of-hospital care. However, little is known about the process of transition of paramedics from a work role in traditional paramedicine to a specialist work role in community paramedicine. To date, specialist work role transitions in paramedicine have been largely neglected in the literature. This study aims to illuminate how qualified paramedics can transition to a specialist role in community paramedicine.

The study recruited ECPs (n=25) from two Australian jurisdictions and CPs (n=11) from a Canadian provincial health service, in a qualitative study exploring their experiences of transition. The data from the three study sites were pooled and interpreted using constructivist grounded theory methodology, as informed by Charmaz (2014). The analysis revealed transition to a work role in community paramedicine involved four phases. The first phase represented a junctional point in a paramedic’s clinical career trajectory in which the decision to enter a community paramedicine pathway was made. Three 'active' phases of transition followed in which participants engaged formally in the transition process. Additionally, four core categories of transition were interwoven through each active phase of transition; Engaging in a Community of Practice, Adjusting to Organisational and Cultural Change, Developing Critical Thinking and, Mastering Skills. The evolution of each of the four core categories contributed 'ancillary markers' of transition, that coalesced to define the end-point of transition: Adequate proficiency in the work role.

The significance of this PhD research is demonstrated by positioning the study beyond the practical transferability of extant work role transition theories. Certainly elements of leading work role transition theories in paramedicine (Devenish, Clark, & Fleming, 2016; McFarlane, 2010), nursing (Barnes, 2014; Benner, 1984; Boychuk Duchscher, 2009) and generic organisational literature (Nicholson, 1984), resonates with the current study. For instance, experiencing negative emotions early in the transition experience was a common finding across the literature. However, no existing theory of work role transition can illuminate adequately the complex interplay between the elements, core categories and phases that comprise the community paramedicine transition experience.

This PhD study makes a significant contribution to the understanding of how paramedics transition to a specialist work role in community paramedicine. The unique knowledge generated by this study allows for additional targeted intervention points for paramedics to navigate more efficiently the transition experience. Ultimately, the precision gained in understanding the relationships between the various elements of transition within a conceptual and temporal framework, may decrease the time frame to deploy high-quality, ready-to-work paramedics in the community.

Keywordsambulance; community paramedic; community paramedicine; CP; ECP; EMS; extended care paramedic; low-acuity; pre-hospital; paramedic; paramedicine; qualitative; specialisation; specialist; work role transition
ANZSRC Field of Research 2020320219. Paramedicine
Byline AffiliationsQueensland University of Technology
Journal TitleQueensland University of Technology
Permalink -

https://research.usq.edu.au/item/q5wyv/out-of-the-silo-a-qualitative-study-of-paramedic-transition-to-a-specialist-role-in-community-paramedicine

  • 205
    total views
  • 8
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

Grounded Theory: An Interpretation of Social Reality
Long, David. 2023. "Grounded Theory: An Interpretation of Social Reality." Olaussen, Alexander, Bowles, Kelly-Ann, Lord, Bill and Williams, Brett (ed.) Introducing, Designing and Conducting Research for Paramedics. Australia. Elsevier. pp. 145-148
Factors Influencing Medication Errors in the Prehospital Paramedic Environment: A Mixed Method Systematic Review
Walker, Dennis, Moloney, Clint, SueSee, Brendan, Sharples, Renee, Blackman, Rosanna, Long, David and Hou, Xiang-Yu. 2023. "Factors Influencing Medication Errors in the Prehospital Paramedic Environment: A Mixed Method Systematic Review." Prehospital Emergency Care. 27 (5), pp. 669-686. https://doi.org/10.1080/10903127.2022.2068089
Widening the conversation: Paramedic involvement in interprofessional care
Long, David and Lord, Bill. 2021. "Widening the conversation: Paramedic involvement in interprofessional care ." Progress in Palliative Care. 29 (2), pp. 57-58. https://doi.org/10.1080/09699260.2021.1890976
Paramedic Attitudes and Perceptions About Continuing Professional Development in Australasia
Hobbs, Lisa, Devenish, Scott, Tippett, Vivienne and Long, David. 2020. "Paramedic Attitudes and Perceptions About Continuing Professional Development in Australasia." International Journal of Qualitative Methods. 19, pp. -30. https://doi.org/10.1177/1609406920909934
Factors impacting the decision-making processes of qualified paramedics moving to a specialist role in community paramedicine
Long, David, Devenish, Scott, Tippett, Vivienne and Clark, Michele. 2018. "Factors impacting the decision-making processes of qualified paramedics moving to a specialist role in community paramedicine." 15th International Roundtable on Community Paramedicine 2018. Auckland, New Zealand 06 - 07 Aug 2018
Out of the silo: A qualitative study of paramedic transition to a specialist role in community paramedicine
Long, David, Devenish, Scott and Tippett, Vivienne. 2019. "Out of the silo: A qualitative study of paramedic transition to a specialist role in community paramedicine." 2019 IHBI Inspires Annual Conference. Brisbane, Australia 12 - 13 Aug 2019
What’s in a name? The confusion in nomenclature of low-acuity specialist roles in paramedicine
Long, David N., Clark, M., Lim, D. and Devenish, S.. 2016. "What’s in a name? The confusion in nomenclature of low-acuity specialist roles in paramedicine." Australasian Journal of Paramedicine. 13 (3), pp. 1-3. https://doi.org/10.33151/ajp.13.3.518
Standing out from the crowd: improving employability through peer programs and continuing professional development in undergraduate paramedic programs
Long, David Nicholas and Hobbs, Lisa. 2020. "Standing out from the crowd: improving employability through peer programs and continuing professional development in undergraduate paramedic programs." Australasian Journal of Paramedicine. 17, pp. 1-3. https://doi.org/10.33151/ajp.17.838
Defining the end-point of transition to a specialist role in community paramedicine: is feeling comfortable enough?
Long, David, Devenish, Scott, Tippett, Vivienne and Clark, Michele. 2017. "Defining the end-point of transition to a specialist role in community paramedicine: is feeling comfortable enough?" 2017 Paramedics Australasia International Conference. Melbourne, Australia 23 - 25 Nov 2017 Australia.
The conundrum of defining paramedicine: more than just what paramedics 'do'
Long, David Nicholas, Lea, Jakki and Devenish, Scott. 2018. "The conundrum of defining paramedicine: more than just what paramedics 'do'." Australasian Journal of Paramedicine. 15 (1), pp. 1-2. https://doi.org/10.33151/ajp.15.1.629
Rote learning: the ugly duckling of student paramedic education?
Long, David Nicholas, Hobbs, Lisa and Devenish, Scott. 2018. "Rote learning: the ugly duckling of student paramedic education?" Irish Journal of Paramedicine. 3 (2), pp. 1-3. https://doi.org/10.32378/ijp.v3i2.97
Paramedic delivery of community-based palliative care: An overlooked resource?
Long, David. 2019. "Paramedic delivery of community-based palliative care: An overlooked resource?" Progress in Palliative Care. 27 (6), pp. 289-290. https://doi.org/10.1080/09699260.2019.1672414
Paramedic students working in snow resort medical clinics: a non-traditional interprofessional clinical placement model
Devenish, Anthony Scott, McKay, Glenn, Long, David Nicholas, Horrocks, Peter David and Smith, Michael. 2019. "Paramedic students working in snow resort medical clinics: a non-traditional interprofessional clinical placement model." Irish Journal of Paramedicine. 4 (1), pp. 1-11. https://doi.org/10.32378/ijp.v4i1.101
Investigating career intentions of undergraduate paramedic students studying in Queensland, Australia
Devenish, Scott, Rolley, Adam and Long, David. 2020. "Investigating career intentions of undergraduate paramedic students studying in Queensland, Australia." Australasian Journal of Paramedicine. 17, pp. 1-6. https://doi.org/10.33151/ajp.17.872
Facilitators, barriers and motivators of paramedic continuing professional development
Hobbs, Lisa, Devenish, Scott, Long, David and Tippett, Vivienne. 2021. "Facilitators, barriers and motivators of paramedic continuing professional development." Australasian Journal of Paramedicine. 18, pp. 1-7. https://doi.org/10.33151/ajp.18.857
From qualified to specialist paramedic: A qualitative study of the process of transition to a low-acuity role
Long, David, Clark, Michele, Lim, David and Devenish, Scott. 2015. "From qualified to specialist paramedic: A qualitative study of the process of transition to a low-acuity role." 2015 Paramedics Australasia International Conference. Adelaide, Australia 02 - 03 Oct 2015 https://doi.org/10.13140/RG.2.1.5059.4644
Experiences from Afghanistan: Traumatic lower extremity amputation in the combat zone
Parkes, J., Long, David and Devenish, S.. 2015. "Experiences from Afghanistan: Traumatic lower extremity amputation in the combat zone." 2015 Paramedics Australasia International Conference. Adelaide, Australia 02 - 03 Oct 2015 Australia.
Out-of-hospital administration of corticosteroids to patients with acute asthma: A case study and literature review
Long, David, Bendall, J. and Bower, A.. 2008. "Out-of-hospital administration of corticosteroids to patients with acute asthma: A case study and literature review." Australasian Journal of Paramedicine. 6 (4), pp. 1-11. https://doi.org/10.33151/ajp.6.4.475