Educating Paramedics For The Future, A Holistic Approach

EDUCATING PARAMEDICS FOR THE FUTURE: A HOLISTIC APPROACH
Author(s): PETER F. O'MEARA, SUSAN FURNESS and RAY GLEESON

Source: Journal of Health and Human Services Administration , FALL 2017, Vol. 40, No.
2 (FALL 2017), pp. 219-253
Published by: SPAEF
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EDUCATING PARAMEDICS FOR THE FUTURE: A
HOLISTIC APPROACH
PETER F. O'MEARA
SUSAN FURNESS
RAY GLEESON
La Trobe Rural Health School
ABSTRACT
The education and training of paramedics largely rema

focused on an emergency medicine dominated curricula with lim
attempts made to expand paramedic education to include primary
and public health topics that might better address the contempor
needs of practicing paramedics. In developed countries, param
roles and scopes of practice are changing in response to agin
populations and the attendant prevalence of chronic conditi
advances in technology, changes in community expectations
broader health system challenges. The emergence of parame
practitioner roles in a number of countries illustrates the impact of
social, technological and economic factors, and how paramedic
being integrated into the health systems of their respective countri
Countries such as the United Kingdom, Australia and N
Zealand, have moved toward near-mandatory higher education mo
for paramedics. While three-year Baccalaureate degrees gener
provide the scope and flexibility to introduce a wider range of st
in primary care and public health, they face the challenge of add
these topics to an already crowded curriculum. In countries with
widespread access to Baccalaureate degrees in paramedicine t
challenge of broadening the education of paramedics would appea
be near impossible within the constraints of relatively short entry
programs.
This paper describes how an Australian university is
responding to this challenge through the development of a four-year
Bachelor of Paramedic Practice with (Clinical) Honours program. The
paramedic program was initially encompassed within a suite of allied
health courses in 2009 and provided students with the qualification of
Bachelor of Health Science / Master of Paramedic Practice. Shortly
after its inception, the course was reviewed against the future needs of

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220 JHHSA FALL 2017
students, industry and the co

educational requirements of f
critically examined in Australia
reviews, conference attendances,
overseas visits. As a result, the pr
review, a new four-year param
commencing students in 2018.
The structure of the program
students to gain skills and kn
traditional paramedicine progr
primary health care and exten
components of the program will
within communities and profess
calls for a holistic model of educ
demands.

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JHHSA FALL 2017 221
BACKGROUND
It has been long argued that the role of the

paramedic is located at the intersection of emergenc
medicine, public safety, and public health domains (U
National Highway Traffic Safety Administration 199
National Association of EMS Educators 2000). A numb
of emergency medical service (EMS) researchers have
advocated for an expanded-scope EMS system that pla
an emphasis on paramedic contributions to public hea
activities in prevention, public education and public safe
(Spaite et al. 1997; Delbridge et al. 1998).
Because of their experience working with patients
in homes and communities, appropriately educate
paramedics are uniquely positioned to meet public hea
needs now that the value of home-based care, the soc
determinants of health and community-based care are mo
widely recognized. This field-based care has the poten
to avoid unnecessary ambulance transports, emergen
department visits, hospitalizations and readmissio
(Munjal and Dunford 2016).
While this discussion has been more prominent i
the United States than in other comparable countr
(Martinez 1998; Paramedic Health Solutions 2016),
concept of re-incorporating public health responsibili
into paramedic roles has been broadly accepted among
providers, educators and researchers (O' Meara, Ruest, an
Stirling 2014; Jensen et al. 2011). Similar arguments hav
been made in the United Kingdom, where Ambula
Service NHS Trusts have been included within the overall
emergency health care services that are made up of pre-
hospital and hospital services, social and community
services, access and communication facilities together with
other areas such as rehabilitation, prevention and regulation
(Turner et al. 2000).

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222 JHHSA FALL 2017
While communities and

dual expectation of a rapid
care in the pre-hospital env
is an evolving set of expect
capacity of Emergency M
provide acute-care triage
primary care, increased par
prevention activities, and li
emergencies (National Ru
Similar aspirations to includ
health care activities are
competency frameworks
Professions Council 2007; Council of Ambulance
Authorities 2010; Paramedic Association of Canada 201 1).
The degree to which this vision has been honoured
in reality is debated in many parts of the world (O'Meara,
Ruest, and Stirling 2014). For a number of practical and
financial reasons, the education and training of paramedics
has tended to concentrate on emergency medicine
competencies and to a lesser degree public safety at the
expense of a broader and more holistic curriculum (Jensen
et al. 2011; Jensen et al. 2012; Lendrum, Wilson, and
Cooke 2000). This is particularly the case when
considering the public health components of the paramedic
role. Few paramedicine programs, whether they are located
in the vocational, college or university sectors, include
strong public and community health content in their
curricula (Hou, Rego, and Service 2013; Willis et al. 2010;
Lazarsfeld-Jensen and O'Meara 2013).
In response to this need for a broader paramedicine
education program, the School of Rural Health at La Trobe
University in Australia developed a paramedic program
within a suite of Allied Health courses in 2009 that
combined generic health sciences (bioscience and public
health subjects) and discipline-specific studies. Toward the
end of this initial program a review was undertaken to

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JHHSA FALL 2017 223
ensure that the future needs

community were being met
the context of regulatory ch
sector in Australia and th
paramedic roles, including e
paramedicine (Ball 2005; B
Pearson, and Walker 2009; O
The South Australian Ambulance Service defines
extended care paramedics (ECPs) as "... highly skilled
clinicians who work collaboratively with other health care
professionals to manage and treat people in their usual
residence." (South Australian Ambulance Service 2008)
While in the U.S., community paramedicine (CP) has been
described as "... a new and evolving model of community-
based health care in which paramedics function outside
their customary emergency response and transport roles in
ways that facilitate more appropriate use of emergency care
resources and/or enhance access to primary care for
medically underserved populations (Kizer, Shore, and
Moulin 2013).
While one of the major catalysts for the review of
the La Trobe University paramedicine program included
changes to the Australian higher education regulatory and
funding frameworks, the review allowed a critical
examination of the current and future needs for a flexible
and adaptive workforce. We asked whether the existing
paramedicine program would prepare graduates to
successfully undertake these emerging professional roles
(O'Meara, Ruest, and Stirling 2014), while continuing to
meet the Australian and New Zealand competencies for
entry-level paramedics (Council of Ambulance Authorities
2010). A further consideration was to identify a curriculum
that would produce graduates who were adaptable enough
to undertake paramedic work in other countries, or in non-
traditional settings such as hospitals, physician clinics,
industrial settings, or undertake humanitarian missions.

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224 JHHSA FALL 2017
This paper describes how one university

paramedicine program is responding to these challenges
using a four-step conceptual framework adapted from
implementation science. During this process of curricula
review, we confirmed that paramedic roles and scopes of
practice are changing in response to changing
demographics and health system reform, while at the same
time education programs are required to satisfy existing
program accreditation requirements that strongly focus on
the emergency response roles of paramedics.
APPROACH TO CURRICULUM RENEWAL
A four-step approach, informed by the

multidisciplinary Promoting Action on Research
Implementation in Health Sciences (PARiHS) Framework,
was used to address the complexity of developing and
implementing an evidence based paramedicine curriculum
(Kitson et al. 2008; Stetler et al. 201 1; Helfrich et al. 2010).
This conceptual framework considers how the three
elements of evidence, context and facilitation influence the
successful implementation of evidence-based practices
(Stetler et al. 2011). Practice trends and the educational
needs of future entry-level paramedics were critically
examined and addressed through a four-step process
consisting of: (1) Collection of relevant evidence; (2)
Review and analysis of data; (3) Curriculum development;
and (4) Implementation.
Step 1 Collection of Relevant Evidence

In order to determine the state of the evidence on
emerging paramedicine practice and education a review of
the literature was undertaken. Database searches were
performed during November 2013, with SCOPUS, Ovid
Medline and CINAHL all producing papers of relevance.
Other papers were found through citation searches and the

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JHHSA FALL 2017 225
knowledge of the review te

for relevant literature was
search for systematic review
articles on the topic was co
the following key words in
'education' and 'public healt
'ambulance', 'EMS', 'EMT
paramedic' were explored
Selected articles were critic
extract key findings or
paramedicine and public hea
journals, commentaries or e
were included in this review to ensure an international
perspective. In particular, there was a recognition that there
are few peer-reviewed paramedicine journals in North
America. Non-English-language literature and material
unavailable in full text were excluded from this review.
Step 2 Review and Analysis of Data

Building on the literature review, the authors
opportunistically visited other educational institutions and
paramedic providers in Australia and Canada, and attended
paramedicine related conferences in Australia, Canada and
the United Kingdom to investigate service delivery and
paramedicine educational innovations. During these visits,
we were particularly interested to see if programs were
incorporating new knowledge and competencies that would
address changes in community needs and emerging
paramedic scopes of practice. In August 2013, the
paramedicine academic team met together and
brainstormed suggestions to better match the La Trobe
University paramedicine program to the identified needs of
students, industry and the community.

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226 JHHSA FALL 2017
Step 3 Curriculum Deve

While the content of the
subjects were important
university approval process
assurance requirements. Con
profession was undertak
Course Advisory Committ
stakeholders, while also ac
needed to receive appropr
1).
Table 1
Australian & New Zealand Paramedic Course
Accreditation
• Partnersh
and Paramedics Australasia.
• Intended to ensure that the workforce skills and
competencies required to meet health care needs are
properly reflected in paramedic education programs.
• Considers all university entry-level paramedic programs.
• Not about standardisation of paramedic education
programs.
• 2 1 entry-level programs are currently accredited.
Step 4
We are
and in
transf
program
intern
program
CURRICULUM REVIEW AND IMPLEMENTATION
In this section, we report on the emerging changes

in paramedic scopes of practice related to public hea

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JHHSA FALL 2017 227
(excluding disasters and b

arguments for curricula re
paramedicine curricula, the
renewing our curriculum a
satisfy university quality s
Zealand paramedic program
Step 1 - Collection of R
The literature search pr
to paramedicine and publ
discussion and debate on th
scopes of practice to includ
responses to disasters a
secondly, the identification
education and efforts to in
baccalaureate paramedic
Zealand and the United Kin
theme was emergency p
disasters and bio-terrorism
from further consideratio
field of emergency medi
included in post-gradua
paramedics and other healt
1. Extended scopes of p
Extended scopes of pra
role of paramedics have b
States since the late 20th c
both refereed and non-r
non-refereed opinion pap
EMS providers, including
to include a wide range
promotion activities (Ta
Taigman 2008; Brown an
2008). A series of papers
generated considerable feed

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228 JHHSA FALL 2017
from excitement, to cynic

should stick to its traditional business. Brown and Devine
(Brown and Devine 2008) discuss potential paramedic roles
within public health, specifically in health promotion, using
a hypothetical example of aging, to demonstrate the
opportunities, identify the barriers to be overcome and
suggest possible solutions to those barriers. Trevino and
colleagues reported on a pilot EMS/Public Health initiative
that was designed to help identify and control hypertension
and diabetes (Trevino et al. 2008).
Two related refereed papers from the U.S. argued
for a cautious move toward an expanded scope of practice
that could include the adoption of some public health roles
for paramedics (Bissell et al. 1999a; Bisseil et al. 1999b).
In the Australian and New Zealand context, these papers
were of limited relevance as they are tied to the concept of
paramedics as physician extenders in contrast to health
practitioners who are capable of setting their own
professional standards and determining their own scopes of
practice through clinical governance and professional self-
regulation (Colbeck 2014; Hodge 2014; Fitzgerald 2014).
The Australian and New Zealand Paramedic Course
Accreditation requirements explicitly state that:
Paramedics are independent practitioners

working, to their specified level of competence,
with patients of all ages, with individuals and in
groups, and are essential members of
interdisciplinary and inter-agency teams. (Council
of Ambulance Authorities 2014)
Another three U.S. papers suggested that

paramedics and other EMS providers could take a more
proactive role in primary injury prevention within their own
workforce and the general community (Garrison et al.
1997; Jasiów, Ufberg, and Marsh 2003; Thoma and Vaca

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JHHSA FALL 2017 229
2004). In Canada, Campbe

Rasmussen 2012) publish
describes those grey are
developed as they take on
original training. More r
have conducted a pragma
trial to evaluate an expan
housing program, inclu
promotion and prevention
Table 2
Expanded Public Health Roles for Paramedics
Relevant Papers Study J Type SumDmary Recommendations of Fi"d'nSs and
Garri
(U.S.) consensus on organizations should be the creation
essential and and maintenance of a culture of health
desirable EMS promotion and safety in their
primary injury communities.
prevention
Bissel
(U.S.) study of a extension of paramedic scopes of
population's practice. Discussed some of the
'emergency' education and training challenges
needs. involved to ensure consistently safe
decisions. Highly reliant on medical
Bissel
(U.S.) study of patients allow properly trained medics to alter
seen in some of their role as physician
two emergency extenders. Cautious support for
departments over extended roles and a call for evidence,
a six-month
Jasl
Marsh 2003 determine EMS primary injury prevention should be a
(U.S.) provider attitudes routine part of practice. However,
toward primary many paramedics had not received
injury prevention. any relevant education, and few
paramedics incorporate it into their

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230 JHHSA FALL 2017
Table 2, continued
Thoma & Vaca Commentary Discussion of an educational
2004 document designed to introduce out-
(U.S.) of-hospital personnel to the concept
of integrating primary and personal
injury prevention, models of
professionalism, data collection, and
injury prevention coalition building
Taigman 2006 Non-refereed This is the first of a series of six

(U.S.) opinion article(s) papers promoting the idea of EMS
providers serving in a public health
capacity, assisting with injury
prevention, and disease management
and education in addition to providing
Brown
2008 opinion article EMS systems within public health,
(U.S.)
Liebowitz, S. and N
Taigman, M 2008 D
(U.S.) facilitated illness prevention and
chronic disease management. It is an
example of emergency medicine-
based health promotion actively
blending EMS with chronic disease
management, health promotion and
Trevin
(U.S) Descriptive study initiative that was designed to help
identify and control two major public
health problems: hypertension and
diabetes. The results of the pilot study
supported the notion that EMS
responders have the ability to
contribute to chronic disease public
Campbell & Ethnographic Highlights the paramedics' role and

Rasmussen 2012 Study how they view this and the grey areas
(Canada) that have developed as a result of
taking on tasks outside the area of
Agarwal et al 201 5 Pragmatic This study aims to evaluate a new

(Canada) clustered model of healthcare that has been
randomised designed to better use the skills and
control trial training of paramedics to deliver a
health assessment, prevention

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JHHSA FALL 2017 231
2. Educational Gaps and Initiatives

The literature shifts from the U.S. narrative on
scopes of practice to the U.K. and Australia where
paramedicine education has largely transitioned from
vocational training to university-based education. While
educators in the U.S. have discussed the concept of
broadening paramedicine education to match suggestions
for broader scopes of practice, little change is evident in the
literature (Brown and Fowler 1999; Smith, Walz, and
Smith 1999). For example, one study identified that the
National Standard Curriculum for the training of both
paramedics and EMTs (Emergency Medical Technicians)
only briefly addresses dying patients and advance
directives (Waldrop et al. 2014). In another U.S. study, the
need for health professionals to better understand public
health was highlighted (Maeshiro et al. 2011). However,
paramedics were not included as study participants, perhaps
highlighting the relative lack of integration between EMS
and the broader health system in the U.S. (Institute of
Medicine of the National Academies 2006).
In contrast, U.K. and Australian educators have
embarked on a wider discussion of how paramedic
university curricula could be broadened to include public
health and health promotion topics (Table 3). In the U.K.,
Cooper (Cooper 2005) and Kilner (Kilner 2004) make the
case for changes in paramedicine curricula, including the
need to address the aging population, growing demand, and
the transition of paramedicine to an autonomous health
profession. The Australian papers largely discuss the
opportunities that are feasible following the transition to
baccalaureate and postgraduate paramedicine programs in
universities. Like the U.K. papers, they consider
demographic changes and professional transition issues
(Joyce et al. 2009). They specifically identify short-
comings in the traditional paramedicine curricula, such as
limited education related to health promotion, death and

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232 JHHSA FALL 2017
dying (Willis et al. 2010;

social determinants of he
health (O'Brien et al. 2013
(Hou, Rego, and Service
delivery of culturally app
and Service 2013). Since thi
short-comings have been id
the implementation of com
that require a strong under
social determinants of heal
2014). The same conclusion
where many of these top
Curriculum and Career Path
(Paramedic Health Solutio

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JHHSA FALL 2017 233
Table 3
Gaps in traditional paramedicine curriculum
Relevant Study Type Summary of Findings and Recommendations
Papers
Smith
and Smith 1999 education in emergency medicine, paramedicine and other
(U.S.) emergency personnel programs who communicate with the
Brown and Non-refere

Fowler 1999 Surveys to
(U.S.) administrators additional emphasis in new programs. These topics were
Kilner 2004 Delphi study Makes a c

(U.K.) better align to consumer led health services and to reflect
the broader professional base seen in programs associated
Cooper 2005 Qual

(U.K.) naturalist s
Joyce et
2009 Editor developments in education, training and career pathways.
(Australia) Linked changes in demand for ambulance services to the
Reeve et al Qualitative st
2008 Interviews of hea
(Australia) paramedics
Willis et al Qualitative study Austra

2010 of paramedic theoretical base in the supporting disciplines, for example
(Australia) graduates' psychological theory on grief, and the impact of social
preparedness to determinants of health on call-out patterns. More overt
practice integration between clinical skills, clinical evidence and the
supporting sciences would facilitate the transition from
Maeshiro et al Sur
201 1 professions responsibilities are in clinical, one-on-one encounters to
(U.S.) better understand and apply prevention and public health
knowledge and skills. Paramedics not specifically
Hou, R
Service 2013 programs, including generic academic skills, mental health,
(Australia) paediatrics with special needs, delivery of culturally
O'Brien et al Survey
2013 year varied clinical placements, future paramedicine curricula
(Australia) paramedicine need more education in mental health, delivery of culturally
students at one appropriate healthcare, dealing with emergency situations
university involving special needs children, contending with death and
Wald
2014 survey of between prehospital and end of life care through improved
(U.S.) paramedics and education and protocols for care in the field.

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234 JHHSA FALL 2017
Step 2 - Review and Analy

The review of the liter
brainstorming activities co
educational curriculum and associated field/clinical
experiences for paramedicine students that would better
equip them for emerging paramedic roles within traditional
ambulance services and other settings, such as the Defence
Forces, remote industrial sites, and overseas humanitarian
missions.
The immediate employment prospects of our
graduates concerned us, as we observed that they were
increasingly competing in a tightening local employment
market, while at the same time being offered the
opportunity to participate in a growing international market
where their skills are highly regarded (Devenish et al.
2015). Our review and iterative analysis (Srivastava and
Hopwood 2009) of the evidence confirmed the view that
paramedic practice was changing globally, especially in the
developed world, in response to aging populations,
emerging technological innovations and broad health
system reform in response to workforce imbalances, and
rising health care costs.
These practice changes are well illustrated in the
emergence of practitioner paramedic models in the U.K.
(Armstrong, Akroyd, and Burke 2012), and extended care
paramedics (ECPs) and community paramedics in parts of
Australia, the U.S. and Canada (Swain, Hoyle, and Long
2010; O'Meara 2003; Ludwig 2012; Nolan 2011; O'Meara
et al. 2016). Locally, in Australia and New Zealand, we
needed to consider the anticipated impact of national
professional registration and self-regulation of paramedics
as health professionals on future practice and education
needs (Eburn and Bendall 2010). In the U.K., aspiring
paramedics are already required to undertake approved
university courses and register with the Health and Care
Professions Council (HCPC) (Devenish et al. 2015). This

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JHHSA FALL 2017 235
has had significant implicat

and professional standards
Table 4
Paramedic Professional Registration in the U.K.
• To practice as a paramedic you must be

Health and Care Professions Council.
• You can only call yourself a paramedic if you are registered.
• National standards are set for education and training, health,
technical proficiency and professional behaviour, (www.hcpc-
Fro
fut
part
fut
inno
care
alre
com
mit
eme
dise
dete
The
nee
par
and
edu
curr
acute illnesses, comorbidities and chronic illness
management, with an overarching objective of producing
critical thinking clinicians who are able to assess and
manage patients with a diverse range of health problems.
We sought to balance a vision for the future with the
practical constraints of the university sector and the
paramedic industry, as well as ensuring the acceptability of

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236 JHHSA FALL 2017
curriculum changes to curr

and relevant professional
was to convince the cou
understand and accept that
future-orientated progr
accepted paramedic compet
Because the university h
year curriculum model for
allied health programs, it w
paramedicine program that
competencies, professiona
elements of primary care,
for paramedic roles that ar
of Medicine of the Nation
that paramedic scopes o
practicing paramedics e
incorporating public healt
into their practice, while
incorporate relevant curric
ever-expanding range of
topics. It is likely that
baccalaureate programs wil
into increasingly cluttered
offering relatively short
probably find achieving th
Step 3 - Curriculum De
The aim of the curricu
respond to the emergen
practice in paramedicin
demographic change, te
research evidence. This thi
more visible links across
safety and public health
necessitated a move bey
model with its emphas

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JHHSA FALL 2017 237
competence, toward a prac

predicated on a broader
problem solving and decis
flexibility (Colbeck 2014; W
The resulting four-yea
practice and extended comm
to provide students with
commence practice as entr
Australia and New Zealand,
roles in extended commun
paramedic services or oth
structure of the program pr
to gain skills and knowle
offered to paramedicine stu
The addition of public
associated development
extended community pa
student horizons and pr
disciplinary, integrated pra
opens up the potential for
public health arena, incl
(Markenson, DiMaggio, and Redlener 2005). The
professional practice consolidation subject will help
students make the transition from undergraduate to
graduate paramedicine through reflection on and
consolidation of knowledge, skills and attributes essential
for safe and professional paramedic practice. The extended
care and community paramedicine graduate subjects
include the development of skills normally beyond
paramedic scopes of practice and includes clinical
placements at a family physician clinic and field
placements with a community paramedic.

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238 JHHSA FALL 2017
Table 5
Paramedicine/Extended Community Paramedicine
Program - 2018
Semester 1 Semester 2
Year 1 Introduction to Biosciences A Introduction to Biosciences B
Foundational Introduction to Professional Practice Research and Evidence in
Studies Practice
Individual Determinants of Health Social Determinants of Health &
Well-being
Selective subject Foundations of Paramedic
Year
Introduction to * §
Paramedicine Communications Skills in
# #
Integratin
Year 3 Paramedic Cardiac & Respiratory § Integrated Cardiac & Respiratory

Paramedic §
Capabilities Paramedic M
*
Complex Trauma Management § * Gerontology & Special Needs §
Year 4 Advanced Mental Health Practice 2 § Death, Dying & Grief#

Paramedic * Extended Care Paramedicine § * Major Incident Management §
Professional Community Care Paramedicine § * Advanced Clinical Management §
Practice Obstetrics for Paramedics § * Professional Practice
* Includ
Parame
In th
regio
found
public
found
year.
progr
skills
(Coun
Austr
servi
placem
comp

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JHHSA FALL 2017 239
Graduate Certificate in Extended Community

Paramedicine. This broad range of professional placements,
including overseas opportunities, is consistent with the
paramedicine education literature (O'Brien et al. 2013;
Hou, Rego, and Service 2013). The curriculum provides
opportunities to engage and interact with other health care
and emergency service disciplines, while the extended and
community paramedicine components of the program
prepare students for enhanced and flexible roles within
communities and across a wider range of professional
settings.
A crucial component of the curriculum development
process was consultation with relevant stakeholders to
ensure a clear passage through the university approval
processes and ultimately to satisfy the requirements for
paramedic course accreditation in Australia and New
Zealand (Council of Ambulance Authorities 2014). We
consulted with the public health promotion program staff,
identified additional resourcing requirements and
negotiated complex rules and tight timelines for formal
university approval. The views and interests of industry and
professional partners, including non-traditional employers
of graduates were considered through the Paramedicine
Course Advisory Committee and other professional
networks.
Step 4 - Implementation
Submissions to the Paramedicine Course Advisory
Committee and the University Academic Committee will
see the previous paramedicine program modified and re-
structured into a four-year program incorporating the
knowledge, skills and attitudes required for current and
future paramedic practice. The Bachelor of Paramedic
Practice with Honours will be available in 2018. A stand-
alone Graduate Certificate in Extended Community
Paramedicine, which draws subjects from the

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240 JHHSA FALL 2017
undergraduate program, wi
offer the opportunity to ar
Health. The interim doub
three-year provisional accr
Council of Ambulance Auth
and full accreditation for
sought during 2017.
The implementation s
continuing and providing op
skills and knowledge beyon
paramedicine programs, in
primary health care, an
paramedicine. These compon
enhanced and flexible roles
a holistic model of educatio
demands. These changes
strengths of the current pr
paramedic program that of
and small class sizes, str
professional linkages, an
extended care topics as th
innovations are designed to enhance graduate
employability, resilience and job readiness.
Sustainability and continuing refinement of the
program will be addressed through continuing quality
improvement activities, maintaining program accreditation
requirements, along with journal articles and conference
presentations following implementation and future
evaluations. Success will be measured in terms of the
employability of the graduates, student satisfaction,
innovation uptake in other educational institutions,
perspectives of patients, employers and funders of the
health system on the innovation, and consideration of
financial implications for the university, the community
and students. Much of this data is already collected through

35.178.184.168 on Sat, 02 Oct 2021 06:06:53 UTC
JHHSA FALL 2017 241
existing graduate outcom

through the Paramedicine C
PARAMEDICINE EDUCATION LESSONS
The La Trobe University four-year paramedi

program is a unique and competitive paramedi
qualification that provides a contemporary mix of sk
knowledge and inter-professional linkages that address
future roles of paramedics in diverse communiti
(O'Meara, Ruest, and Stirling 2014). The program
continue to prepare graduates who can successfu
undertake emerging professional roles, such as commun
paramedics or remote area paramedics. Graduates
obtain a qualification that incorporates topics in extend
and community paramedicine that will broaden and enr
their career options as they move through their workin
life. The program aligns with international trends towar
more holistic approach to the education and training
paramedics that is evident in the North Central E
Institute community paramedicine curriculum and
Paramedic Health Solutions National Curriculum and
Career Pathway that have been developed in the United
States and have become de facto benchmarks for the
education of community paramedics (Garza 2008; Kizer,
Shore, and Moulin 2013; North Central EMS Institute
2012; Paramedic Health Solutions 2016).
We found that the use of the PARiHS conceptual
framework was a useful tool to help facilitate and manage
paramedicine curriculum renewal, however it is clear that it
needs to be combined with a coherent vision for the future
of paramedicine and the health workforce in general. This
use of implementation science to review and refresh a
health science curriculum provided structure and clarity to
the curriculum renewal process and could be usefully

35.178.184.168 on Sat, 02 Oct 2021 06:06:53 UTC
242 JHHSA FALL 2017
applied to reviews of other

grapple with similar demog
Our experience illustr
incorporate public health
paramedicine topics into a
within a four-year stru
professional standards in pa
aging populations, growin
technological innovations a
it is likely that we will see
programs emerging to m
consideration needs to be
requirements of regulatory
while remaining aware of
personal competencies that
provide to graduates beyond
Other university-leve
considering the developm
innovative curricula need to consider the broad societal and
health system trends that will influence future paramedic
scopes of practice. They need to be mindful of the interests
and perspectives of other parties such as potential
employers, labor unions and professional bodies that may
sometimes be more concerned with short-term workforce
planning issues than bold visions for the future of
paramedicine.

35.178.184.168 on Sat, 02 Oct 2021 06:06:53 UTC
JHHSA FALL 2017 243
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Educating Paramedics For The Future, A Holistic Approach

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EDUCATING PARAMEDICS FOR THE FUTURE: A HOLISTIC APPROACH

Author(s): PETER F. O'MEARA, SUSAN FURNESS and RAY GLEESON

Stable URL: https://www.jstor.org/stable/44631860

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The education and training of paramedics largely rema

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students, industry and the co

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It has been long argued that the role of the

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While communities and

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ensure that the future needs

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This paper describes how one university

APPROACH TO CURRICULUM RENEWAL

A four-step approach, informed by the

Step 1 Collection of Relevant Evidence

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knowledge of the review te

Step 2 Review and Analysis of Data

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Step 3 Curriculum Deve

• 2 1 entry-level programs are currently accredited.

CURRICULUM REVIEW AND IMPLEMENTATION

In this section, we report on the emerging changes

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(excluding disasters and b

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from excitement, to cynic

Paramedics are independent practitioners

Another three U.S. papers suggested that

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2004). In Canada, Campbe

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Taigman 2006 Non-refereed This is the first of a series of six

Campbell & Ethnographic Highlights the paramedics' role and

Agarwal et al 201 5 Pragmatic This study aims to evaluate a new

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2. Educational Gaps and Initiatives

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dying (Willis et al. 2010;

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Brown and Non-refere

Kilner 2004 Delphi study Makes a c

Cooper 2005 Qual

Willis et al Qualitative study Austra

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Step 2 - Review and Analy

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has had significant implicat

• To practice as a paramedic you must be

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curriculum changes to curr

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competence, toward a prac

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Year 3 Paramedic Cardiac & Respiratory § Integrated Cardiac & Respiratory

Complex Trauma Management § * Gerontology & Special Needs §

Year 4 Advanced Mental Health Practice 2 § Death, Dying & Grief#

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Graduate Certificate in Extended Community

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