A grounded theory study of the preparedness of paramedics to undertake the role of preceptor in the clinical setting

This thesis explores the capability of paramedics to perform the role of preceptor in the Australian statutory ambulance service environment. The educational role and work context of paramedics working with learners, is investigated to establish theory about the nature of their role and how they are best prepared for that role.

During the late 1990’s and early 2000’s the paramedic profession began a change process from a traditional on the job (vocational) educational model to a pre-employment tertiary model of education. This change process is ongoing today with all but one statutory ambulance service fully adopting the tertiary model. The remaining ambulance service operates both the vocational and tertiary educational models concurrently.

This change in educational model brought with it change in the expectations placed on paramedics working with learners. There was an additional change in the workload, as universities began to offer paramedic programs and seek clinical placement opportunities for their students. This, along with the ambulance service based educational programs for transitioning graduates to independence (internships) as well as internally operated promotional courses, resulted in paramedics being required to work with learners more frequently than before. These changes occurred in an organisational, educational and professional environment that lacked clear definition for the role paramedics performed when working with learners. While some research has examined the experiences of learners in the new paramedic educational context this study focusses on the paramedics themselves.

This study used a grounded theory approach to investigate the experiences of paramedics in performing the preceptor role in two Australian states, Tasmania and New South Wales. A series of intensive interviews were conducted between August 2013 and March 2015 to investigate paramedics’ experiences of working with learners.

A major finding was that the role paramedics performed in working with learners lacked definition and clarity, resulting in inconsistent application of preceptorship at all levels of paramedic education. This study found that paramedics were both untrained and unprepared for the preceptor role which was perceived as being thrust upon them without choice and, in most cases, consultation.

This research established the theoretical construct of the paramedic preceptor, which is expected to vastly improve the experiences of paramedics with flow on effects to the paramedic education system as a whole. Furthermore, this research has identified five key recommendations for the paramedic profession. First that the language used by the profession be standardised through the use of the term preceptor; second that the role of the paramedic preceptor be clearly defined to encompass the unique needs of the profession; third that a set of criteria be developed to aid in the selection of preceptors and that a selection process be applied to occupants of that role; fourth, that an initial training program be developed in partnership between the profession and the universities for paramedic preceptors, along with continuing professional development opportunities; and finally, fifth, that employers and universities establish clear communication and support mechanisms to aid paramedics in performing the role of preceptor.