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A comparison of the practice of rural and urban paramedics: Bridging the gap between education, training and practice


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Mulholland, P 2010 , 'A comparison of the practice of rural and urban paramedics: Bridging the gap between education, training and practice', Research Master thesis, University of Tasmania.

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This thesis compares rural and urban paramedic practice within two states in
Australia to establish whether rural paramedics have distinct roles
necessitating specifically directed education and training. Other Australian
health professions specialize in rural practice, with education and training to
suit however there have been few studies comparing the roles of rural
paramedics with urban paramedics in Australia. The topic is particularly
significant given suggestions of a mismatch between paramedic education,
training, and practice. This study contributes to the foundations needed to
establish relevant education and training for rural paramedics in Australia by
providing a comparison of rural and urban paramedic practice.
A comparative case study strategy was used, and multiple sources of data
were collected. These included semi-structured interviews with intensive care
paramedics across two states in Australia; an audit of case dispatch data;
review of documentation, including job descriptions, ambulance service and
union websites, archival information, local media, and universities; and
observation of paramedics within their local environment looking at key
processes and events. The use of multiple data sources allowed triangulation
of data with consequent reduction of research bias. The major finding of this study was the presence of clear differences between
rural and urban paramedic practice. Rural paramedics:
1. practice a community response rather than a case dispatch response,
2. are multidisciplinary team members rather than solely ambulance team
3. are educators and managers of volunteers rather than clinical supervisors
4. are isolated health workers rather than having access to full resources.
Two main similarities were noted, and these were a strong concern for
progress in continuing professional development, and dispatch of similar
types of cases in both rural and urban areas.
The comparison of results suggests that there is a need in Australia for
paramedic education and training with specific rural components. Rural
clinical placements, along with community based and multidisciplinary
components could form an integral part of this education and training process.
Future directions for continuing professional development require input from
paramedics themselves. Further research concerning the three tiers of
undergraduate education, postgraduate education, and continuing professional
development will ensure education and training for the rural paramedic in
Australia avoids the risk of a mismatch between training, education and

Item Type: Thesis - Research Master
Authors/Creators:Mulholland, P
Keywords: paramedics, rural, urban, education, training, practice comparison
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