Paramedics provide emergency service in physically hazardous and socially complex situations. These work settings present unique challenges in terms of managing resources and relationships in a multicrisis context, in order to enable the delivery of emergency patient care. Using data obtained from interviewing paramedics, this study demonstrates the usefulness of symbolic interaction theory for context analysis, by analyzing an important aspect of paramedic practice: scene management. Through grounded theory methodology, this study also presents the first interactionism‐based theory of how paramedics manage emergency scenes. This theory emphasizes the critical role of social processes in establishing social control in work spaces.
This study introduces the first formal theory of paramedic scene management and suggests that recognition of this aspect of practice will improve both pre- and in-service educational programming and assist with medical quality assurance.
Introduction:In Ontario, Canada, Emergency Medical Care Assistants (EMCAs) have many opportunities for continuing education. However, little is known about how EMCAs learn.Objectives:The intent of this study was to explore the distribution of learning styles, preferences for major learning environment characteristics, and the associations between these two factors among the EMCA population in Ontario, Canada.Methods:Following review of the literature, a 32-item survey of learning environment characteristics was constructed to measure the respondents' preferences. Using a random number generator, 386 EMCAs were selected for participation. Each received: a) an explanatory cover letter; b) a copy of the Kolb Learning Style Inventory (LSI) questionnaire; c) a second questionnaire consisting of learning environment characteristics; and d) a stamped, return addressed envelope. Completed surveys were scored to determine the respondent's Learning Style. The LSI and Learning Environment survey results were entered into a data base and subjected to Dual Scaling analysis in order to 1) Identify the distribution of learning styles; and 2) Explore associations between styles and environmental characteristics.Results:A total of 75 completed surveys were returned, each of the four styles of learning (Converger; Diverger; Assimilator; and Accommodator) were identified in the sample. Dual Scaling analysis indicated a noteworthy association (R(jt) correlation >0.300) between learning style and 10 of the 32 environmental characteristics. The data describe the usefulness of each of the learning styles.Accommodators believed courses with a strong emphasis on practical applications and working in groups to be very useful, but were less interested in courses with a strong emphasis on theory. Assimilators felt lectures and courses with a strong emphasis on theory very useful, but were less interested in providing input into course objectives. Divergers found that a lot of verbal explanation is useful, but were less interested in working with teachers who act as coaches. Convergers believed that working with teachers who act as coaches is useful. They also preferred courses with a strong emphasis on practical applications, but were less interested in courses with a strong emphasis on theory.Conclusion:The findings in this study, provide some additional insight into the connections between learning style and elements of the learning environment, and their application may contribute to operationalizing learning theory.
Scene-management is an important, yet under-researched aspect of paramedic practice. Using a grounded theory methodology, this qualitative inquiry acquired data from in-depth interviews with paramedics working in rural, suburban, and urban settings in Ontario, Canada. The findings comprise a theory of how expert paramedics accomplish the very difficult task of managing emergency scenes, which is a crucial pre- and co-requisite for the provision of patient care. This theory introduces a new term, the ‘paramedic kairotope’ as a conceptualization of this expertise, comprised of knowing when and where to act in a field/clinical situation. The theory further describes this competency as being informed by two social processes: substantial use of interpersonal communication and innovative problem solving.
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