Paramedic involvement in health education within metropolitan, rural and remote Australia: a narrative review of the literature

Abstract

Objective A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expanded-scope paramedics, health promotion and the role of paramedics as key members of local communities. There were no studies specifically related to the paramedic role in health education, although many papers referred to health education as one of many roles paramedics engage in today. Conclusion This review highlights a broadening of paramedicine’s traditional scope of practice, and an indication of how vital paramedics could be to local communities, particularly in rural and remote areas. An expanded role may help address health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers. What is known about the topic? A broadening of paramedicine’s traditional scope of practice has been linked to improvements in health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers, such as rural and remote Australia. Health education, as well as health promotion, primary health care and chronic disease management, have been proposed as potential activities that paramedics could be well placed to participate in, contributing to the health and well-being of local communities. What does this paper add? This paper identifies and synthesises literature focusing on paramedic-initiated health education in the Australian context, assessing the current health education role of paramedics in metropolitan, rural and remote areas. It provides an understanding of different geographical areas that may benefit from expanded-scope prehospital practice, indicating that the involvement of paramedics in health education in Australia is significantly determined by their geographical place of work, reflecting the influence of the availability of healthcare resources on individual communities. What are the implications for practitioners? Today’s paramedics fill broader roles than those encompassed within traditional models of prehospital care. Rural and remote communities facing increasing difficulty in obtaining health service provision appear to benefit strongly from the presence of expanded-scope paramedics trained in health promotion, primary injury prevention, chronic disease management and health education: this should be a consideration for medical and allied health practitioners in these areas. Australian paramedics are uniquely placed to ‘fill the gaps’ left by shortages of healthcare professionals in rural and remote areas of the country.

Motivations and Career Decisions in Occupational Therapy Course: A Qualitative Inquiry of Asia-Pacific International Students in Australia

“…This is due to the increasing illness rates, a larger patient population, the stress of dealing with difficult patients, and professionals ageing out of the workforce. [16][17][18] However, secondary school graduates and professionals choosing a second career continue to follow more popular professional routes such as nursing, physical therapy, and public health. 19,20 Although members of the general public need additional time to understand each health discipline's background and operation, the Australian government has continued to establish schemes to alleviate the human resources shortages in the health and social care system.…”

“…Universities followed these recommendations and expanded their academic departments and programs. 18 The Bradley Review 12,22 further indicated that overall enrolment at Australian universities would increase significantly due to developments such as improved quality of education and the growing international student population. In the 2020/2021 academic year, according to the Australian Health Practitioner Regulation Agency, 23 universities with more than 60 academic programs in most Australian states (except for Tasmania and the Northern Territory) offered degree programs for bachelor's, master's, and master's (graduate entry) degrees.…”

“…As increasing numbers of people gradually move to rural areas, the demands placed upon health and social care professionals will dramatically increase. 18,[24][25][26][27] Different agencies and departments in the Australian government continue to encourage professionals (eg, doctors, nursing professionals, teachers, computer science/ information technology professionals, and blue-collar workers) to move from urban to rural areas. 18,[24][25][26][27] For example, as part of their nursing programs, many colleges and TAFE institutions (Technical and Further Education) offer a post-secondary diploma and certificate for secondary school graduates and adults joining the nursing profession.…”

“…18,[24][25][26][27] Different agencies and departments in the Australian government continue to encourage professionals (eg, doctors, nursing professionals, teachers, computer science/ information technology professionals, and blue-collar workers) to move from urban to rural areas. 18,[24][25][26][27] For example, as part of their nursing programs, many colleges and TAFE institutions (Technical and Further Education) offer a post-secondary diploma and certificate for secondary school graduates and adults joining the nursing profession. 28 These academic programs do not require full-time training for four years and therefore allow graduates to join the workforce in a short space of time.…”

Prehospital risk stratification in non-ST-elevation acute coronary syndrome; a paramedic echocardiography pilot study.

“…Outside the Franco-German EMS model (17), emergency physicians are not routinely dispatched to the large group of patients with undifferentiated chest pain, as patients are more efficiently evaluated by regular ambulance paramedics (27). Improved competency and expanded procedure repertory among paramedics seem promising in improving patient care (28), and telemedicine is helpful to provide expert knowledge to the scene (29). We believe the interdisciplinary cooperation between the in-hospital cardiologist and paramedics could be a The five standard TTE projections, stored as ECG synchronized cineloops on the EchoPac server:…”