Paramedic student confidence, concerns, learning and experience with resuscitation decision-making and patient death: A pilot survey

Anderson, Natalie; Slark, Julia; Faasse, Kate; Gott, Merryn

doi:10.1016/j.auec.2019.07.001

Cited by 14 publications

(15 citation statements)

References 47 publications

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“…All studies were conducted in the past 2 years, indicating the exploration of this area is relatively new to the literature. It was consistent that paramedics who were uncertain on whether to resuscitate were more likely to begin resuscitation than not (Anderson et al, 2018a;Anderson et al, 2018b;Anderson, 2019). Additionally, Davey et al (2016) identified that paramedics looked to the law to help guide their decisions but noted the law did not always guide paramedics to a decision they felt was right.…”

Section: Decision Makingmentioning

confidence: 91%

Non‐technical skills in paramedicine: A scoping review

Bennett

Mehmed

Williams

2020

Nursing & Health Sciences

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This scoping review aims to identify which non-technical skills have been empirically identified in the literature, to create the first list of empirically identified non-technical skills for paramedics and allied health personnel. A five-stage scoping literature was undertaken in March 2020. The search retrieved a total of 4756 citations. A total of 93 studies met the inclusion criteria and were analyzed for data charting. A total of 26 non-technical skills were identified in the literature. The top five non-technical skills included decision-making (33%, n = 31), communication (24%, n = 23), empathy (17%, n = 16), leadership (12%, n = 12), and ethics (10%, n = 10). Furthermore, only five studies investigated the assessment or measurement of non-technical skills. This scoping review identified 26 non-technical skills that had been investigated in the paramedic literature to create the first list of empirically based desirable non-technical skills for a paramedic. Subsequently, research can then begin to focus on identifying the link that these have to paramedic practice and patient safety.

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Section: Decision Makingmentioning

confidence: 91%

Non‐technical skills in paramedicine: A scoping review

Bennett

Mehmed

Williams

2020

Nursing & Health Sciences

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“…Ambulance training often makes use of simulation training, but very few participants had any experience with the simulation of unsuccessful resuscitation or patient death. Study 3 15 showed that paramedic students had high self‐reported confidence in their ability to identify cardiac arrest and initiate resuscitation or identify and verify patient death. Confidence was lowest in non‐technical skills, including discussing patient resuscitation wishes, breaking bad news and providing emotional and practical support to bereaved relatives.…”

Section: Resultsmentioning

confidence: 99%

“…Novices may find it particularly difficult to terminate resuscitation, break bad news and provide care after death. Key findings from individual studies have previously been compared and contrasted with existing literature 3,13–15 . The focus of this discussion is to outline implications for the preparation and support of emergency ambulance personnel.…”

Section: Discussionmentioning

confidence: 99%

“…14 Study 3 was an online survey of New Zealand paramedicine students, exploring their confidence, concerns, learning experiences and exposure to resuscitation decisionmaking and managing patient death. 15…”

Section: Methodsmentioning

confidence: 99%

“…Study 2 was a focus group study with 20 experts in ambulance personnel clinical education and peer support, identifying supports before, during and after resuscitation decision‐making events 14 . Study 3 was an online survey of New Zealand paramedicine students, exploring their confidence, concerns, learning experiences and exposure to resuscitation decision‐making and managing patient death 15 …”

Section: Methodsmentioning

confidence: 99%

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Prehospital Resuscitation Decision Making: A model of ambulance personnel experiences, preparation and support

Anderson

Slark

Gott

2021

Emerg Medicine Australasia

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Objective: This paper presents the first Naturalistic Decision Making model of prehospital resuscitation decision-making, which has clear implications for education, practice and support. Methods: A mixed-methods exploratory sequential research design consisting of interviews with ambulance personnel (study 1), focus groups with ambulance educators, managers and peer supporters (study 2), and an online survey of graduating paramedic students (study 3). This paper reports the model developed from integrated findings, across all three studies. All research was undertaken in New Zealand and underpinned by a critical realist worldview. Results: The Prehospital Resuscitation Decision Making model identifies key processes, challenges and facilitators before, during and after ambulance personnel attend a cardiac arrest event. It is the only descriptive model of resuscitation decision making which acknowledges the decision-maker, nonprognostic factors and the importance of adequate preparation and support. Conclusions: This research project is the first to comprehensively explore and model ambulance personnel perspectives on decisions to start, continue or stop resuscitation.The decision-making process is complex and difficult to simply formularise. Education and supports must assist ambulance personnel in navigating this complexity. Where resuscitation is withheld or terminated, ambulance personnel need to feel confident that they can effectively provide after-death care.

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Threat assessment, sense making, and critical decision-making in police, military, ambulance, and fire services

Penney

Launder²,

Cuthbertson

et al. 2022

Cogn Tech Work

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Military and emergency response remain inherently dangerous occupations that require the ability to accurately assess threats and make critical decisions under significant time pressures. The cognitive processes associated with these abilities are complex and have been the subject of several significant, albeit service specific studies. Here, we present an attempt at finding the commonalities in threat assessment, sense making, and critical decision-making for emergency response across police, military, ambulance, and fire services. Relevant research is identified and critically appraised through a systematic literature review of English-language studies published from January 2000 through July 2020 on threat assessment and critical decision-making theory in dynamic emergency service and military environments. A total of 10,084 titles and abstracts were reviewed, with 94 identified as suitable for inclusion in the study. We then present our findings focused on six lines of enquiry: Bibliometrics, Language, Situation Awareness, Critical Decision Making, Actions, and Evaluation. We then thematically analyse these findings to reveal the commonalities between the four services. Despite existing single or dual service studies in the field, this research is significant in that it is the first examine decision making and threat assessment theory across all four contexts of military, police, fire and ambulance services, but it is also the first to assess the state of knowledge and explore the extent that commonality exists and models or practices can be applied across each discipline. The results demonstrate all military and emergency services personnel apply both intuitive and formal decision-making processes, depending on multiple situational and individual factors. Institutional restriction of decision-making to a single process at the expense of the consideration of others, or the inappropriate training and application of otherwise appropriate decision-making processes in certain circumstances is likely to increase the potential for adverse outcomes, or at the very least restrict peak performance being achieved. The applications of the findings of the study not only extend to facilitating improved practice in each of the individual services examined, but provide a basis to assist future research, and contribute to the literature exploring threat assessment and decision making in dynamic contexts.

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Paramedic student confidence, concerns, learning and experience with resuscitation decision-making and patient death: A pilot survey

Cited by 14 publications

References 47 publications

Non‐technical skills in paramedicine: A scoping review

Non‐technical skills in paramedicine: A scoping review

Prehospital Resuscitation Decision Making: A model of ambulance personnel experiences, preparation and support

Threat assessment, sense making, and critical decision-making in police, military, ambulance, and fire services

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