Paramedics are increasingly seen as an integral component of health systems in high income countries. This editorial discusses the factors driving the evolution of paramedicine and the role paramedics may play in the delivery of community-based palliative care. The challenges facing paramedics in palliative care contexts are reviewed briefly. Ultimately, this editorial argues that paramedics are important stakeholders in the delivery of community-based palliative care and have been a notable omission in health service policy and planning.

<p><strong>Abstract</strong></p><p>This study investigates the experiences of undergraduate paramedic students completing interprofessional clinical placements in snow sport injury clinics. Qualitative methods were used to investigate the experiences of participants (n=6) undertaking a non-traditional ambulance clinical placements as part of a multidisciplinary healthcare team.  Ethical approval was obtained through X University. Data were collected via one-on-one face-to-face interviews and analysed using holistic and focused coding. Results were divided into three main categories, namely pre-placement, intra-placement and post placement phases. As it was a new placement, student capabilities were not initially known by clinic staff. Nevertheless the workplace culture was inclusive and supportive, and paramedic skills were applicable in the clinic environment.  Despite the placement costs being excessive, participants viewed it as an investment in their future careers. Benefits of the placement included improved maturity levels, acquisition of professional networks, an understanding of interprofessional practice and an exposure to clinical skills not normally practiced on traditional ambulance placements. The interprofessional clinical placement appears to be a valid alternative to traditional ambulance placements. However, using this model to replace mainstream placements is problematic due to the costs involved, the limited number of spots available and the seasonal occurrence of snow sports. </p>

A significant paradigm shift in the care of non-urgent, low-acuity patients by paramedics has been gathering momentum over the last two decades. However the current nomenclature to define paramedics who specialise in the low-acuity setting is confusing, inconsistent and arguably misrepresentative. This commentary contends that two discernible paradigms lie along the spectra of low-acuity service delivery in paramedicine and argues that the nomenclature should also reflect this difference. Consistency in nomenclature has implications for the evolving professionalism in paramedicine and the movement towards national registration.

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Introduction As registered health professionals, Australian paramedics are required to abide by professional registration standards including the maintenance of continuing professional development (CPD). The broader health literature identifies facilitators, barriers and motivators for engaging in CPD, however the body of knowledge specific to paramedicine is weak. This research seeks to address this gap in the paramedicine body of knowledge. Methods This study adopts a constructivist grounded theory methodology. Data were collected through semi-structured interviews, and analysed using first and second cycle coding techniques. Paramedics from various state-based Australasian ambulance services and private industry (N=10) discussed their experiences specific to their attitudes, perceptions and engagement about CPD. Results Paramedic CPD goes beyond the traditional approach to mandatory training. Paramedics are motivated by factors such as modality of delivery, professional expectations, clinical/professional improvement and, sometimes, fear. Facilitators included organisational support, improved clinical knowledge, practitioner confidence, self-directed learning opportunities and perceived relevance of content. Barriers include cost, workload/fatigue, location, rostering, lack of incentive to engage, lack of employer support and technological problems. Conclusion By understanding what facilitates or motivates engagement in CPD activities, paramedics can navigate their CPD in conjunction with regulatory requirements. Although paramedics report some similar experiences to other health professionals, there are nuances that appear specific to the discipline of paramedicine. Of interest, a unique finding related to fear influencing paramedic CPD engagement. The results of this study informs paramedic employers and paramedic CPD providers with insights to assist in the development of positive CPD experiences and interactions.