Ambulance Clinicians with ‘Research Skills’: Alien Concept or Artificial Intelligence? Attitudes, perceptions and experiences of evidence-based practice learning and implementation by student paramedics.

Abstract

Background: Evidence-Based-Practice (EBP) is regarded as the conscientious and judicious use of the best contemporaneous evidence in partnership with patient values and clinical expertise to guide healthcare professionals in clinical practice [Titler, 2008]. As a result, EBP is a recommended component of healthcare education [Lehane et al, 2018; Ramis et al, 2019] and considered fundamental for improving patient outcomes [Leufer & Cleary-Holdforth, 2009]. The subjects teaching and learning principles have thus become deeply-rooted in higher education curricular [European University Association, 2022]; but only in recent years has EBP begun to permeate the world of paramedic practice [Simpson et al, 2012]. Despite this paradigm, the impact of EBP may be limited in real-world practice because students (and qualified staff) can struggle to implement these skills [Emms & Armitage, 2010; Warren, et al. 2016] and whilst the concept may be considered favourable amongst graduates [Wilson et al. 2021] a variety of barriers impact translation and application [Jones & Jones. 2013; Lehane et al. 2018; Leufer & Cleary-Holdforth 2009; European University Association 2022]. Methods: Using an evaluation style methodology an educational enquiry was conducted to better understand the attitudes, perceptions and experiences of EBP learning and implementation amongst student paramedics. This pilot study aimed to gain insight into the epistemological and metacognitive barriers impacting student experience in order to help improve teaching and learning practices. Results: 70% of BSc (Hons) students versus 33% of DipHE students agreed to some extent or greater, that EBP represented minimal benefit in real-world practice due to the guidelines set-out by the Joint Royal College Ambulance Liaison Committee and the presence of Trust policy (Welch’s t = 2.571, df = 26, p=0.016 two-sided). 25% felt ambulance service guidelines and standard operating procedures negatively impacted their ability to implement EBP; although 39% reported EBP improved their ability to implement improved patient care. Conclusion: A strong likelihood that EBP does not dovetail well with standard operating procedures in the ambulance service is apparent; and an evident disparity between theoretical learning and its application is present within this population.