Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review

Rudman, Jordan S; Farcas, Andra; Salazar, Gilberto; Hoff, J J; Crowe, Remle P.; Whitten-Chung, Kimberly; Torres, Gilberto; Pereira, Carolina; Hill, Eric; Jafri, Shazil; Page, David; Isenburg, Megan von; Haamid, Ameera; Joiner, Anjni

doi:10.1080/10903127.2022.2130485

Cited by 15 publications

(10 citation statements)

References 89 publications

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“…Despite this, there remain significant barriers to access equitable care in rural communities due mostly to worsening physician shortages, 45,46 and for SGM populations, especially transgender people seeking gender affirming care, they are more likely to travel greater distances for equitable care and fear discrimination when accessing it 47 . LGB people have fewer community supports rurally as well, and EMS systems are still struggling to be as diverse as the population they serve 47,48 . Given this, rural SGM patients already face more barriers to equitable and safe medical care, including prehospital care, than their urban counterparts.…”

Section: Discussionmentioning

confidence: 99%

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A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics

Kruse,

Bigham,

Phillips

2024

AEM Education and Training

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IntroductionSexual and gender minorities (SGM) make up 4% of the Canadian population. Due to existing barriers to care in the community, SGM patients may seek more help and be sicker at presentation to hospital. Paramedics occupy a unique role and can remove or decrease these barriers. There are no existing evaluations of training programs in SGM health for prehospital providers. A training program to develop better allyship in paramedics toward SGM populations was developed and assessed.MethodsA 70‐ to 90‐min mandatory, asynchronous, online training module in SGM health in the prehospital environment was developed and delivered via the emergency medical service (EMS) system's learning management system. A before‐and‐after study of cisgender, heterosexual, frontline paramedics was performed to measure the impact of the training module on the care of SGM patients. The validated Ally Identity Measure (AIM) tool was used to identify success of training and includes subscales of knowledge and skills, openness and support, and oppression awareness. Demographics and satisfaction scores were collected in the posttraining survey. Matched and unmatched pairs of surveys and demographic associations were analyzed using nonparametric statistics.ResultsOf 609 paramedics, 571 completed the training, and 239 surveys were completed before and 105 (n = 344) surveys after the training; 60 surveys were paired. Overall AIM scores of matched pairs (n = 60) improved by 12% (p < 0.001), with knowledge and skills accounting for most of the increase (21%, p < 0.001). Unmatched pairs (n = 344) were similar in demographics and scores. Rural paramedics also had significantly lower pretraining oppression awareness scores and had lower posttraining AIM scores compared to suburban paramedics (6% difference). Satisfaction scores rated the training as relevant and applicable (87% and 82%, respectively).ConclusionsA novel prehospital training program in the care of SGM patients resulted in a statistically significant increase in allyship in cisgender, heterosexual‐identified frontline paramedics.

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Section: Discussionmentioning

confidence: 99%

“… 47 LGB people have fewer community supports rurally as well, and EMS systems are still struggling to be as diverse as the population they serve. 47 , 48 Given this, rural SGM patients already face more barriers to equitable and safe medical care, including prehospital care, than their urban counterparts.…”

Section: Discussionmentioning

confidence: 99%

A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics

Kruse,

Bigham,

Phillips

2024

AEM Education and Training

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“…Increasing diversity within the EMS workforce represents an important means for reducing inequities in EMS medical care. The diversity of newly nationally certified EMS clinicians has been relatively stagnant for more than a decade, and surveys suggest limited diversity among EMS educators and training officers 29–32 . Research is needed to identify and overcome barriers, including implicit biases within education programs and assessments, recruitment for underrepresented groups in EMS, and developing effective retention strategies.…”

Section: Discussionmentioning

confidence: 99%

Defining priorities for emergency medical services education research: A modified Delphi study

Lancaster¹,

Leggio

Ashford³

et al. 2023

JACEP Open

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Objective As out‐of‐hospital medicine evolves, emergency medical services (EMS) education practices must also be updated to ensure that EMS professionals acquire and maintain the skills needed to best serve patients. We aimed to identify and rank the top 10 research priorities related to EMS education in the United States. Methods We conducted a convenience survey of EMS educators to identify challenges facing EMS education before leveraging a purposefully selected panel of EMS educators to prioritize research gaps through a modified Delphi approach. Data were collected electronically (March 2021–June 2021) over 4 survey rounds consisting of idea generation (Rounds 1 and 2), importance scoring (Round 3), and consensus ranking (Round 4). At the end of Round 4, composite scores were used to generate a list of 10 prioritized research gaps related to EMS education. Results In the pre‐Delphi survey, 463 EMS educators identified 2055 challenges facing EMS education. We recruited 32 EMS education experts as Delphi panelists and 28 completed all 4 rounds. Panelists submitted 77 knowledge gaps. The top 10 knowledge gaps included defining competency of EMS learners and educators, association of curricula and accreditation requirements with real‐world practice, the effects of diversity and cultural humility among educators and learners on equitable patient care, evidence‐based teaching methods, and public perception of the EMS profession and education system. Conclusions Although 10 gaps were prioritized, panelists deemed all 77 gaps as having considerable importance for EMS education. This suite of knowledge gaps is intended to guide researchers and research‐funding bodies for future resource allocation.

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“…Our participants were primarily men that identified as either Hispanic or White. A recent scoping review found that women and nonwhite personnel are underrepresented in the EMS workforce (Rudman et al, 2022). Our results may be influenced by our sample type and size; previous studies have reported a slight increase in stress among female personnel (Blau et al, 2012; Cash et al, 2020).…”

Section: Limitationsmentioning

confidence: 99%

“…Bureau of Labor Statistics, 2023). These factors place EMS workers at risk for burnout and departure from the profession (Rudman et al, 2022). The average EMS career spans 5 years (Backberg, 2019).…”

mentioning

confidence: 99%

PTSD, Relationship Satisfaction, and Social Support for EMS Workers and Their Romantic Partners

Henry,

Burks,

Zoernig

2023

The Family Journal

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Emergency medical service (EMS) personnel are subjected to intense and traumatic workplace scenarios, which place workers at risk for developing trauma reactions that lead to mental health conditions such as posttraumatic stress disorder (PTSD), depression, and anxiety. However, little research has explored the impact of EMS workers’ work-related stress on their romantic partners despite evidence supporting the impacts of secondary traumatic stress (STS). This study explored the relationship between EMS workers’ self-reported PTSD symptomology and EMS workers’ romantic partners’ self-reported PTSD symptomology, relationship satisfaction, and social support. The sample consisted of 30 couples, 13 married and 17 unmarried. Findings confirmed that EMS workers with more severe PTSD symptomology were in relationships with partners who also reported higher symptomology. Additionally, increased PTSD severity among EMS workers was associated with partners’ decreased satisfaction with the quality of social support. This study confirms the effect of STS among EMS workers and their partners and highlights practical applications for improving the mental health of EMS workers and their partners. Implications for these findings include assessing partners for dysphoric arousal, psychoeducation, counseling assistance to EMS personnel, and focusing on opportunities for vicarious posttraumatic growth among couples are discussed.

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Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review

Cited by 15 publications

References 89 publications

A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics

A novel online training program for sexual and gender minority health increases allyship in cisgender, heterosexual paramedics

Defining priorities for emergency medical services education research: A modified Delphi study

PTSD, Relationship Satisfaction, and Social Support for EMS Workers and Their Romantic Partners

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