Tying It Together: Examining the Relationship between Student Affective Domain Traits and Restraint Use
Rebecca Valentine, B.S., EMT-P, NCEE, I/C, Sahaj Khalsa, BS, NRP, Nicholas Miller MS, NRP, Dylan Kratzke EMT-B, 
Psychiatric emergencies, a common EMS call, may require patient restraint, putting all involved at risk. In order to reduce the frequency of restraint use, factors increasing restraint use should be identified and mitigated. This study examines the relationship between paramedic student affective domain traits, as measured by
the Fisdap Entrance Exam (EE), and their rate of restraint use in patients experiencing psychiatric crises.
Patients treated by students with higher levels of agreeableness or conscientiousness or lower levels of neuroticism will be less likely to be physically or chemically restrained.
Patient care data entered by students who took the EE (2013 – 2016) and consented to have their anonymous data used for research were reviewed. We used an independent samples t-test to compare levels of agreeableness, conscientiousness and neuroticism in students who cared for patients with a primary or
secondary impression of “behavioral/psychiatric” and to examine the relationship between those traits and restraint use. If the differences were statistically significant, we used a logistic regression model to predict the probability of restraint use predicted by affective domain trait.
Our sample included 2026 patients, 349 students and 72 instances of restraint use. Patients in this sample were restrained 3.5% of the time. However, patients treated by highly conscientiousness students (75% percentile of conscientiousness) were restrained 4.2% of the time. While only 3.5% of patients were restrained,
21% of students restrained a patient. Analysis showed no statistically significant relationship between agreeableness or neuroticism and restraint use. We found statistically significant (p≤.07) higher levels of conscientiousness in students who used restraints at least once (84 vs. 81). Furthermore, regression analysis
showed more conscientious students are significantly more likely to use restraints.
The null hypothesis was supported. With so many factors involved in restraint use, further research is needed to clarify the relationship between student affect and restraint use. It is possible that highly conscientious students are more accurately documenting their interventions. Additionally, other factors, beyond the student’s
affect, likely impact the decision to restrain.