Does a paramedic student's exposure to cardiac cases during internship, clinical component, or simulation deepen understanding of cardiac conditions?
Authors: Barr N, Newton D, Tape B, Cecchini N, Spang L, Goss C, Patrick I, Gurliacci R, Master J
Introduction: Work readiness of paramedic students is influenced by experiences during field internship, clinical placements and laboratory simulations. This study explored the relationship between exposures to cardiac cases during field, clinical, or laboratory practicum and the odds of passing the Cardiac Unit Examination (CUE) or Paramedic Readiness Examinations (PRE).
Methods: A retrospective analysis of paramedic student records in the Fisdap database was conducted. Only students with at least one score on the PRE3, PRE4 or CUE were included. Student PRE3 and PRE4 (overall and cardiac subsections) and CUE scores were dichotomised to established cut scores (pass/fail). Logistic regression models were fitted (ɑ= 0.05) using predictor variables: adult cardiac patients in field, clinical and laboratory settings encountered prior to taking examinations. Ethics approval was provided by the USC, Australia (E/17/074).

Results: A total of 1290 student records, 157,971 cardiac patient encounters, 1094 PRE3 attempts, 489 PRE4 attempts and 567 CUE attempts were analysed. Cardiac learning opportunities during field placement were most strongly associated with improvement in both the PRE3 and CUE examinations but not PRE4. Laboratory simulations were associated with better performance on PRE4 and CUE but had no association with performance on the PRE3. Clinical encounters had a negative association with the CUE and no observed association with performance on the PRE3 or 4. Figure 1 shows the results of the logistic regressions.


Conclusions: Program coordinators should value cardiac encounters for paramedic students in the field and laboratory settings more than additional encounters in the clinical setting.