1. The
Transition
of
Australian
Paramedics
Graduates
to
United
Kingdom
Ambulance
Services:
Should
we
be
Concerned?
Matthew Simpson1, Scott Devenish2 , Michele Clark2
1
Higher Research Degree Candidate, Queensland University of Technology, and Intensive/Extended Care Paramedic, 2
School of Clinical Sciences, Queensland University of Technology
Matthew Simpson is a Higher Degree by Research Student, at Queensland University of Technology.
Matthew’s professional background includes over 15 years with NSW Ambulance, Paramedics Australasia
Director and Future Health Leaders Council – Paramedicine Representative . Matthew currently works
as an Intensive and Extended Care Paramedic with NSW Ambulance in rural NSW.
Contact Email: emtsa@bigpond.net.au Phone: +61 429 047754
1. Colbec k , M. 2014. "Australas ian consultant paramedic: A future direction?" Australas ian Journal of Paramedicine11(5): 1-2.
2. College of Paramedic s (2014) Paramedic Curric ulum Guidanc e. 3rd ed. Bridgewater UK: College of Paramedics
3. Counc il of Ambulance Authorities (2010) Guidelines for the ass ess ment and ac creditation of entry-level paramedic educ ation programs .
Flinders Park , Adelaide: Conv ention of Ambulance Authorities for Aus tralia and New Zealand.
4. Dev enis h, S. (2014). Ex perienc es in Bec oming a Paramedic: A Qualitativ e Study Ex amining the Profes sional Soc ialisation of Univ ers ity
Qualified Paramedic s, PhD Thes is, Faculty of Health, Queens land Univ ers i9ty of Tec hnology
5. Daws on, D. (2008). Univ ersity educ ated ambulance paramedics : J ob ready or not? Paper pres ented at the Aus tralian College of
Ambulanc e Profes s ionals (ACAP) 2008 National Conferenc e, Southbank , Melbourne.
6. Gregory , P. (2013). The Reality Shock . Journal of Paramedic Practice, 5(1), 5.
7. Kramer, M. (1974). Reality s hoc k: Why nurs es leav e nursing. St Louis : C.V. Mos by Company.
8. Laz ars feld-J ens en, A., Bridges, D., & Loftus , S. (2011). Trans itions : Command culture and autonomous paramedic practice. Bathurst:
Charles Sturt Univ ersity.
9. O'Brien, K., Moore, A., Hartley, P., & Daws on, D. (2013). Les sons about work readiness from final y ear paramedic s tudents in an
Aus tralian univers ity . Australas ian J ournal of Paramedicine, 10(4), 1-13.
10. O'Meara, P., Williams , B., Dick er, B., & Hick son, H. (2014). Paramedic clinic al plac ement duration and quality v ariance: An international
benc hmark ing s tudy . La Trobe Univ ers ity , Bendigo, Aus tralia: Report c ommis s ioned for Health Work forc e Australia.
http://hdl.handle.net/1959.9/316231
11. O'Meara, P., Tourle, V., Madigan, V., & Lighton, D. (2012). Getting in touc h with paramedic s tudent c areer intentions . Health Educ ation
J ournal, 71(3), 376 - 385
12. Thomps on S (2015) The perceived concerns of newly qualified paramedics commenc ing their c areers: a pilot s tudy. J ournal of Paramedic
Prac tic e 7 (2): 74-78.
References
The recent shortages of both paramedics and potential paramedic graduates in
the United Kingdom have seen some National Health Service Ambulance Trusts
actively recruiting Australian paramedic graduates to fill many of these positions.
Paramedic graduates include two distinct groups these being university
graduates and paramedics currently employed by government ambulance or
government contracted ambulance services. The focus of recruitment by National
Health Service Ambulance Trusts has been from the university graduate pool,
with active recruitment occurring through social media, universities and
attendance paramedic conferences in Australia.
Background
The literature pertaining to the transition of paramedic graduates to the
workplace is limited.
The literature examines issues such as the perceived work readiness of
graduates, the transition from university to the workplace, identifies a reality
shock encountered by United Kingdom paramedic graduates entering National
Health Service ambulance services, and outlines a model of paramedic
professional socialisation of Australian and United Kingdom paramedic
graduates.
What has not been examined is the transition of paramedic graduates from
Australian universities to international ambulance services, such as United
Kingdom National Health Service Ambulance Trusts.
› Anticipatory socialisation (O'Meara et al., 2012;; Devenish, 2014)
› Work readiness (Dawson, 2010;; O’Brien, 2013)
› Education and practice in transition (O’Brien, 2014)
› Transition to a command an control ambulance culture (Lazarsfeld-Jensen et
al., 2011)
› Transition to the workplace (Devenish, 2014;; Thompson, 2015)
› Reality shock (Gregory, 2013;; Devenish, 2014)
› A model of paramedic professional socialisation (Devenish, 2014)
Current Literature
As the transition of Australian paramedics graduates to the UK is a relatively new
phenomenon, the following questions need to be asked:
• Is an internship year necessary for Australian paramedic graduates to
intergrade successfully into UK paramedic practice?
• How is a possible lack of experience going to impact on their transition to the
workplace?
• Mature students or any previous university study
• Double degree students
• Graduate entry students
• The development of preconceptions and the decision to move the UK?
• Is this a quick fix by UK Ambulance NHS Trusts and Foundation Trusts?
• Could this reflect poorly on Australian university paramedic programs?
• In the event of being struck off by the HCPC, could someone obtain paramedic
employment in Australia?
Questions
From the available literature, there appears to be a gap in the paramedic body of
knowledge relating to the transition of Australian paramedic graduates to
employment with international ambulance services.
Thus the lead author proposes to fill this research gap by completing a higher
research degree to investigate the transition of Australian university paramedic
graduates to UK NHS ambulance trusts.
The research is timely, particularly given the trend towards the
internationalisation of the health workforce.
Conclusions
Results
University Clinical Placements
United Kingdom
› Minimum number of practice placement hours for a program of study should be
2250 hours over a three year program
› 50% of learning takes place in the clinical practice environment
› No more than 25% of placement hours can occur outside of the operational
paramedic setting
› Students are supernumerary but not observers and need to participate in the
care of the patient appropriate to the level of their academic education
› (CoP, 2014)
Australia
› No consistency between university programs and ambulance services
› Minimum number of clinical practice hours vary from 240 to 1068 hours of
clinical placement
› No minimum clinical placement hours in paramedic clinical practice
environment
› No maximum clinical placement hours occurring in non-paramedic settings
› Students may have ‘observers’ status only on clinical placements with some
ambulance services
The aim of this literature review on the transition of paramedic graduates to the
workplace, is to identify a gap relating to research on the transition of Australian
paramedic graduates to United Kingdom National Health Service Ambulance
Trusts.
Aim
Transition to Employment
United Kingdom
From the moment of registration with the HCPC:
› paramedics are autonomous and accountable
› newly registered paramedics are often employed as lead clinicians from the
outset of their career.
› Although deemed safe and competent at the point of registration, newly
registered paramedics are ‘novice practitioners’ and that the period of time
following registration can be challenging in this unique setting. (CoP, 2014)
Australian graduates will have 1 month orientation and between 1 – 3 months
supervised/supernumerary practice before making the transition to lead clinician.
Australia
› No national registration
› “In the main, graduates of accredited paramedic programs … will undertake a
graduate placement period/internship with the respective ambulance service
employer for a period of up to twelve months. During this period, graduates will
be inducted into the workplace and undertake specific orientation, internal
training and competency assessment activities to meet the requirements of their
employment”(CAA, 2010. pp 16-17).
› Thus it seems the employer may stipulate when a paramedic is ‘qualified’ not a
national body or a university such as in many Australian ambulance services
› Cost of living:
› LAS starting salary of £30K
› includes 15% London loading and ‘unsocial’ hours payment of 25%
› High workload and over crowding of the population
› Recruitment message versus reality of work in East London slums
› Stab vests – gang violence
› Working autonomously/independently with an emergency care assistant
› Maintaining one’s registration
› Possible mismatch - skills, procedures and pharmacology
Expectations ≠ Reality
A review of the peer-reviewed literature was undertaken to identify current
research on the transition of paramedic graduates to the workplace.
Methods
