Engaging in community conversation: A means to improving the paramedicine student clinical placement experience

Abstract

Community conversations are structured, inclusive conversations that bring together a group of people to engage in meaningful conversation, share knowledge and ideas, and discuss solutions to complex problems. This article focuses on the methodological aspects of using community conversations as a research approach. Participants included paramedics, ambulance service managers, paramedicine students and paramedicine educators, who gathered at La Trobe University in Bendigo in February 2013 to attend a conference titled ‘Paramedic Education and Leadership. Conversations took place over three days, with participants spending around five hours discussing the key issues related to paramedicine student clinical placements. Three stages of community conversations are described, along with the participants’ evaluation of the process, leading to the conclusion that community conversations are a valuable and effective way to bring together groups of people to discuss ideas and solutions to complex social problems.

Keywords

Community conversations paramedic clinical education clinical placements

Background

In February 2013, the Department of Paramedicine, La Trobe Rural Health School, hosted a ‘Paramedic Education and Leadership’ conference that was attended by 53 delegates, including 30 Paramedics and 16 students. In Australia and New Zealand, the joint Council of Ambulance Authorities’ (CAA) and Paramedics Australasia (PA) course accreditation process requires that clinical placements are a component of all university entry-level paramedicine courses. An underlying expectation from industry is that paramedicine graduates are ‘work ready’. Unlike most other health professions there are no mandatory requirements such as the duration or quality standards for clinical placements in paramedic courses. Within Victoria (Australia) there is discussion of 360 h of clinical placement within the paramedicine environment. This is not enforced and there is debate about what learning activities should occur during these placements. In addition, some of the educational providers only offer traditional paramedicine placements, whilst others offer a combination of ambulance service, hospital and other community-based primary health care placements for their students. Writers, including Boyd (2012) and Lord, McCall, and Wray (2012), suggest that educators, ambulance service and students need to engage in conversations to ensure that quality learning can occur for paramedicine students during clinical placements. In a practice-based profession such as paramedicine, conversations about clinical education are critical to ensure that students are exposed to a range of realistic learning experiences (Williams, Brown, & Archer, 2009; Williams, Brown, & Winship, 2012).

As a part of the conference, attendees were invited to participate in a three-stage community conversation about the key issues surrounding paramedicine clinical placements, and to explore how clinical placements could be improved in response to the rapidly growing number of paramedicine students in Australian universities. Following this, participants were asked to identify and generate actions for positive change in the way clinical placements are organized and delivered in Australia (O'Meara, Hickson, & Huggins, 2014). This article will focus on the methodological aspects of the research, and the experience of using ‘community conversation’ as a research approach.

Literature review

Community conversations are structured, inclusive discussions that are designed to promote meaningful conversation, sharing of knowledge and ideas and open communication about innovative solutions. Most articles in the literature can be traced back to design structures such as World Café (Brown & Isaacs, 2005) and magic round tables (Benking, Lenser, & Stalinski, 2004) and are influenced by collaborative research methodologies (Fouché & Light, 2011) including action research and participatory action research (Reason & Bradbury, 2008), community based participatory research methodologies (Minkler & Wallerstein, 2008) and appreciative inquiry (Cooperrider, Whitney, & Stavros, 2008).

In the literature, early examples of community dialogue can be traced back to Habermas’ (1984) theory of communicative action and found in the roots of the Tavistock Institute’s work in bringing together a group of people to participate in their recovery from experiences in World War 2 (Rapoport, 1970). The action research discourse describes a family of research approaches that explain how people can work together to address issues and solve problems. Action research methods and methodology are generally attributed to Kurt Lewin (1946), although there are elements of action research in the work of Argyris and Schon (1978), Dewey (1910) and Freire (1970). Lewin (1946) was interested in the relationship between theory and practice and developed a theory of action that involved a cycle of planning, acting, observing and reflecting. This model has been revised numerous times by researchers including Elliot (1991), Koshy (2005) and O'Leary (2004) and there are now many action research models that feature an ongoing cyclical process.

Action research can be defined and used in a number of different ways, but primarily it involves “engagement with people in collaborative relationships, opening new ‘communicative spaces’ in which dialogue and development can flourish” (Reason & Bradbury, 2008, p. 3). Action researchers consider that knowledge is socially constructed and are committed to a form of research that challenges social and political systems and practices (Brydon-Miller, Greenwood, & Maguire, 2003). The key characteristics of action research are that it is participatory (Meyer, 2000), problem focussed (Waterman, Tillen, Dickson, & de Koning, 2001), and involve cycles of action and reflection, theory and practice (Reason & Bradbury, 2008).

When planning action research, researchers also need to consider the factors that influence group dynamics. Most writing about group dynamics is attributed to Tuckman (1965) who suggested that there are a number of stages of group development that groups will go through if they continue to meet over a period of time. Similarly, Gayá Wicks and Reason (2009) describe a series of similar phases of group development and add that the action researcher will need to be aware of these phases to ensure that participants feel included and engaged with the group dynamics. Gustavsen and Engelstad (1986) discuss the design of conferences (conversations) and suggest that there needs to be ‘democratic dialogue’ where it is understood that all participants bring knowledge and the aim is collaboration and sharing of ideas amongst equals. Martin (2008) discusses large group processes and suggests that although it can be difficult to differentiate between them, large groups that are established for political or cultural purposes are different to groups that are designed for learning and change. For example, a conference-like event might have the purpose of delivering the same messages to all participants at the same time or to align the culture of organisation with the vision of the manager. These events might not be considered action research, as although participants are engaged in the process, the cyclical steps of critical thinking and reflection are absent. Alternatively, an action research group event will have steps that involve sharing of collective knowledge and assumptions, generation of new knowledge and critical thinking and reflection of these ideas.

In the literature, community conversations are generally traced back to the World Café method (Brown & Isaacs, 2005), which is based on seven design principles: set the context, create hospitable space, explore questions that matter, encourage everyone’s contribution, cross pollinate and connect diverse perspectives, listen together for patterns, insights and deeper questions, harvest and share collective discoveries. Community conversation is based on the assumption that when people are able to communicate in an open and free manner, they can discover mutual understandings through which new opportunities for action can emerge. By fostering dialogue, people can enjoy meaningful conversation and share their collective intelligence. This enables them to think more deeply about the critical issues that affect their community and to think about creative and innovative pathways to shape the future. The World Café method brings people together to network, share knowledge and learn from each other by sitting around tables (like in a café) with paper and a scribe to capture ideas (Paige, 2011). The World Café has been used successfully in Singapore (Tan & Brown, 2005) to create a learning culture and aims to engage people in more open and inclusive conversation. Similarly, the World Café can be used to deconstruct and explore complex societal problems which feature contested understandings, for example, climate change policy (Carson, 2011).

Community conversations have been used in a broad range of cultural contexts around the world (Beyer, Comstock, & Seagren, 2010; Moulton, Miller, Offutt, & Gibbens, 2007), including post-performance reflection in the theatre (Ellis, 2000), finance management (Gilpatrick, 1999), and as a way to address mental health stigma with ethnic minority communities in Scotland (Knifton et al., 2010). Most notably, community conversations have been used extensively by the Nelson Mandela Foundation as a key feature of their community dialogue program to engage key stakeholders in local communities to talk openly about violence in their communities (Nelson Mandela Foundation (NMF), 2009) and the HIV/AIDS pandemic in South Africa (NMF, 2010). This was developed following the Community Capacity Enhancement through Community Conversation (Family Health International (FHI), 2010) that was developed by the United Nations Development Programme (UNDP) and is an integral part of their Leadership for Results program (UNDP, 2005). Community conversations have been held in Cambodia as a forum to identify and untangle community problems (Storer, Lean, Virya, & DelVecchio, 2011) and in Ethiopia to talk about the spread of HIV/AIDS in the community (UNDP, 2004).

In Australia, community conversations have been used in the remote Western Australian township of Leonora to bring together the various population groups and to create a conversation to discuss sustainability issues (Marinova, Lozeva, & Seemann, 2010). In Leonora, community conversations provided a unique opportunity for participatory democracy, where representatives had a voice and were able to influence the sustainability of the town and the shape of the future. The Indigenous Leadership Network – Victoria (ILNV) has also had success with community conversations as an alternative to community consultation (Stone-Resneck, 2010). ILNV argues that the difference is in the outcome, where findings can be seamlessly implemented in a respectful and effective manner.

Whilst there are a number of articles that describe how a community conversation approach has been used, there are few articles in peer-reviewed academic literature that systematically outline or review the methodology of community conversations. This article will address that gap.

Our approach to community conversations

We have outlined several examples of how community conversations are used around the world. Although a number of different models have been described, there are not actually any substantial differences between the different theories and methods, simply variations in vocabulary and the context in which it is utilized. All of the models are structured around similar values of engaging stakeholders in meaningful conversation, promotion of sharing knowledge and ideas and open communication about innovative solutions.

It is important to understand how we defined community conversation as this interpretation has influenced the design of this research. We chose the term ‘community conversation’ because we thought that it pragmatically described the elements that we wanted to foster – conversation within a community of paramedicine. We approached this research with ideas about the cyclical nature of action research and the hope that participants would engage, as stakeholders within their community of paramedicine, in a series of conversations about clinical education. Our approach was fluid and flexible – we wanted to facilitate conversations around clinical education and allow the processes to evolve continuously and dynamically. We had some plans about the timeframe for each cycle as this needed to be included in the conference planning, however we had few expectations about the outcomes of the conversations, preferring to be open to all ideas that emerged.

There were benefits and challenges in adapting the community conversations approach to our context. The benefits during our community conversation included the flexible and inclusive approach to a conversation about an issue that all stakeholders were concerned about and engaged with. This meant that all participants had the opportunity to express their views and to hear ideas and suggestions from their peers. The context of community conversations amidst a conference presented challenges as we were unsure about exactly who would participate and whether there would be diversity of participants. Fortunately, most delegates at the conference participated in the conversations. However, this conversation was only the beginning of a conversation that needs to extend across the profession in Australia.

The researchers

In action research, investigators are aware of the effect of their role and intervention and how this may influence the findings and outcomes of the research (Denzin & Lincoln, 2011). For these conversations, there was a diverse team with a unique range of skills and interests. The lead investigator for this research was Dr Peter O’Meara. Dr O’Meara is a Paramedic Academic and has worked as a Paramedic Manager. His PhD research was about models of service delivery and he is currently Professor of Rural and Regional Paramedicine at La Trobe University. In addition, Dr Chris Huggins and Dr Helen Hickson were investigators in this research. Dr Huggins is a Paramedic Academic and was a Paramedic before making the transition to the Department of Community Emergency Health and Paramedic Practice at Monash University. His DEd research focused on the use of simulation training in paramedic education. Dr Hickson is a Social Worker and Lecturer at La Trobe University. She has recently completed a PhD exploring how social workers learn and use reflection. Dr O’Meara was the conference chair and lead investigator for this research, whilst Dr Huggins and Dr Hickson each facilitated the activities for the groups in their enquiry-based learning classrooms. All investigators attended group conversations to clarify processes, answer questions and observe the interactions of participants. In addition, all investigators contributed to the thematic analysis after stage 1 and the analysis at the conclusion of the conversations.

Planning steps

In February 2013, La Trobe Rural Health School at La Trobe University in Bendigo, central Victoria, hosted a conference titled ‘Paramedic Education and Leadership’. One of the aims of the conference was to bring together paramedics, ambulance service managers and paramedicine students to talk about the key issues surrounding paramedicine clinical placements. The community conversation approach was interwoven with the conference program and participants moved seamlessly from the conference presentations to the community conversations.

Before the first conversation, the facilitators introduced themselves, explained the concept of community conversations and how the process was expected to work. The approach that we developed consisted of three stages held over three days, where participants formed small groups and discussed issues and solutions in relation to the issue of quality in paramedicine student clinical placements. As the process and outcomes of the conversation were intended to be examined for research purposes, ethics approval was obtained through the La Trobe University Human Research Ethics committee (approval FHEC 12/209). Conference participants were provided with a Participant Information Sheet and asked to read through and sign a consent form if they wished to participate in the research. There was an option for any participants who were interested in joining in the conversation but not the research, to form a separate group. However, all conference participants signed the consent form and moved to the conversation rooms.

Participants had been randomly divided into groups during the conference registration by a colour coded name badge, and these groups became community conversation groups. Each group was headed by a ‘Wizard’– a senior La Trobe University Paramedicine student, adorned with a colour coded ribbon on a black wizard hat. There were five wizards in total. Each wizard was known to the lead investigator (who was also a professor at the university) and was selected based on their interest and willingness to undertake the role. The wizards were identified as a resource for conference participants and also had a role each day, seeking feedback from delegates about their experience at the conference.

Stage 1

There were two enquiry-based learning classrooms used for the conversations, and each room had two or three conversation groups (n = 5 groups in total). The number of participants in each group varied from five to eight people. Conversation groups sat around round tables, and each group had a Wizard (group facilitator) and a note taker to record ideas. Unlike the World Café model, the group membership was consistent for the three days, with only minor changes to group membership as participants were absent from parts of the conversation. Participants spent around 90 min for each conversation, and there were three conversation stages over the course of the conference.

The research was confidential in that no names, codes or identifying data collected. Group data was identified by a colour code (e.g. red group, green group), but responses are not able to be attributed to an individual.

In the first stage of the process, each group was asked to spend some time on introductions and getting to know one another. This was seen as important as participants were not necessarily known to one another and had a varied geographic, educational and experiential background. In addition, this time allowed group dynamics to begin to progress through Tuckman’s (1965) stages of group development. This was a time of lively discussion as each person spoke about their pathway to becoming a paramedic or paramedicine student, and their experiences. Following this, participants were asked to identify what they considered to be important paramedicine clinical placement issues. For this first encounter a total of 90 min was allowed. The participants were asked to think deeply and identify the issues that they would like to see improved. It was a time of brainstorming as issues and problems were able to be explored to tease out the intricacies of how problem situations affect people in practice. The wizard’s role as discussed earlier was to ensure that each person had an opportunity to have their say and monitor time. From the group, a note taker was selected to record the issues and discussion. This role was not part of the wizard’s function and the wizards were also part of the conversation along with the note taker. At the end of stage 1, each group was asked to summarise or prioritise the issues that they had identified. The aim of this step was to allow the researchers some insight into understanding how the participants saw the importance of the issues that had been identified.

Second stage

On day two of the conference, delegates were busy with a conference program that included a variety of interesting presentations and there were no community conversation activities planned. For the conversation facilitators, this time was used to read through the issues, identify themes and develop a list of questions that would be presented back to the conversation groups the following day. This was a challenging activity which is not dissimilar to thematic data analysis, but with only a few hours to work with the data. Each facilitator read through the material from each conversation group and a white board was used to identify themes. A second white board was brought in to assist facilitators to translate themes into questions that could be presented back to the group. For example, a number of issues were raised about the places where paramedic students can learn clinical skills and this translated into the question: ‘What type of clinical placements should paramedicine students be exposed to?’ Overall, eight questions were developed and are listed in Appendix 1.

Third stage

On day three of the conference, the third stage of the community conversation was conducted over two sessions with two 90-min community conversations sessions scheduled: one in the morning and one in the afternoon. The groups reassembled into their same colour conversation groups from stage one. New conference delegates were briefed about the earlier stages of the conversation, informed about the research and invited to consent to participate, before being introduced to a group. The material from stage 1 had been collated and the ideas and issues were short-listed and returned to the groups as questions for discussion. The questions were randomly distributed to groups, and each group spent between 30 and 60 min to explore their question. The construction of each question was deliberately broad and open with participants encouraged to explore the issues presented and discuss actions and proposed solutions. As there were five groups and eight thematic questions, each question was presented to at least two different groups for their discussion. As with stage 1, each group was facilitated by a Wizard, who ensured that each person had an opportunity to have their say, and a note taker to record the ideas that were discussed.

For example, one question was, ‘Define a quality clinical placement. How should it be measured?’ This question was presented to three different conversation groups and was designed to encourage educators, managers and paramedics to reflect on their experiences from the perspective of both the paramedic student and the clinical instructor. Students were encouraged to talk about their experiences of clinical placement and their views about perceived gaps between what they have experienced and what they would like to experience. The first part of the question encouraged participants to be creative and innovative as they discussed the elements that make up a quality clinical placement. The second part of the question encouraged the participants to become much more specific as they tried to develop tangible methods, processes and tools for measurement.

Lessons learned

At the end of stage 3, wizards were asked to facilitate a discussion about participant’s experiences of community conversations and record a summary of each group’s feedback. Overall, the feedback from participants was positive and supported the concept of community conversations as a way for people to enjoy meaningful conversation, share their collective intelligence and engage more deeply with the critical issues that affect their community. This type of conversation is valuable as a learning tool, and leads to creative and innovative solutions. Participants noted that linking the community conversation with the conference meant that the right people were there and they were open and willing to listen to new ideas. In addition, the conversations were seen as a way for participants to be more involved than is usual at a conference when a passive, lecture-style approach is used. For one group, a strong network of previously unknown colleagues was established, contact details were exchanged and arrangements were made to continue the conversations in the future.

There were some suggestions for ways to improve the community conversation approach that we used. Three groups suggested that the allocation of group membership could have been improved. Participants were randomly allocated to groups based on their arrival at the registration desk. It turned out that the ratio of student to experienced paramedic varied in each group, and feedback from some participants was that they would have preferred a more even student to experienced paramedic ratio. However to divide the groups in that manner would have reduced the benefits of random selection to minimize bias. But, in turn, the uneven groups may have reduced the voice of the student cohort. This is not seen in the data but may be present. In addition, some participants found that the time allocated to each session was too long and it was especially difficult to maintain interest and engagement at the end of the third day of a conference. One potentially useful suggestion was that the conversation be continued informally in an alternative location with refreshments provided!

Discussion

In this study, the community conversations began with a group of students, paramedics and managers who came together to discuss paramedicine student clinical placements. Community conversations were an effective way to bring a group of people together, in a way that they would not ordinarily meet, to engage in meaningful conversation, share knowledge and ideas, and discuss solutions to complex problems. In our conversations, participants were interested in learning and professional development because they were there to attend a conference about this topic. Community conversations provided an opportunity for direct interaction between educators, students, paramedics and managers to explore issues and solutions about a topic they were all interested in, and had a vested interest in improving: quality in paramedicine student clinical placements.

Overall, participants reported that the conversations were ‘constructive’, ‘worthwhile’, and ‘an interesting and valuable learning tool’. One group commented that there was ‘cynicism about whether there is enough desire to solve the problems’ and described a sense of ‘frustration – rehashing old problems (year after year after year)’. This is an important finding and worthy of further elaboration. When this issue surfaced in the group, it was initially raised by one experienced paramedic, then other experienced paramedics added details of their experiences. The wizard thanked the participants for their honesty and encouraged the conversation to develop, commenting that it was ‘constructive’ and helped him to ‘develop a greater understanding of the workforce’.

The wizards played an important role in this research. We had assumed that the role of the wizard would encourage students to be more involved in the conference and we were pleased that the wizards took a leadership stance within their group and provided a communication conduit between the conference delegates and the convener. Wizards had multiple roles in this study, as is common with action research. Wizards participated in the conversation groups, yet also had a role as observer and facilitator.

Students described it as a ‘good exercise’ and felt that ‘the role of Wizards was empowering’ and led to them ‘not feeling left out of conversations’ as can sometimes happen to junior participants without power. Experienced participants also noticed this and commented that it was a ‘great chance to bridge the gap between university and Ambulance Victoria’ and that it was ‘good to chat with all levels of paramedics’. On the whole, participants reported that they enjoyed the opportunity to reflect on their expectations and experiences, and each developed a clearer understanding of the factors that influence the experience of students on clinical placement.

In good action research, it is important for the researchers to critically reflect on their influence on the research and their assumptions. For the researchers, it was exciting to be involved in an innovative and dynamic research methodology. Whilst we have all been involved in qualitative research before, it was fascinating to watch it unfold as an observer as well as a participant. We had few pre-determined expectations about the outcomes of the conversations or the ideas that emerged, preferring to take a curious stance and meander wherever the conversation flowed. In our reflection at the end of the conference, we discussed the influence of the three researchers on the conversation groups. We surmised that although we tried hard to explicitly be observers in the conversations, our presence and informal conversation will influence the research. This is common in action research, where the boundaries between participant, facilitator and observer can become blurred (Koshy, 2005; Waterman et al., 2001).

The conversation method that we used was very quick in comparison to typical action research projects. In our activity we started with a brainstorming approach, identified themes and then fed the questions back to participants for clarification and elaboration. Generally, action research projects include several cycles and longer time (can be from a few months up to 1–2 years) in between each cycle to allow for reflection and the opportunity to deepen understanding about the issue (Koshy, 2005). Our conversations necessarily took place over three days whilst participants were gathered for a conference. The benefits of this were that participants were engaged and immersed in the topic during this time, without the distractions of work or other interruptions. In other action research examples (Elliot, 1991; O'Leary, 2004), longer time in between and repeated cycles allowed for unconscious thought processing, critical reflection and higher order thinking, which can lead to solutions that can be implemented, evaluated and re-considered.

Whilst we were unable to find a specific model of community conversation that reflected what we wanted to do, there are many connections between the model that we used and the community conversation and action research literature. We wanted to bring together a group of people to tease out the issues and the possible solutions to a complex problem for the paramedicine profession. Our research design was participatory, problem focused and involved cycles of identifying the issues, thematic analysis, brainstorming solutions and involved cycles of action and reflection, theory and practice (Brydon-Miller et al., 2003; Meyer, 2000; Reason & Bradbury, 2008; Waterman et al., 2001). We expected democratic dialogue (Gustavsen & Engelstad, 1986) where all participants felt valued for their contribution and created the role of wizards to counter what we saw as potential power imbalances for students. We were aware of the importance of group dynamics (Gayá Wicks & Reason, 2009; Martin, 2008; Tuckman, 1965) and allocated time in stage 1 to encourage participants to get to know one another. The power of a conversation with a large group like this is not the number of people who attend and contribute to or agree on the outcome, but the diversity of knowledge that is shared, the various ideas and different perspectives and the new knowledge that are generated.

It was also a new opportunity for networking that often does not become available at a conference, particularly in rural and regional areas. In a profession like paramedicine, multi-disciplinary and inter-disciplinary relationships are important (Jacob, Barnett, Missen, Cross, & Walker, 2012; Mulholland, O'Meara, Walker, Stirling, & Tourle, 2009). However, some paramedics reported that whilst they develop strong relationships with their partner and a small group of colleagues, they may not have the opportunity to establish strong networks outside this domain. Connections, networks and shared strategies about student clinical placements could lead to further collaboration and sharing of information, resources and ideas. The conversations that have commenced through this community conversation process can and should move beyond this one topic and continue. The researchers feel the obligation to make sure that the voices of the conversation are heard. This small project has contributed to a larger international study, where ideas and suggestions from the conversations can be tested and compared with the findings from qualitative interviews with paramedic instructors and quantitative surveys of paramedic students. We will have the opportunity to deepen understanding about the issues and evaluate the solutions proposed. Further research will be required, but the community conversation has established a strong foundation for understanding the complexities of the issue.

The community conversation method could be used by other disciplines to explore the issues that dominate their relationships with quality clinical placements. Disciplines including medicine (Gallagher, Carr, Wang, & Fudakowski, 2012; Karakitsiou et al., 2012), social work (Lazarsfeld-Jensen, 2010) and physiotherapy (Patton, Higgs, & Smith, 2013) attempt to provide authentic clinical learning opportunities for students. Perhaps an interdisciplinary or multi-disciplinary conversation could be the springboard for new networks and collaborative opportunities. In addition, community conversations could be used at the community, state or national level to explore issues and solutions in relation to big and small problems. For example, conversations could be used to discuss the science and politics of climate change or to develop effective warning systems to notify communities of the impending risk of fire or flood.

Conclusion

In this article, we have explored the different theories and methods for community conversation and the connections with action research methodology. We have defined and described how we developed a community conversation approach to tackle a complex issue for the paramedicine profession. We have reflected on our experiences of using community conversations as a way to deconstruct and explore how paramedicine students’ clinical placements could be improved. Participants reported that the concept of community conversations was an enjoyable way for people to engage in meaningful conversation, share their knowledge and ideas and discuss solutions to complex problems. This approach provided an opportunity for direct interaction between educators, students, paramedics and managers to engage in conversation about a topic that they were all interested in, and had an interest in improving.

In a practice-based profession such as paramedicine, student clinical education is a burgeoning issue for educators, ambulance services, clinical instructors and paramedicine students. Whilst all agree that clinical placements form a critical element of student learning and development, there are currently no mandatory requirements such as duration or quality standards for clinical placements in paramedic courses.

Footnotes

Acknowledgement

The authors would like to thank Svante Lifvergren for leading the review process of this article. Should there be any comments/reactions you wish to share, please bring them to the interactive portion (Reader Responses column) of the website: .

Authors Note

Ethics approval: FHEC 12/209.

Funding

This work was supported by an Office of Learning and Teaching Grant titled: ‘The Australian and New Zealand Paramedic Learning and Teaching Network’ (SI11-2128).

Author biographies

Helen Hickson is an accredited social worker with a long-standing interest in rural health workforce and sustainable models of service delivery in rural Australia. Helen completed her PhD in 2013 and has begun building her research profile. She is an experienced researcher, with excellent leadership and time management skills and has managed multiple research projects concurrently. Over the past year, Helen has completed a study exploring paramedic student clinical placements, which involved completed surveys from 652 paramedicine students and personal interviews with 15 paramedic instructors in Victoria and Auckland, New Zealand. Helen is currently involved in a number of research projects related to rural health workforce and health outcomes and is beginning to establish herself as an early career researcher.

Peter O'Meara is the Professor of Rural and Regional Paramedicine at La Trobe University in Bendigo where he supervises a wide range of higher degree students and teaches paramedicine students evidence-based practice and rural health. Peter was one of the first paramedics in the world to be awarded a doctorate and has undertaken extensive Australian and international research related to rural health and ambulance services over the last 15 years. His current research encompasses the quality of paramedic clinical placements and the emerging role of community paramedics across the globe.

Chris Higgins works in the Faculty of Medicine, Nursing & Health Sciences at Monash University as a Lecturer. His research interests include learning through simulation, critical decision making and community involvement in pre and out of hospital care. His qualifications and awards include: OBStJ, AssDipHSc (Ambulance Officer), BHSc (Pre-Hospital Care), DipEd&Trang (Melb), DipFLM, MTrang&Dev (Melb).

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