Hanna, Hilding2021-06-162021-06-162021http://hdl.handle.net/2440/130768Objective This systematic review aims to identify and explore the barriers to and facilitators of learning and preparedness for clinical practice among undergraduate paramedicine students, graduate/intern paramedics and their preceptors. Introduction The educational landscape for paramedicine has evolved considerably since the introduction of the first paramedicine Bachelor’s degree. A need to identify the contemporary barriers to and facilitators of learning within the context of early career training in paramedicine education is needed. Inclusion criteria Participants were undergraduate paramedicine students, graduate/intern paramedics, newly qualified UK paramedics and their preceptors, within Australia, the UK and New Zealand. Published and unpublished English studies utilizing qualitative research designs were considered. Methods Five bibliographic databases (PubMed, CINAHL, ERIC, Embase and ProQuest dissertations and theses) were searched in 2018. Websites relevant to paramedic learning and a hand search of paramedicine journals (2019) were also undertaken. All studies identified from the search were examined against the inclusion criteria. Papers selected for inclusion were assessed by two independent reviewers for methodological quality prior to inclusion in the review. Qualitative research findings were extracted and pooled. Findings were assembled and categorized based on similarity in meaning. These categories were then subjected to a meta-synthesis in order to produce a single, comprehensive set of synthesized findings. Results Twenty-six studies were included in the review: eleven studies used semi-structured interviews, five used open-ended interviews and ten used focus groups, with a total sample size of 564 participants. Sixteen studies focussed on undergraduate paramedicine students, four involved paramedic preceptors, two focused on paramedic educators at paramedicine universities, and four included undergraduate paramedicine students and their preceptors. A total of 295 findings were extracted and grouped into twenty-eight categories. Categories were grouped into five synthesised findings as follows; • The role of mentoring/preceptorship • Opportunities to develop emotional intelligence and communication skills • The role of non-traditional placements/experiences • The role of non-traditional classroom teaching methods • Preparedness for practice Conclusions A variety of learning models exist with barriers and facilitators that impact on paramedicine students, graduate paramedics, and preceptors. The findings emphasize the importance of a preceptor to student learning; and the need to develop paramedicine students’ skills/capacity in dealing with the emotional side of paramedic practice. Paramedicine students and paramedic graduates were found to be underprepared to communicate effectively with patients, families and other professionals. Most of these barriers could be mitigated by the utilization of non-traditional placements/experiences and with the use of non-traditional teaching methods. The introduction of a paramedic facilitator model was shown to have considerable benefits, suggesting that the introduction of a national model, similar to that of other allied health models, may be beneficial. The findings indicate a need for more effective communication between the education sector and industry in relation to the challenges that currently exist in paramedicine education and what models appear to facilitate learning, development and preparedness for clinical practice.enGraduate paramedicinternship paramedicparamedic learningparamedicine studentparamedic preceptorThesis