The Paramedic Preceptor Experience: Improving Preparation and Support

The preceptorship model of clinical education is widely used across Australia to assist new graduate and trainee paramedics in their transition from the classroom to the practical real world of providing pre-hospital emergency care. Preceptorship has been explored in-depth in many of the health professions, but despite being recognised as an essential component of paramedic education, there is a dearth of research that has explored the experience of being a paramedic preceptor.The aim of this study was two-fold. Firstly, to understand the experience of being a paramedic preceptor to novice paramedics who are in their first year of on-road clinical practice within an Australian ambulance service. Secondly, use this new understanding to inform the development of recommendations that will enhance the effectiveness of paramedic preceptorship programs. To achieve these aims, the study employed a hermeneutic methodology informed by the philosophical hermeneutics of Hans-Georg Gadamer (1900-2002). Audio recorded conversations were conducted with eleven qualified paramedics from a single Australian ambulance service who have experience as a paramedic preceptor in order to explore their lived experiences of being in the preceptor role.Out of this research emerged a comprehensive understanding of the paramedic preceptor as a complex, multi-dimensional role in which a paramedic acts as a coach, role model, socialiser and protector while working one to one with a novice paramedic in their first year of on-road practice. Through in-depth conversations the psycho-emotional experience of being a paramedic preceptor was revealed as emotionally demanding, with participants describing a tangible sense of having a greater level of responsibility, accountability and increase in work load, which led to feelings of stress, frustration, and mental and physical exhaustion. Despite this, paramedics gained intrinsic rewards and benefit from being in the preceptor role. Participants described feeling a sense of satisfaction from seeing the novice develop and grow professionally in their competence and confidence. It was also an opportunity for the preceptor's own professional development, and many of the participants developed close friendships with their preceptees.At the organisational level, this study disclosed a lack of preparation for paramedics to undertake the role of preceptor. Furthermore, the study participants described an environment of minimal support from on-road clinical educators during preceptorship. In contrast however, most participants felt well supported by their peers and colleagues. These findings highlight a substantial opportunity to improve paramedic preceptorship. To this end, important recommendations are made which include a proposed model for a preceptor preparation course that outlines three learning modules: understanding paramedic preceptorship, roles and responsibilities of the paramedic preceptor, and managing yourself during preceptorship. Further, several strategies are recommended that will improve the support provided to paramedic preceptors while undertaking this critically important role in the formative education of novice paramedics.Significantly, this study offers a new framework for understanding paramedic practice and learning during paramedic preceptorship. Through a sociomaterial approach, the framework presented in this thesis emphasises the process of becoming a competent, autonomous paramedic as an effect of the everyday relational networks, of human and non-human elements, in which the novice and preceptor practice.