Undergraduate paramedic students’ perceptions of their experiences in an inpatient mental health setting: Does a mental health placement prepare students for managing mental health presentations?

Abstract
Introduction
This research project aims to evaluate the experiences of undergraduate paramedic students who participated in a mental health placement initiative. There is extensive research that states that the paramedic workload associated with mental health presentations is increasing, although, the existing undergraduate education and practical training provided to paramedic students does not meet this demand. This results in paramedics lacking confidence and preparedness to manage mental health presentations effectively in practice. Current literature emphasises the significant benefits associated with a mental health placement for medical students, yet a significant gap exists in the literature regarding the benefits of a similar mental health placement for paramedic students. This study seeks to explore the educational and practical value associated with a mental health placement for paramedic students to begin to address this gap. The aim is to determine whether this type of work-integrated learning is effective in preparing paramedic students to better manage with mental health presentations by enhancing their confidence, as well as improving their mental health literacy and clinical skills. The results of this research provides evidence that the integration of similar mental health placements into the undergraduate paramedicine degree is a valid means of achieving these aims.
Methods
This mixed-methods research study involved eight second-year paramedic students from Charles Sturt University Port Macquarie. These students participated in a work-integrated placement initiative held in an inpatient mental health setting at Port Macquarie Base Hospital during their first year of study. Students were invited to participate in this study via email, which included a statement and description of the objectives of the study. The survey instrument included in this study was the Clinical Placement Evaluation Questionnaire which has been previously published and validated as an evaluation tool for nursing clinical placements. This survey has been commonly applied to nursing students to identify learning opportunities during clinical placements with the goal of developing strategies to enhance clinical skills. With this in mind, it is the first known instance where the use of this instrument has been applied in paramedicine. This study incorporates a mixed method approach, where data was collected utilising five-point Likert-scale questions and open-ended response type questions within the survey instrument.
Results
The response rate for the survey was 87.5%, with 75% of participants completing both the quantitative and qualitative sections and 12.5% of participants completing only the quantitative sections of the survey. Participants were required to respond to quantitative questions regarding whether there was adequate orientation provided, whether students were expected by the venue, whether staff members were willing to and available to assist in learning and whether the clinical experience would benefit others. Overall, the response was positive, with significant percentages of respondents selecting either strongly agree or agree for the majority of questions. Following this, thematic analysis incorporating triangulation was utilised to analyse the qualitative findings and to identify any associations with the quantitative data. Four central themes were highlighted which included the benefits of the mental health placement, quality of the nursing staff, improvements for the mental health placement and the need for additional training and education. It was identified that there was convergence, partial convergence and dissonance in different aspects of the convergence coding matrix. Overall, our results demonstrated significant educational and practical value associated with a mental health placement for paramedic students.
Discussion
There was evident alignment between the research included in the literature review and the results of this research study. Paramedic students reported considerable improvements in communication, clinical skills, aswell a deepened knowledge and understanding of mental illness. Further, paramedic students reported that they experienced enhanced confidence, comfort levels and resilience, as well as an improved ability to work as part of a multi-disciplinary team. Also, it was emphasised that paramedic students experienced reduced incidence of negative stigma and improvements in attitudes towards mental health patients. These results identify and demonstrate the need and value of a mental health specific placement experience for paramedic students and provide the evidence to support the incorporation of such a placement into the undergraduate paramedicine curriculum. An implication of this study is the potential for a well-received mental health subject designed for undergraduate paramedic students that incorporates theoretical education and practical training. As mentioned above, there are a multitude of practical benefits associated with the results of this research. One of which is the improvement of clinician and patient safety, ensuring industry readiness and adequate preparation for the workforce, as well as allowing paramedics to be better equipped to recognise and understand their own mental health and wellbeing. The results of this study adds to the current literature regarding mental health education and practical training in paramedicine and provides the opportunity for additional research possibilities in this field.