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Background: Together with addressing social determinants of health, culturally safe healthcare provision is essential for closing the health outcomes gap experienced by Aboriginal and Torres Strait Islander (Indigenous) Australians. Rural placements potentially provide students of the health professions with opportunities to enhance their knowledge and skills regarding cultural safety. We used rural placements data systematically collected from allied health students, including commencement- and end-of-placement questionnaire responses, to investigate the determinants of confidence in working with Indigenous people., Methods: The study comprised data from all students who provided survey data at both commencement and end of their first placement directly supervised by the administering University Department of Rural Health during the period 2019-2022. Five-point ordered responses to the question 'How confident do you feel about working with Aboriginal people?' were used to assess student and placement-related determinants of confidence (Confident/Very confident versus other) at baseline and increased confidence (≥ 1 point) during the placement using crude and adjusted multivariable robust Poisson regression., Results: Participating students (N = 489) were from diverse allied health disciplines (including pharmacy n = 94, 19.2%; chiropractic n= 66, 13.5%; physiotherapy n= 65, 13.3%; social work n = 59, 12.1%; and occupational therapy 58, 11.9%). Confidence in dealing with Aboriginal people was lower at commencement among females compared with males (adjusted relative risk [aRR] 0.65; 95% confidence interval [CI] 0.53-0.80), and higher among students of Australian rural origin compared with others (aRR 1.49; CI 1.22-1.83) and those who reported previous experience working with Indigenous people compared with those reporting none (aRR 1.40; CI 1.14-1.72). Placement attributes associated with increased confidence working with Indigenous people between placement commencement and end were interaction with Indigenous people within the placement (aRR 2.32; CI 1.24-4.34), placement model reflecting more structured academic supervision (aRR 1.18; CI 1.02-1.37), and placement length (aRR per additional day 1.002; CI 1.001-1.004). These associations were robust to modelling that accounted for a ceiling effect on increased confidence., Conclusions: While influenced by students' demographic attributes and prior experiences, confidence of allied health students in working with Indigenous people is enhanced during rural placements, particularly through direct contact with Indigenous people., (© 2024. The Author(s).)

Heart rhythm management is a continuously evolving sub-speciality of cardiology. Every year, many physicians and allied professionals (APs) start and complete their training in cardiac implantable electronic devices (CIEDs) or electrophysiology (EP) across the European Heart Rhythm Association (EHRA) member countries. While this training ideally ends with an EHRA certification, the description of the learning pathway (what, how, when, and where) through an EHRA core curriculum is also a prerequisite for a successful training. The first EHRA core curriculum for physicians was published in 2009. Due to the huge developments in the field of EP and device therapy, this document needed updating. In addition, a certification process for APs has been introduced, as well as a recertification process and accreditation of EHRA recognized training centres. Learning pathways are more individualized now, with Objective Structured Assessment of Technical Skills (OSATS) to monitor learning progression of trainees. The 2024 updated EHRA core curriculum for physicians and APs describes, for both CIED and EP, the syllabus, OSATS, training programme and certification, and recertification for physicians and APs and stresses the importance of continued medical education after certification. In addition, requirements for accreditation of training centres and trainers are given. Finally, suggested reading lists for CIED and EP are attached as online supplements., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The prevalence of mental and behavioural illnesses in the Australian community is increasing. Paramedics are frequently the first health responders to a mental health crisis, and their workload associated with mental health presentations is also increasing. The present study explored the experience and perspectives of undergraduate paramedic students who participated in a pilot mental health placement., Methods: A pilot workplace learning opportunity was established in which students completed a portion of their community service hours in an inpatient mental health setting at Port Macquarie Base Hospital. Eight students attended and completed the placement and were administered the Clinical Placement Evaluation Questionnaire., Results: Student responses to this placement experience were overwhelmingly positive. The data showed that all the students responded "Strongly Agree" or "Agree" to each of the survey items. Thematic analysis of the qualitative data yielded four central themes related to benefits, additional training and education, nursing staff, and improvements., Conclusions: This pilot study suggests that mental health placements for paramedics have meaningful educational value and can impact student learning. Since this pilot study, mental health placements have been permanently included as part of the undergraduate curriculum in our institution., (© 2024. The Author(s).)

Background: In the realm of trauma response preparation for prehospital teams, the combination of Augmented Reality (AR) and Virtual Reality (VR) with manikin technologies is growing in importance for creating training scenarios that closely mirror potential real-life situations. The pilot study focused on training of airway management and intubation for trauma incidents, based on a Trauma AR-VR simulator involving reserve paramedics of the National EMS service (Magen David Adom) who had not practiced for up to six years, activated during the Israel-Gaza conflict (October 2023). The trauma simulator merges the physical and virtual realms by utilizing a real manikin and instruments outfitted with sensors. This integration enables a precise one-to-one correspondence between the physical and virtual environments. Considering the importance of enhancing the preparedness of the reserve paramedics to support the prehospital system in Israel, the study aims to ascertain the impact of AR-VR Trauma simulator training on the modification of key perceptual attitudes such as self-efficacy, resilience, knowledge, and competency among reserve paramedics in Israel., Methods: A quantitative questionnaire was utilized to gauge the influence of AR-VR training on specific psychological and skill-based metrics, including self-efficacy, resilience, medical knowledge, professional competency, confidence in performing intubations, and the perceived quality of the training experience in this pilot study. The methodology entailed administering a pre-training questionnaire, delivering a targeted 30-minute AR-VR training session on airway management techniques, and collecting post-training data through a parallel questionnaire to measure the training's impact. Fifteen reserve paramedics were trained, with a response rate of 80% (n = 12) in both measurements., Results: Post-training evaluations indicated a significant uptick in all measured areas, with resilience (3.717±0.611 to 4.008±0.665) and intubation confidence (3.541±0.891 to 3.833±0.608) showing particularly robust gains. The high rating (4.438±0.419 on a scale of 5) of the training quality suggests positive response to the AR-VR integration for the enhancement of medical training, CONCLUSIONS: The application of AR-VR in the training of reserve paramedics demonstrates potential as a key tool for their swift mobilization and efficiency in crisis response. This is particularly valuable for training when quick deployment of personnel is necessary, training resources are diminished, and 'all hands on deck' is necessary., (© 2024. The Author(s).)

Background: Research forms an important part of clinical practice for nurses, midwives and allied healthcare professionals (NMAHPs). However, it is known there is a lack of confidence in this community in the development and use of research skills. The 4Ps Programme is a bespoke research-training programme that focuses on four areas: place, project, person and plan., Aim: To report an evaluation of the 4Ps Programme that used a survey to record the confidence levels reported by NMAHPs., Discussion: An increase in participants' confidence was observed across all modules in the 4Ps Programme. This exceeded the standard deviation in the 'place' session, demonstrating genuine improvement. It was not possible to demonstrate a significant improvement in all cases. Low response rates affected the quality of the data obtained in the study, which would have benefitted from a more targeted approach to questions and better enabled the tracking of individuals' improvement over the course of the programme., Conclusion: Participation in bespoke, targeted training related to research could lead to an increase in NMAHPs' confidence in research-related activities. Efforts need to be made to refine the evaluation approach and improve response rates., Implications for Practice: The 4Ps Programme can improve research-related confidence. Improved and further longitudinal evaluation will assess its impact in developing future clinical academics., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Introduction: When used appropriately, focused limited-scope ultrasound exams could potentially provide paramedics with accurate and actionable diagnostic information to guide prehospital decision-making. In this study we aimed to investigate the impact of a 13-hour prehospital ultrasound training course on the simulated clinical decision-making of paramedics as well as their ultrasound skills, knowledge, and self-confidence., Methods: We evaluated the ultrasound competence of 31 participants using post-course written and practical assessments. Written clinical decision scenarios were administered pre- and post-training. Post-training scenarios included an uninterpreted ultrasound clip to aid decision-making. Scenarios included extended focused assessment with sonography in trauma, pulmonary exam, and focused echocardiography combined with carotid pulse check exams. Correct answers to scenarios were defined as those selected by a veteran emergency physician. Participants also indicated their confidence in each of their decisions using a Likert scale., Results: Training yielded a statistically significant increase in both mean scenario score (35.5% absolute increase) and mean participant self-confidence (15.8% relative increase), across all exam/decision types assessed ( P  ≤ 0.001). The focused pulmonary exam yielded the largest increase in both mean score improvement (59.7% absolute increase) and paramedic confidence in their decisions (28.6% increase)., Conclusion: Trained paramedics can perform focused ultrasound exams and accurately interpret and apply actionable exam findings in the context of written scenarios. Analysis through our model characterized the theoretical clinical yield of each prehospital ultrasound exam and demonstrated how each exam may provide improved decision accuracy in several specific simulated clinical contexts. These results provide support for growing evidence that focused limited-scope ultrasound may be an effective prehospital diagnostic tool in the hands of trained paramedics., Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors received financial support from the Carmen Pettapiece Student Research Fellowship and the University of New England College of Osteopathic Medicine. There are no other conflicts of interest or sources of funding to declare.

Allied and behavioral health professionals (ABHP) interact with clients who may be at higher risk for substance misuse or substance use disorders (SUD) due to mental health problems, relational problems, and acute/chronic pain due to injury/illness. These problems can lead to more substance misuse and affect daily life activities and overall health and wellbeing. Unfortunately, not enough individuals seek treatment due to stigma associated with substance use, partially because of the lack of properly trained and educated healthcare professionals. The researchers developed an interprofessional training program using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) to develop learning modules focused on understanding the science of addiction, the stigma related to addictions, and the basic interviewing and assessment techniques to support appropriate substance use intervention and referral. The goal was to prepare ABHP students to appropriately address substance use as part of their future professional practice. The SBIRT learning modules used pre/post test quizzes to collect data on the effectiveness. 140 occupational and physical therapy and mental health counselling students completed the training and the results showed a significant increase in participants knowledge supporting the value of the SBIRT training.

Introduction: The retention of resuscitation skills is a widespread concern, with a rapid decay in competence frequently following training. Meanwhile, training programmes continue to be disconnected with real-world expectations and assessment designs remain in conflict with the evidence for sustainable learning. This study aimed to evaluate a programmatic assessment pedagogy which employed entrustment decision and the principles of authentic and sustainable assessment (SA)., Methods: We conducted a prospective sequential explanatory mixed methods study to understand and address the sustainable learning challenges faced by final-year undergraduate paramedic students. We introduced a programme of five authentic assessments based on actual resuscitation cases, each integrating contextual elements that featured in these real-life events. The student-tutor consensus assessment (STCA) tool was configured to accommodate an entrustment scale framework. Each test produced dual student led and assessor scores. Students and assessors were surveyed about their experiences with the assessment methodologies and asked to evaluate the programme using the Ottawa Good Assessment Criteria., Results: Eighty-four students participated in five assessments, generating dual assessor-only and student-led results. There was a reported mean score increase of 9% across the five tests and an 18% reduction in borderline or below scores. No statistical significance was observed among the scores from eight assessors across 420 unique tests. The mean student consensus remained above 91% in all 420 tests. Both student and assessor participant groups expressed broad agreement that the Ottawa criteria were well-represented in the design, and they shared their preference for the authentic methodology over traditional approaches., Conclusion: In addition to confirming local sustainability issues, this study has highlighted the validity concerns that exist with conventional resuscitation training designs. We have successfully demonstrated an alternative pedagogy which responds to these concerns, and which embodies the principles of SA, quality in assessment practice, and the real-world expectations of professionals., (© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Aim: This study aims to identify the prospective skill requirements for future radiographers practising in the United Arab Emirates (UAE). Such information will inform educational institutions, healthcare organisations, and policymakers in developing effective strategies., Methods: A cross-sectional study was conducted involving currently practising radiographers, nuclear medicine technologists, sonographers, and radiation therapists in the UAE (n =74). A comprehensive survey questionnaire was developed and validated through piloting and expert consultations. Ethical approval was obtained, and data were collected through purposive sampling. Descriptive statistics, reliability analysis, Chi-square tests, and factor analysis were employed in the data analysis., Results: The results showed that 73%, 47.3%, 43.2%, 40.5%, 39.2%, 33.8% interested in radiology safety, image interpretation, interprofessional and interpersonal skills, research and managerial skills, Picture Archiving and Communication System (PACS) administration and AI (Artificial Intelligence) and, clinical supervision and assessment, respectively. The factor analysis showed four factors factor considered for CPD training are training settings (15.12), training topics (1.88), CPD credits (1.72) and, presenter and expenses (1.49)., Conclusion: This study sheds light on the CPD requirements and aspirations of radiographers in the UAE, offering insights into their preferences and challenges. These findings can inform strategies for improving CPD opportunities and ensuring that radiographers are equipped to meet the evolving healthcare demands in the UAE, including performing enhanced practice., Implications for Practice: Development of flexible and comprehensive CPD programmes tailored to radiographers' career interests is required. Employers should provide financial support and flexibility in training options. Regulatory bodies should continue to mandate CPD, fostering a culture of lifelong learning. Supportive work environments, interdisciplinary collaboration, and technological fluency are crucial. Emphasising patient-centred care, research opportunities, and continuous assessment further enhances radiography practice., (Copyright © 2024. Published by Elsevier Inc.)

Paramedics face various unconventional and secondary task demands while driving ambulances, leading to significant cognitive load, especially during lights-and-sirens responses. Previous research suggests that high cognitive load negatively affects driving performance, increasing the risk of accidents, particularly for inexperienced drivers. The current study investigated the impact of anticipatory treatment planning on cognitive load during emergency driving, as assessed through the use of a driving simulator. We recruited 28 non-paramedic participants to complete a simulated baseline drive with no task and a cognitive load manipulation using the 1-back task. We also recruited 18 paramedicine students who completed a drive while considering two cases they were travelling to: cardiac arrest and infant seizure, representing varying difficulty in required treatment. The results indicated that both cases imposed considerable cognitive load, as indicated by NASA Task Load Index responses, comparable to the 1-back task and significantly higher than driving with no load. These findings suggest that contemplating cases and treatment plans may impact the safety of novice paramedics driving ambulances for emergency response. Further research should explore the influence of experience and the presence of a second individual in the vehicle to generalise to broader emergency response driving contexts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Work-integrated learning (WIL) is a core aspect of allied health education. WIL placements typically focus on developing clinical skills, with broader conceptions of work readiness a secondary consideration. Near-peer mentoring (NPM), where senior students mentor junior students, is one WIL placement model that holds promise for developing students' work readiness, along with additional benefits for educators and service users. While there is emerging evidence of the benefits of NPM in allied health, a more comprehensive understanding of the design and outcomes of NPM WIL placements for allied health students, their educators and service users is needed., Methods: A systematic search of seven electronic databases (CINAHL, ERIC, ProQuest Education, Medline, PsychInfo, EMBASE and Scopus) from 2003 to 2022 was conducted with 4195 records reviewed. Included studies reported on near-peer mentoring between at least one of the identified 11 allied health professionals providing services to real people (i.e. not simulation). Data extracted included pedagogical approaches, type of service model and relationship of peers to each other and educator, objectives for implementing the NPM, and effects for students. Quality appraisal was undertaken using the Standards for Reporting of Qualitative Research (SRQR)., Results: Fourteen studies met the inclusion criteria. The majority were North American in origin, from the disciplines of pharmacy, physiotherapy, psychology and occupational therapy, and used a range of research designs. Four types of placement design were observed from incidental co-location of students and observing outcomes through to deliberate preparation of students and/or educators for their roles in a NPM placement. Outcomes for junior students included lowered anxiety leading to increased confidence and motivation to learn and thus enhanced clinical skills. Senior student outcomes included development of educator skills, increased confidence, and enhanced professional reasoning. Service users and educators also benefited from NPM; however, evidence was sparse in these areas., Conclusion: The evidence supports near-peer mentoring as a valuable WIL model to support work readiness, and several general pedagogical designs are evident. Future research should design NPM WIL with a greater integration of educational theory and evaluate outcomes beyond satisfaction and self-reported experiences., (© 2024. The Author(s).)

Introduction: 20 years ago, health professional student placements in rural areas of Australia were identified as an important rural recruitment strategy and funding priority. Since then, there has been a growing body of research investigating the value, impact, barriers and facilitators of student placements in rural areas of Australia. Charles Sturt University, Three Rivers Department of Rural Health, was recently awarded an Australian Government grant to expand their Rural Health Multidisciplinary Training (RHMT) programme, designed to increase multi-disciplinary student placements in rural areas of New South Wales (NSW), Australia. The aim of this study is to determine if the expanded RHMT has a positive social return on investment (SROI)., Methods and Analyses: The RHMT Programme will expand into the Forbes/Parkes/Lachlan local government areas of NSW where there is a population of 21 004 people, including 3743 First Nations peoples. Data collection includes collecting programme outputs, programme costs and conducting surveys and interviews with students, host organisations, supervisors and community members including First Nations peoples. The SROI will quantify the 'investment' required to implement the RHMT programme, as well as the 'social return' on the RHMT programme from the student, organisational, supervisor and community perspectives. The SROI will compare the combined cost with the combined return, from a societal perspective, including a 3-year time horizon, with cost data presented in $A 2024/25., Discussion: The findings of this SROI study may influence future Australian government investment in RHMT as a mechanism for supporting rural allied health recruitment and for investing in the local rural economy., Ethics and Dissemination: This study has been approved by the Charles Sturt University Human Research Ethics Committee (#H23589) and the Aboriginal Health and Medical Research Council of New South Wales (#2130/23). Results will be disseminated via a peer-review journal publication, as well as conference presentations., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The aim of the study was to identify continuing professional development (CPD) needs of allied health professionals (AHP) in regional and rural Victoria., Design: This study was an online cross-sectional design conducted between December 2022 and February 2023., Settings and Participants: AHPs employed at a large multi-site regional public health service providing acute, subacute, community and outpatient care in Victoria, Australia., Main Outcome Measure(s): The online questionnaire included four sections investigating satisfaction of CPD, prioritised topics for CPD, preference for CPD sourcing and perceived capabilities in delivering education. To investigate prioritised topics of CPD, a tool was adapted from the Hennessy Hicks Training Needs Analysis questionnaire to align with allied health (AH) career pathways. For organisational alignment, a second questionnaire was sent to AH managers., Results: The response rate was 17% (53/316 AHPs) from members of 10 AH professions. The median years of clinical experience for participants was between 2 and 5 years. Participants with 6-10 years of clinical experience reported the lowest level of satisfaction. Research and education were identified as areas of highest training need. Self-perceived competence in education delivery was proportionately lower in areas of assessment, developing digital learning and constructive alignment., Conclusion: CPD needs for AHPs in a regional and rural health service were shown to vary by career stage and weighted towards developing research and education delivery capabilities. Findings from this study may support public health sector and policy investment in CPD opportunities to support horizontal career progression opportunities, a balance of internal and externally sourced professional development and strategic investment in education delivery capabilities., (© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Background: Allied health clinicians supervising healthcare students in workplace learning play a key role in a learner's progression to autonomous practice, yet expert educator practice is not well understood. How expert clinical educators in allied health professions are defined, enact their role, develop educational expertise and bring value to workplace learning is unclear., Methods: A scoping methodology was chosen to understand what is known about clinical educator expertise in allied health, focusing on definitions, characteristics, impacts and development. Searching seven databases, the authors used an iterative, systematic approach to the selection, collation and analysis of peer-reviewed and grey literature., Results: Within 21 included papers, diverse terms and definitions were used to describe expert clinical educators across 9 allied health professions and 5 countries. Expert educator characteristics included advanced skills in facilitating learning, the ability to build positive relationships with learners and a proactive attitude to developing personal supervision skills through reflection. Impacts were identified for learners and educators, and the few sources examining educator development found that expert practice grows in a dynamic, multi-mode, non-linear fashion., Conclusion: A comprehensive picture of the expert clinical educator in allied health is not yet conceptualised, despite some characteristics being associated with expertise. The differences between expert and less proficient educators are unclear with little examination of the impacts, value or development of expert educator capabilities. We offer a framework for future research and advocate for focused studies that examine clinical educator expertise, to enhance approaches to professional development and recognition of excellence in clinical educator practice., (© 2024 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Background: Paramedics are expected to record electrocardiograms (ECGs) as part of their clinical assessment; however, it is an extremely difficult skill to learn and understand as it has a high intrinsic cognitive load which can also be challenging to teach effectively., Aims: This article will explore the use of cognitive load theory to assist in the teaching of ECG interpretation within the context of paramedical education., Description: Cognitive load theory can be useful to aid teaching within complex medical and health science domains including clinical skills teaching., Conclusions: The application of cognitive load theory to the teaching of ECG interpretation can be useful as it allows for the development of understanding, building schemata linking information currently being learned to knowledge already gained within the long-term memory, which can maximise germane load by the appropriate selection of intrinsic load, minimising extraneous load therefore not overloading the working memory., (© 2024 The Author. The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Background: Post graduate master's degree qualifications are increasingly required to advance allied health profession careers in education, clinical practice, leadership, and research. Successful awards are dependent on completion of a research dissertation project. Despite the high volume of experience gained and research undertaken at this level, the benefits and impact are not well understood. Our study aimed to evaluate the perceived impact and legacy of master's degree training and research on allied health profession practice and research activity., Methods: A cross-sectional online survey design was used to collect data from allied health professionals working in the United Kingdom who had completed a postgraduate master's degree. Participants were recruited voluntarily using social media and clinical interest group advertisement. Data was collected between October and December 2022 and was analysed using descriptive statistics and narrative content analysis. Informed consent was gained, and the study was approved by the university research ethics committee., Results: Eighty-four responses were received from nine allied health professions with paramedics and physiotherapists forming the majority (57%) of respondents. Primary motivation for completion of the master's degree was for clinical career progression (n = 44, 52.4%) and formation of the research dissertation question was predominantly sourced from individual ideas (n = 58, 69%). Formal research output was low with 27.4% (n = 23) of projects published in peer reviewed journal and a third of projects reporting no output or dissemination at all. Perceived impact was rated highest in individual learning outcomes, such as improving confidence and capability in clinical practice and research skills. Ongoing research engagement and activity was high with over two thirds (n = 57, 67.9%) involved in formal research projects., Conclusion: The focus of master's degree level research was largely self-generated with the highest perceived impact on individual outcomes rather than broader clinical service and organisation influence. Formal output from master's research was low, but ongoing research engagement and activity was high suggesting master's degree training is an under-recognised source for AHP research capacity building. Future research should investigate the potential benefits of better coordinated and prioritised research at master's degree level on professional and organisational impact., (© 2024. The Author(s).)

In the paramedical training establishments and institutes of Northern Gironde, all stakeholders are mobilizing to enhance the attractiveness of healthcare professions. The human resources department and the general coordination of care activities are implementing a proactive social and managerial policy in connection with training institutes that are working to attract learners to a peri-urban and rural area. Like an invitation to live an epic, a commitment to share an adventure with passion, that of discovering the caring professions., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Clinical supervision typically occurs between clinicians who are trained in the same discipline, and this assumption is present across much of the relevant literature. However, the use of interprofessional supervision (IPS), wherein clinicians do not share the same discipline, has increased in recent years. As IPS increases in usage, it is key that the implications of this approach are explored. In order to map the existing evidence, a scoping review was conducted to explore what is known about the use of IPS across five allied health professions (psychology, speech and language therapy, occupational therapy, physiotherapy and social work). A systematic literature search of four electronic databases was conducted, with 27 articles meeting the inclusion criteria. The data were analyzed using thematic synthesis. Six key themes were identified relating to factors impacting the appropriateness of IPS, necessary steps in the IPS process, and impacts of IPS for clinicians. Limited application of standardized tools and theoretical frameworks within the existing research was highlighted. The findings identified within this review present a broad overview of the existing research relating to IPS, which can be used to inform future research in this area.

Background: Staff shortages limit access to health services. The bidirectional benefits of allied health clinical placements are understood in the domains of student learning, health service delivery, and future workforce development. Still, the benefits to current workforce outcomes remain unknown. This review provides insights into the effects of allied health student placements in acute and primary care settings, particularly on healthcare staff's knowledge and procedural skills., Methods: This search was based on the integrative review process established by Whittemore and Knafl in 2005. In October 2023, the first author (MH) searched five major electronic databases: Medline-EBSCO, PubMed, CINAHL, Embase, and Scopus. The CLUSTER model was used to track additional references. The first three authors (MH, SM, and SC) were involved in screening, quality appraisal, and synthesis of the studies. Data were thematically synthesised and analysed., Results: MeSH headings and keywords were used in key search areas: health education, health professional training, clinical placements, and allied health professions. The systematic search yielded 12 papers on allied health student placements across various healthcare settings in rural and metropolitan areas, with no high-quality methodologies measuring student placements' impact on staff knowledge and skills. Four main themes were identified from the analysis: meaningful student integration in service delivery, targeted educational support to healthcare staff, development of staff procedural skills and confidence, and the mechanisms of why student placements work in this aspect., Conclusions: This review suggests that offering allied health student placement could be a promising approach to supporting rural healthcare staff in performing patient assessments and treatments proficiently and collaboratively. However, this requires further investigation to confirm., (© 2024. The Author(s).)

Background:  Healthcare professionals are required to work effectively together to deliver the best healthcare services. Without awareness of other healthcare professionals' roles and responsibilities, interprofessional practice (IPP) cannot be optimally achieved., Objectives:  This study aimed to investigate healthcare professionals' awareness of audiology and speech-language pathology (SLP) services in Saudi Arabia., Method:  This cross-sectional descriptive study consisted of two parts. The content of a 20-item paper questionnaire was firstly validated. The full-scale study addressed the aim through distributing questionnaire items among potential participants. Descriptive statistics and chi-square test were used., Results:  A total of 403 participants completed the questionnaires for the main study. Most of the participants were Saudi citizens (84.1%), aged 18 years - 40 years (84.8%) years, and lived in Riyadh region (76.2%). Allied health professionals (40.2%), physicians (22.6%), nursing (15.4%) and dentistry (11.2%) were the main group of participants working mainly at governmental hospitals (69.2%). Of the total participants, 92.6% and 95.3% reported being fully aware of the services provided by audiologists and SLPs, respectively. No statistically significant association between the specialty of participants and their familiarity with the scope of practice for SLPs and audiologists was determined., Conclusion:  Our study examined healthcare professionals' awareness of audiology and SLP services and revealed a high level of awareness.Contribution: The existed level of awareness is expected to facilitate IPP and enhance the quality of care. Still, awareness campaigns about audiology and SLP services are needed to address the existing lack of knowledge among some healthcare professionals.

Aim: To develop a better understanding of the perceptions of first point of contact roles within primary care by pre-registration students of the Allied Health Professions (AHPs)., Background: General practice in the UK is under growing pressure from declining general practitioner (GP) numbers and increased service demand. The National Health Service (NHS) is attempting to mitigate this demand by making more effective use of its highly experienced workforce through the creation of first contact practitioners (FCPs). Working in primary care, FCPs are highly experienced AHPs with three or more years of relevant clinical experience., Methods: An abductive qualitative research approach underpinned by a descriptive phenomenological methodology was adopted. Thematic analysis was used to analyse the focus group transcripts., Findings: Twenty two final-year pre-registration AHP students participated in three focus groups. Two themes with sub-themes were identified: (1) Understanding of the role-pathway to the role; role clarity; and sources of knowledge. (2) Impact on service-positives and challenges., Conclusions: This study synthesised new findings from the previously unexplored FCP stakeholder of pre-registration AHP students. Participants generally understood the FCP's purpose of unburdening GPs and perceived the FCP model to contribute to the solution of rising clinical and financial pressures within the NHS, and primary care specifically. However, there was confusion regarding the scope of practice of an FCP. It is vital that the future workforce understand this role through effective education., (© 2024 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.)

Background: Limited knowledge exists regarding how paramedics acquire an understanding of the scene they encounter upon arrival, despite their need to quickly gather information for effective clinical decision-making. This study examined visual scanning behaviour during the early stages of simulated emergency calls., Methods: Eye movements of 10 paramedicine students were recorded during simulated calls conducted in both a high-fidelity classroom setting and a full sensory immersion setting., Results: Students focused on similar areas in both settings, with most time spent looking at the patient rather than distractors such as room features or other people. Analysis of gaze behaviour across the first five minutes revealed a more nuanced pattern: attention initially gravitated towards distractors but decreased as students became familiar with their surroundings and focused on the task at hand. This pattern was consistent across both simulation settings, indicating that information-seeking strategies may be independent of scene complexity., Conclusions: Expertise relies on the ability to differentiate between relevant and irrelevant information. Given the unpredictable nature of their work, paramedics must continuously adapt their understanding of a scene from the moment they enter it. Understanding how this skill develops may help identify expert strategies to inform training of novice paramedics., Competing Interests: Declaration of Competing Interest This is an original manuscript devised, conducted and written by the research team. The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

Objectives: It is important that allied health professionals (AHPs) are prepared for clinical practice from the very start of their working lives to provide quality care for patients, for their personal well-being and for retention of the workforce. The aim of this study was to understand how well newly qualified AHPs were prepared for practice in the UK., Design: Systematic review., Data Sources: Embase, MEDLINE, CINAHL, ERIC and BEI were searched from 2012 to 2024. Grey literature searching and citation chasing were also conducted., Eligibility Criteria: We included primary studies reporting the preparedness for practice of UK graduates across 15 professions; all study types; participants included graduates who were up to 2 years postgraduation, their supervisors, trainers, practice educators and employers; and all outcome measures., Data Extraction and Synthesis: A standardised data extraction form was used. Studies were quality assessed using the Quality Appraisal for Diverse Studies tool. 10% of articles were independently double-screened, extracted and quality assessed; 90% was completed by one researcher., Results: 14 reports were included (9 qualitative, 3 mixed-method and 2 quantitative). Six papers focused on radiographers, three on a mixture of professions, two on paramedics, and one each on physiotherapists, clinical psychologists and orthotists. An important finding of the review is the paucity and low-medium quality of research on the topic. The narrative synthesis tentatively suggests that graduates are adequately prepared for practice with different professions having different strengths and weaknesses. Common areas of underpreparedness across the professions were responsibility and decision-making, leadership and research. Graduates were generally well prepared in terms of their knowledge base., Conclusion: High-quality in-depth research is urgently needed across AHPs to elucidate the specific roles, their nuances and the areas of underpreparedness. Further work is also needed to understand the transition into early clinical practice, ongoing learning opportunities through work, and the supervision and support structures in place., Prospero Registration Number: CRD42022382065., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To evaluate how the codesigned training programme, 'No conversation too tough', can help cancer, palliative and wider healthcare professionals support patients to communicate with their dependent children when a parent is dying. We examined perceptions of learning provided by the training, its contribution to confidence in communicating with families when a parent is dying, and subjective experience of, and reactions to, the training. We also explored potential changes in practice behaviours., Design: Pre-post, convergent, parallel, mixed-methods study. Motivations for practice change were measured quantitatively, and qualitatively through semi-structured interviews. Non-parametric analysis was conducted for self-efficacy and outcome expectancy measures; descriptive statistics examined perceptions of usefulness; intentions to use learning in practice and reactions to the training. Semi-structured interviews examined motivations and perceptions of learning in depth. A 6-week, practice log recorded immediate practice effects and reflections., Setting: 1-day training delivered 3 times, total delegates 36: online December 2021, February 2022, face-to-face March 2022. Questionnaires delivered correspondingly in online or paper formats, semi-structured interviews online., Participants: Pre-post: palliative care professionals (n=14/12), acute cancer clinical nurse specialists (n=16/11), other healthcare professionals (n=5/5)., Results: Positive changes were observed in self-efficacy (17 of 19 dimensions p<0.003) and outcome expectancies (3 of 14 beliefs p<0.036). Perceptions of usefulness and intentions to use learning in practice mean scores were 82-94 (scales 0=low to 100=high). There was high affirmation for sharing learning and influencing change in the workplace and wider practice. Content, style and delivery were positively endorsed. Further elements to be included in the training were identified., Conclusions: The training programme has the potential to effect change in practice behaviours. A large-scale study will evaluate the roll-out of the training delivered to individual professionals and whole teams across the UK. It will provide longer-term feedback to understand practice behaviour and mediators of change across professional roles., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Clinical supervision supports patient care and health worker wellbeing. However, access to effective clinical supervision is not equitable. We aimed to explore the access and effectiveness of clinical supervision in allied health workers., Methods: A cross-sectional survey design using the Manchester Clinical Supervision Scale (MCSS-26), including open-ended survey responses, to collect data on effectiveness. Multivariable regression was conducted to determine how MCSS-26 scores differed across discipline, work location and setting. Open-ended responses were analysed using content analysis., Results: 1113 workers completed the survey, with 319 (28%) reporting they did not receive supervision; this group were more likely to hold management positions, work in a medical imaging discipline and practice in a regional or rural location. For those who received supervision, MCSS-26 scores significantly differed between disciplines and work settings; psychologists and those practising in private practice settings (i.e. fee-for-service) reported the highest levels of effectiveness. Suggested strategies to enhance effectiveness included the use of alternate supervision models, dedicated time for supervision, and training., Conclusion: Targeted subgroups for improving access include senior staff, medical imaging professionals, and those working across regional and rural settings. Where supervision was least effective, strategies to address behaviours with organisational support may be required.

Introduction: Strict safety practices are essential to ensure the safety of patients and staff in Magnetic Resonance Imaging (MRI). Training regarding the fundamentals of MRI safety is well-established and commonly agreed upon. However, more complex aspect of screening patients, such as image review or screening of unconscious patients/patients with communication difficulties is less well discussed. The current UK and USA guidelines do not suggest the use of communication training for MRI staff nor indicate any training to encourage reviewing images in the screening process. This review aims to map the current guidance regarding safety and patient screening training for MRI diagnostic and therapeutic radiographers., Methods: A systematic search of PubMed, Trip Medical database and Radiography journal was conducted. Studies were chosen based on the review objectives and pre-determined inclusion/exclusion criteria using the PRISMA-ScR framework., Results: Twenty-four studies were included in the review, which identified some key concepts including MRI safety training and delivery methods, screening and communication, screening of unconscious or non-ambulatory patients and the use of imaging., Conclusion: Training gaps lie within the more complex elements of screening such as the inclusiveness of question phrasing, particularly to the neurodivergent population, how we teach radiographers to screen unconscious/unresponsive patients and using imaging to detect implants., Implications for Practice: The consequences of incomplete or inaccurate pre-MRI safety screening could be the introduction of unexpected implants into the scanner or forgoing MRI for a less desirable modality. The development of enhanced training programs in implant recognition using imaging and communication could complement existing training., Competing Interests: Conflict of interest statement None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Many transgender individuals face inequities, discrimination, and sometimes even a lack of transgender-specific knowledge in health care settings. Educational curricula can address such disparities and help future health professionals to become more knowledgeable, confident, and well-prepared for addressing the needs of transgender individuals. This systematic review aims to summarize current training interventions about care of transgender individuals for health and allied health students, and to analyse the effects of the respective intervention. A total of six databases (Pubmed, MEDLINE, Scopus, Web of Science, Embase and SciSearch) were screened for original articles published between 2017 and June 2021. Search terms and eligibility criteria were pre-specified, and after a structured selection process 21 studies were included into further analysis. Extracted data contained information on general study properties, population, design, program format and outcomes of interest. A narrative synthesis was used to summarize detected results. Study quality was assessed for each individual study. A self-developed 18-item checklist combining criteria of two prior published tools was used to assess overall quality of quantitative studies. For qualitative studies a 10-item checklist by Kmet et al. [HTA Initiat, 2004] was applied. Eligible studies were designed for multiple health or allied health profession students, and varied widely regarding program format, duration, content, and assessed outcomes. Almost all (N = 19) interventions indicated improvements in knowledge, attitude, confidence and comfort levels or practical skills concerning care for transgender clients. Major limitations included the lack of long-term data, validated assessment tools, control groups and comparative studies. Training interventions contribute to prepare future health professionals to deliver competent and sensitive care and which may improve the prospective experienced health care reality of transgender individuals. However, currently there is no common consensus about best practice of education. Additionally, little is known about whether detected effects of training interventions translate into noticeable improvements for transgender clients. Further studies are warranted to assess the direct impact of specific interventions in the light of the respective target populations., (© 2023. The Author(s).)

Background: Community paramedicine (CP) is an extension of the traditional paramedic role, where paramedics provide non-acute care to patients in non-emergent conditions. Due to its success in reducing burden on hospital systems and improving patient outcomes, this type of paramedic role is being increasingly implemented within communities and health systems across Ontario. Previous literature has focused on the patient experience with CP programs, but there is lack of research on the paramedic perspective in this role. This paper aims to understand the perspectives and experiences, both positive and negative, of paramedics working in a CP program towards the community paramedic role., Methods: An online survey was distributed through multiple communication channels (e.g. professional organizations, paramedic services, social media) and convenience sampling was used. Five open-ended questions asked paramedics about their perceptions and experiences with the CP role; the survey also collected demographic data. While the full survey was open to all paramedics, only those who had experience in a CP role were included in the current study. The data was qualitatively analyzed using a comparative thematic analysis., Results: Data was collected from 79 respondents who had worked in a CP program. Three overarching themes, with multiple sub-themes, were identified. The first theme was that CP programs fill important gaps in the healthcare system. The second was that they provide paramedics with an opportunity for lateral career movement in a role where they can have deeper patient connections. The third was that CP has created a paradigm shift within paramedicine, extending the traditional scope of the practice. While paramedics largely reported positive experiences, there were some negative perceptions regarding the slower pace of work and the "soft skills" required in the role that vary from the traditional paramedic identity., Conclusions: CP programs utilize paramedic skills to fill a gap in the healthcare system, can improve paramedic mental health, and also provide a new pathway for paramedic careers. As a new role, there are some challenges that CP program planners should take into consideration, such as additional training needs and the varying perceptions of CP., (© 2024. The Author(s).)

Aim: To offer a practical way in which the status of healthcare assistants (HCAs) can be increased by drawing on their experience, knowledge and skillset, whilst mentoring medical students during an HCA project., Design: Qualitative, reflexive thematic analysis., Methods: One-to-one semi-structured interviews were conducted between April and June 2019, with 13 participants. Participants included five healthcare assistants; three practice development nurses, two of whom were former HCAs; one registered general nurse and four clinical educators., Results: Two themes were identified: HCAs as silent, invisible caregivers (theme 1) and the formation of an HCA identity through mentoring (theme 2). HCAs are often silent performers of complex patient care with limited opportunity to engage in the interprofessional team dialogue. Social perceptions of HCAs describe them as a marginalised, poorly understood, 'unqualified' group with 'lowly status'. Mentoring medical students allows HCAs to draw on their experience, knowledge and skillset by actively contributing to the learning and development of future doctors., Conclusion: The mentoring of medical students gave HCAs an active voice within the interprofessional team, instilling their confidence and self-worth. Mentoring allowed HCAs to move from a homogenous, group-based social identity to a role-based one that enabled HCAs to reveal the true extent of their work whilst negotiating their place and identity within the interprofessional team., Impact: Leaders in healthcare will see that a re-evaluation of HCAs as performers of basic, hands-on patient care is needed to breakdown ingrained beliefs, eliminating a 'us and them' mentality. Involving HCAs in the mentoring of medical students will impact on the personal development of both HCAs and medical students in the cultivation of a future, person-centred, inclusive and collaborative workforce., Reporting Method: COREQ guidelines to enhance methodological rigour were strictly adhered to., Patient and Public Involvement: There is no patient or public involvement., (© 2024 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: To explore the attitudes and experiences of allied health students working with older adults on residential aged care placements., Method: A systematic literature search was conducted to identify studies of any design describing allied health student experience of residential aged care placements. Online databases searched to identify potentially relevant documents included Scopus, Web of Science, PubMed, CINAHL Complete (EBSCOhost) and Health and Medicine (ProQuest). Studies were excluded if residential aged care facilities or allied health professional students could not be extracted from the data. No restrictions were applied to methodological design, language, geographical location or year of publication. The Mixed Methods Appraisal Tool was used to assess methodological quality. Extracted studies were analysed to identify the study design, participant and placement characteristics, study methodology and student experience measures. Data from the included studies were analysed thematically using meta-synthesis., Results: Six studies (total number of participants, n = 308) met inclusion criteria, with four papers scoring a 5/5 on the Mixed Methods Appraisal Tool. Studies included undergraduate and master's students from physiotherapy (n = 3), speech language pathology (n = 2), dietetics (n = 1) and audiology (n = 1). Placement length varied from two to 15 h, between one and six residential aged care visits. Three themes were identified; (1) Opportunity to improve skills and gain confidence, (2) Development of empathy and shift in attitudes towards older adults and (3) Recognised challenges associated with older adults and residential aged care settings., Conclusion: While the size of the evidence-base is limited, the studies were largely consistent in demonstrating an increase in positive attitudes towards older adults following residential aged care placements. Future research, innovations and planning around workforce size, preparation and motivation must be prioritised to ensure older adults receive the care they need and deserve., (© 2023 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Australia.)

Background: Mentorship is a mutually beneficial voluntary relationship between mentor and mentee. In principle, the mentee trusts in the mentor for guiding career development and acquiring new knowledge and skills while the mentor finds giving back to the profession rewarding. Mentorship is beneficial at every career stage, but little is known about current programs and processes., Objective: To review the literature about mentorship in allied health to inform programs and practices in occupational therapy. Scoping focused on barriers, facilitators and reported outcomes of programs and attributes of mentors and mentees., Data Sources: A search was applied to six databases on 8 February 2022 in Ovid MEDLINE, Ovid Embase, Scopus, PUBMED and CINAHL Complete. Search terms were developed in consultation with an academic librarian and using the population, concept and context mnemonic., Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the JBI Manual for Evidence Synthesis. Data extraction forms were piloted with two reviewers and dual extraction occurred with a portion of papers. Where conflicts arose, discussion occurred until a consensus was reached., Findings: Sixty-two papers were included from eleven countries. The papers arose from ten allied health disciplines, with five in occupational therapy. One-on-one mentoring was most common followed by groups and the use of online platforms. Structured approaches were often used, with the support of professional associations. Trust and willingness to share expertise were required attributes of mentors. Mentees appreciate self-selecting their mentor and having protected time for mentorship., Conclusion and Significance: This synthesis provides a description of the available literature on mentorship in allied health. Benefits of mentorship were recorded with the acquisition of skills and knowledge being the most prominent. This synthesis provides ideas for future development and refinement of mentorship in occupational therapy., (© 2023 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

Background: Although paramedics can use adrenaline autoinjectors (AAIs) during their duties, the actual conditions of their use and the challenges faced remain unclear. We investigated the actual situation and issues pertaining to creating an environment in which paramedics can operate AAIs more effectively., Methods: A web-based survey was conducted among paramedics who participated in a web-based training session related to their latest knowledge on food allergies and emergency responses in 2022. The survey items included practice and training environments, practices of AAI administration, and regarding AAI administration., Results: Seventy paramedics responded to the survey. Twenty-eight respondents (40%) had experienced cases in which they wished they had an AAI in their work to date, but only one had actually administered one. Thirty-four (49%) indicated that it would be good to have an AAI in the ambulance at all times; 48 (69%) were not concerned about the use of AAI, and the level of concern about its use was significantly related to length of service. The study also revealed that paramedics do not have an adequate training environment regarding AAI., Conclusion: Few paramedics have experience in administering AAI, although they are aware of the need for it. For more effective use of AAI, it is necessary to establish a training environment to familiarize paramedics with anaphylaxis and an environment that enables them to use AAI promptly in the field.

Objective: This systematic review aims to identify the diagnostic accuracy of posterior circulation stroke (PCS) by paramedics and the causes and duration of delay in its recognition., Methods: A systematic search using CINAHL Plus, MEDLINE, Scopus, and PubMed was performed. All databases were searched up to May 25, 2022. Studies were included where patients were adults, assessed by paramedics, and PCS was the primary diagnosis. Bias was assessed using the Newcastle-Ottawa Scale and the Effective Practice and Organization of Care tool. Results have been described by proportions, and both sensitivity calculations and subgroup analysis were performed utilizing MedCalc., Results: A total of 797 titles/abstracts and a subsequent 87 full texts were screened, of which 15 were included. There were 5395 patients who were assessed by paramedics and had a confirmed diagnosis of PCS. Among five studies containing both true positive and false negative data, there were 98 (45.8%) true positives. PCS patients lost an average of 27 min ( p  < 0.001) compared to anterior stroke patients in the prehospital setting. One study revealed that educational intervention, including implementing the finger-to-nose test, increased the sensitivity for diagnosis from 45.8 to 74.1% ( p  = 0.039) and decreased the time from door to computed tomography from 62 to 41 min ( p  = 0.037)., Conclusion: There is a substantial lack of evidence regarding the diagnosis of PCS by paramedics. Despite the low quality of evidence available, overall, the sensitivity for paramedic PCS diagnosis appears to be poor. Further investigation is required into paramedics' diagnosis of PCS and the use of educational interventions.Prospective Register of Systematic Reviews Registration Number: CRD42022324675.

Purpose: The duties of paramedics and emergency medical technicians (P&EMTs) are continuously changing due to developments in medical systems. This study presents evaluation goals for P&EMTs by analyzing their work, especially the tasks that new P&EMTs (with less than 3 years’ experience) find difficult, to foster the training of P&EMTs who could adapt to emergency situations after graduation., Methods: A questionnaire was created based on prior job analyses of P&EMTs. The survey questions were reviewed through focus group interviews, from which 253 task elements were derived. A survey was conducted from July 10, 2023 to October 13, 2023 on the frequency, importance, and difficulty of the 6 occupations in which P&EMTs were employed., Results: The P&EMTs’ most common tasks involved obtaining patients’ medical histories and measuring vital signs, whereas the most important task was cardiopulmonary resuscitation (CPR). The task elements that the P&EMTs found most difficult were newborn delivery and infant CPR. New paramedics reported that treating patients with fractures, poisoning, and childhood fever was difficult, while new EMTs reported that they had difficulty keeping diaries, managing ambulances, and controlling infection., Conclusion: Communication was the most important item for P&EMTs, whereas CPR was the most important skill. It is important for P&EMTs to have knowledge of all tasks; however, they also need to master frequently performed tasks and those that pose difficulties in the field. By deriving goals for evaluating P&EMTs, changes could be made to their education, thereby making it possible to train more capable P&EMTs.

Background: Research has shown paramedics form rapid intuitive impressions on first, meeting a patient and these impressions subsequently affected their clinical reasoning. We report an experiment where theory-based interventions are developed with the goal of reducing reliance on intuitive reasoning by paramedics and paramedic students in simulated patients., Method: Australian paramedics (n = 213; 49% female) and paramedicine students (n = 83; 55% female) attending paramedic conferences completed a 2 × 2 fully between participants experiment. They saw a written clinical vignette designed to be representative of Acute Coronary Syndrome (ACS) in which key clinical information was precise or degraded (stimulus), they then either chose the single most likely diagnosis from a list, or ranked competing diagnoses (response). Outcome variables were diagnostic rate and response time., Results: There were no differences in the proportion of participants choosing ACS across the four stimulus-response conditions (0.75 [0.65, 0.84] vs 0.79 [0.68, 0.87] vs, 0.78 [0.65, 0.87] vs 0.72 [0.59, 0.82], p = 0.42) CONCLUSION: This is the first study attempting to experimentally examine clinical reasoning in paramedics using a theory-based intervention. Neither of the interventions tested succeeded in altering measures of clinical reasoning. Similar to previous research on physicians, paramedic reasoning appears robust to manipulation., Competing Interests: Conflicts of interest The authors have no conflicts of interest to report., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Allied Health Professionals (AHPs) are well placed to deliver physical activity advice but this is currently not routine clinical practice. Increasing evidence demonstrates physical activity can improve quality-of-life for people affected by cancer, enable behaviour change, improve survival and reduce long-term treatment effects. We aimed to understand AHPs' current knowledge and practice in advising about physical activity., Materials and Methods: AHPs' self-reported knowledge, competency and training needs in managing physical effects of cancer, and the merits of physical activity data were collected via an online survey. The survey link was cascaded electronically to all NHS and NHS-affiliated AHPs working across several generic and non-cancer-specific healthcare interfaces across one city in England., Results: Eighty AHPs responded. Forty-one percent of AHPs had patients with current or past diagnoses of cancer. Overall, AHPs reported low confidence in giving physical activity advice, with physiotherapists the most confident. 60% of respondents identified training needs concerning the impact of cancer., Conclusions: Although the merits of physical activity for people affected by cancer is clearly evidenced, low levels of AHP confidence and competence in discussing this topic limit patients' awareness and access to services. Addressing this confidence and competence has potential to improve patient outcome.

Peer-assisted learning (PAL) describes a program in which students learn from students from the same health discipline. This teaching method has gained significant momentum over the past decade as an effective learning strategy for undergraduate healthcare students. Paramedic programs are increasingly utilizing PAL, however there is a scarcity of literature about interprofessional PAL, particularly between Paramedics and allied health students. This project was an evaluation of a pilot educational intervention involving final year undergraduate paramedic students. Occupational Therapy (OT) peer instructors facilitated a session on falls' risk assessments during a scheduled undergraduate Paramedic practical class. The OT peer instructors discussed pertinent considerations for Paramedics attending to elderly patients who have fallen, and then provided direct feedback to the Paramedic students during a case simulation. At the conclusion of the session, Paramedic students completed a survey evaluating their reaction to and learning from the teaching session. Results indicated that interprofessional PAL can improve undergraduate paramedic students' knowledge and confidence in performing a new skill that is well understood by another allied health profession. This adds to the body of empirical research on interprofessional PAL and supports its inclusion as a teaching modality into undergraduate healthcare programs such as Paramedicine.

This 2023 update of the Core Curriculum in Cardiovascular Nursing (2015) embraces the formation of the Association of Cardiovascular Nursing and Allied Professionals and reflects the diverse professional backgrounds of our members, including nurses, allied health professionals, and healthcare scientists (in this document referred to collectively as Nurses and Allied Professionals)., Competing Interests: Conflict of interest: The authors report that there are no conflicts of interest in relation to this work., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: Information on factors influencing learner choice between in-person and video-based continuing professional development (CPD) would help course leaders with planning and implementation. This study aimed to investigate how registration patterns differ between in-person and video-based offerings for the same CPD course., Method: The authors obtained data from 55 CPD courses offered in-person (at various U.S. locations) and via livestreamed video, January 2020 to April 2022. Participants included physicians, advanced practice providers, allied health professionals, nurses, and pharmacists. Registration rates were compared by participant and course features including professional role, age, country of residence, distance to and perceived desirability of the in-person destination, and timing of registration., Results: Analyses included 11,072 registrations, of which 4,336 (39.2%) were for video-based learning. There was significant heterogeneity in video-based registrations across courses, ranging 14.3% to 71.4%. Multivariable analysis showed higher video-based registrations for advanced practice providers (vs physicians; adjusted odds ratio [AOR] 1.80 [99% confidence interval, 1.55-2.10]), non-U.S. residents (AOR 3.26 [1.18-9.01]), longer distance (AOR 1.19 [1.16-1.23] for each doubling of distance), and courses in July-September 2021 (vs January-April 2022; AOR 1.59 [1.24-2.02]); video-based registrations were lower for current or former employees or trainees of our institution (AOR 0.53 [0.45-0.61]), destinations of moderate or high desirability (vs low; AOR 0.42 [0.34-0.51] and 0.44 [0.33-0.58], respectively), and early registration (AOR 0.67 [0.64-0.69] for each doubling of days between registration and course start). There was no significant difference by age (AOR 0.92 [0.82-1.05] for participants > 46 years old vs younger participants). The multivariable model correctly predicted actual registration 78.5% of the time., Conclusions: Video-based livestreamed CPD is popular (chosen by nearly 40% of participants), although choices varied widely by course. Professional role, institutional affiliation, distance traveled, location desirability, and registration timing have small but statistically significant associations with choice of video-based vs in-person CPD., (Copyright © 2023 by the Association of American Medical Colleges.)

In a rapidly changing health and care landscape, there is acknowledgement that the organization of care should be integrated with the patient placed at the centre. In reality, care systems are often fragmented, disjointed, and focused on the condition rather than the patient. The Science Committee of the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology recognizes the need for a statement on integrated care to guide health professionals caring for people with cardiovascular disease. This statement outlines the evidence for integrated cardiovascular care, identifies challenges, and offers advice for practice, education, and research., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Out-of-hospital births (OOHBs) are rare representing ∼0.05% of prehospital callouts. OOHBs are at increased risk of complications including life-threatening conditions such as postpartum haemorrhage and neonate resuscitation. This research investigated Australian paramedics perceptions of' training, experience, and confidence with OOHBs., Methods: Semi-structured qualitative interviews were undertaken in late 2021 via online conference or face-to-face. Sessions were audio-recorded and transcribed. Data was analysed and coded into over-arching themes using thematic analysis., Results: Fourteen participants were interviewed from military, industrial, and jurisdictional ambulance services. Nine participants were female, and experience ranged from 1.5 to 20 years. Six Australian states were represented, incorporating rural and metropolitan regions. Participants reported sporadic or infrequent training. No participant had exposure to OOHBs during their undergraduate degree, with the most experienced paramedic only attending six births. Participants with little/no experience reported low confidence, and even more experienced participants reported anxiety when attending OOHBs, particularly if there were long distances to definitive care or potential complications., Conclusion: Many paramedics expressed low confidence and high anxiety regarding OOHBs, especially regarding complications. Many felt insufficient time was dedicated to OOHBs during education and training. This has the capacity to impact on patient care and outcomes., Competing Interests: Disclosures Nothing to declare., (Copyright © 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)

Introduction: Continuing allied health professional (AHP) clinical education is essential to ensure high-quality patient care; however, the effectiveness of current education programs is unclear. This review aimed to determine whether AHP education programs improve the knowledge of AHPs, change their clinical practice behavior, and/or improve patient-related clinical outcome and to identify important components of these programs., Methods: Four electronic databases were searched. Controlled clinical trials investigating the effectiveness of clinical education programs were included. Education programs were diverse, varying in design, delivery mode, and intensity. Only therapy-specific AHPs were included. Effectiveness was determined by differences in group outcomes in the domains of AHP knowledge, AHP clinical practice behavior, and patient-related clinical outcomes., Results: Forty-four studies were identified, of which 26 included physiotherapists only. Most control groups were waitlist, passive dissemination of information, or usual care, limiting comparisons between programs. Changes in AHP knowledge was investigated in 20 trials, with 13 showing an improvement. Thirty studies investigated changes in AHP clinical practice behavior, with half demonstrating a difference between groups. Seventeen studies investigated a patient-related clinical outcome, with five finding a difference between groups. Where improvements in outcomes were demonstrated, programs tended to incorporate self-selection and cater to the learner's contextual needs., Discussion: AHP knowledge is effectively improved through targeted education programs. To change AHP behavior and patient outcomes, it seems important to incorporate self-selection for the program and consider the learner's individual needs and contexts through mentoring, outreach visits, reflection, and incorporating patient participation in the learning., Competing Interests: Disclosures: The authors declare no conflict of interest., (Copyright © 2023 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.)

Purpose: Clinician experience and confidence can negatively impact pediatric feeding service availability, but limited research has investigated what training allied health professionals (AHPs) need to increase these factors. This study developed and distributed a survey investigating Australian AHPs' self-reported confidence and anxiousness, training needs, factors impacting training access, and training preferences., Method: This study was conducted over two phases. Phase 1 involved development and refinement of the survey, and Phase 2 involved distribution to Australian AHPs. Questions pertained to general demographics, feeding experience, feeding confidence and skills perception, and training needs. The questions were composed of multiple-choice, Likert scale, and short-response options., Results: Overall, 198 complete responses were received. Participants reported significantly lower confidence and higher anxiousness working with infants compared to older children ( p < .01). Increased frequency of service provision predicted higher self-reported confidence and lower anxiousness ( p < .01). Practical training opportunities including case discussion, videos, and clinical feedback were preferred. Access facilitators were online, on-demand training; however, respondents reported preferring hands-on training opportunities. Common barriers included cost, time, competing professional development priorities, and distance/travel., Conclusions: Findings have highlighted that recency and frequency of practice impact self-reported confidence and anxiousness, and that AHPs self-report lowest confidence and highest anxiety working with infants compared to older age groups. Overall, the findings highlight the need for flexible, practical, and remotely accessible training opportunities, as well as the need for access to regular clinical supervision and a pediatric feeding caseload.

Background and context The Canterbury health system adopted a whole-system approach towards integrated patient care. There was a need to optimise the use of allied health resources, across private and public settings. Assessment of the problem There was no common means for consensus and communication among allied health professions about consistent patient care, and barriers such as a lack of trust existed. This paper describes the implementation and monitoring of Allied Healthways, a website for allied health professionals, set up in 2017 using the HealthPathways approach. Results Over 100 pathways have been published on Allied Healthways, with >13 000 clinicians using the site in Canterbury. Targeted education sessions for allied health professionals, combined with newsletters, raised awareness of new pathways or changes in the system. A survey highlighted the usefulness of Allied Healthways, and the majority of respondents agreed that the site should be available nationwide. Strategies for improvement Development of pathways was found to be a useful mechanism for improving integration in the system. The workgroups and direct meetings engaged allied health professionals and helped achieve local consensus on pathways. They also enabled improvements to be designed and then communicated as a pathway. Lessons learnt Although the patient journey should be consistent, irrespective of their point of contact with the health system, guidance and processes need to be relevant to their target audience. It was essential to write pathways specifically for allied health professionals.

Objectives: This research aimed to fill a current knowledge gap, namely the current scope of clinical role of paramedics in primary care, in relation to specific constructs such a level of education and clinical experience., Setting: The survey was distributed to paramedics in primary care across the UK through the College of Paramedics., Participants: A total of 341 surveys were returned (male=215). 90% of responses were from paramedics in England, 1.7% from paramedics in Northern Ireland, 4.6% from paramedics in Scotland and 2.9% from paramedics in Wales. This represents approximately 33% of the primary care paramedic workforce in England and Wales. Estimates for percentages in Northern Ireland and Scotland are unavailable due to the lack of workforce datasets capturing paramedics in primary care., Results: Considerable variation was found in job titles, level of education and provision of clinical supervision of paramedics in primary care. Differing levels of practice were noted, despite guidance documents that attempt to standardise the role. Statistical analysis of quantitative data highlighted that relationships exist between paramedic clinical exposure in primary care, level of education, and ability of independently prescribe medicines and the extent to which clinical presentations are seen and examinations performed. However, free-text responses indicated that challenges in relation to access to further education and clinical supervision to support clinical development resulted in frustration for paramedics who work in this setting., Conclusions: As well as offering an insight into the demographics of the primary care paramedic work force, there is indication of the clinical scope of role undertaken in this setting. Based on our findings, we recommend changes to education and support, governance and legislation to ensure paramedics employed in primary care can work to achieve the full extent of their professional capability., Competing Interests: Competing interests: GE is a Trustee in the College of Paramedics. The recruitment of paramedics to the survey was made by application to the College of Paramedics Research Design Advisory Committee and was not associated with GE’s trusteeship. The remaining authors declare no competing interests., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Background: This narrative review presents a brief chronological history of the Anglo-American paramedic system, combining decades of stories from across ambulance services in western, English-speaking developed countries METHODS: Databases, including Embase, MEDLINE, Web of Science, CINAHL and Google Scholar were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forwards and backwards searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Included studies were summarised using narrative synthesis structured around the exploration of the history of the Anglo-American paramedic system., Results: The research team structured the narrative in chronological order and used metaphorical models based on philosophical underpinnings to describe in detail each era of paramedicine. The narrative explores several key milestones including, industrial orientation, scope of practice, innovation, education and training, regulation as well as significant clinical and technological advancements in the delivery of traditional and non-traditional paramedic care to patients., Conclusions: Paramedicine, like other allied health professions, has successfully navigated the pathway toward professionalisation in a considerably short period of time. From its noble beginnings as stretcher bearers in times of war, the profession has looked outwards to emulate the success of our healthcare colleagues in establishing its own unique body of knowledge supported by strong clinical governance, national registration, professional regulatory boards, self-regulation, and a move towards higher education supported by the development of entry-to-practice degrees. Whilst the profession has achieved many great milestones, their application across multiple jurisdictions within the Anglo-American paramedic system remains inconsistent, and more research is needed to explore why this is., Competing Interests: Conflicts of interest The authors declare that they have no competing interests with respect to the authorship and/or the publication of this article. No funding was received for this work, and the authors have no conflict of interest., (Copyright © 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)

Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.)

Summary Statement: Emerging literature continues to demonstrate the use of innovative practices such as simulated-based learning experiences to prepare students for professional placements. This scoping review aimed to provide a broad overview of how simulated-based learning experiences have been implemented within or immediately before the professional practice placements of entry-level allied health programs. Four databases (MEDLINE, EMCARE, CINAHL, and Scopus) were searched up to August 2020. Kirkpatrick's evaluation framework was used to categorize outcomes, and the Simulation-Based Research Extension for the CONSORT statement was used to appraise the quality of simulation reporting. The search revealed 6584 unique abstracts with 321 full-text articles reviewed. Forty-eight studies met the inclusion criteria. This review has shown a clear trend toward using simulation within or immediately before the professional practice placements of allied health programs. Using Kirkpatrick's evaluation framework, most studies reported on student reaction (level 1) and learning (level 2) obtained during the simulation experience. There was limited evidence showing how the benefits gained in simulation translated to the clinical environment (level 3) or impacted the organization (level 4). Further research is required to review the optimal proximity of simulation to allied health professional placements and how gains are obtained from simulation transition to the clinical environment. In addition, more consistent reporting of simulation methodologies and evaluation methods are needed to strengthen the evidence base., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society for Simulation in Healthcare.)

Community paramedic roles are expanding internationally, and no review of the literature could be found to guide services in the formation of community paramedicine programmes. For this reason, the aim of this restricted review was to explore and better understand the successes and learnings of community paramedic programmes across five domains being; education requirements, models of delivery, clinical governance and supervision, scope of roles and outcomes. This restricted review was conducted by searching four databases (CENTRAL, ERIC, EMBASE, MEDLINE and Google Scholar) as well as grey literature search from 2001 until 28/12/2021. After screening, 98 articles were included in the narrative synthesis. Most studies were from the USA (n = 37), followed by Canada (n = 29). Most studies reported on outcomes of community paramedicine programmes (n = 50), followed by models of delivery (n = 28). The findings of this review demonstrate a lack of research and understanding in the areas of education and scope of the role for community paramedics. The findings highlight a need to develop common approaches to education and scope of role while maintaining flexibility in addressing community needs. There was an observable lack of standardisation in the implementation of governance and supervision models, which may prevent community paramedicine from realising its full potential. The outcome measures reported show that there is evidence to support the implementation of community paramedicine into healthcare system design. Community paramedicine programmes result in a net reduction in acute healthcare utilisation, appear to be economically viable and result in positive patient outcomes with high patient satisfaction with care. There is a developing pool of evidence to many aspects of community paramedicine programmes. However, at this time, gaps in the literature prevent a definitive recommendation on the impact of community paramedicine programmes on healthcare system functionality., (© 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)