Graduates welcome on-road: A culture shift in ambulance preceptorship made clear through retrospective analysis

Abstract

A cultural shift in ambulance services has improved the experience of university-educated paramedics going on-road for the first time in New South Wales. In the "bad old days", graduate paramedics reported routine rites of initiation, including barbed humour and contempt for skills gained in a university setting. Those educated in the on-road vocational system believed universities did not provide a tough enough environment for future paramedics. In this study, data were drawn from two projects involving university-educated paramedics who graduated between 1996 and 2011 and whose novice on-road experiences were several years apart. Comparative retrospective analysis of data provided evidence of a change in attitude towards New South Wales graduates, with an increase in support and inclusion. Novices with greater confidence in their own capacity was evidence of an attitudinal shift. Engaged on-road preceptors who won the respect of the novice was evidence of an increase in support. Inclusion had been a painful issue for both early cohorts of graduates and industry. Failure to fit is associated with attrition. Early in their on-road practice, recent novices reported a sense of belonging. The authors suggest that the shift in attitude could be attributed, first, to a critical mass of graduates on-road, including increasing numbers with postgraduate qualifications, and secondly, the stated preference of ambulance services in Australia to employ graduates.