Improving paramedic confidence with paediatric patients: A scoping review

Abstract

Introduction Paediatric patients comprise a reasonable minority of paramedic workload, but cases involving children often evoke anxiety and discomfort. Subsequent feelings of low confidence and self-efficacy have been linked with a reluctance to initiate treatment and possibly, poorer care. It is unknown to what extent these apprehension-producing perceptions are held by paramedics and what educational strategies can improve them. This study aims to fill this gap by reporting on a scoping review that examined and mapped the effectiveness of educational interventions on improving paramedic perceptions of caring for paediatric patients. Methods Arksey and O’Malley’s scoping methodology was used. CINAHL, AMED, EMBASE, MEDLINE and PsychINFO databases were searched, alongside several networks and grey literature services. The search strategy was validated by a subject research-librarian. Two reviewers independently reviewed retrieved articles against inclusion and exclusion criteria determined in advance. Results Seventeen articles were included in the review, comprising six conference abstracts, one letter to the editor and 10 journal articles. These articles were categorised into three themes: identifying educational needs and preferences, novel education programs and evaluating education delivery methods. Conclusion Paramedics feel uncomfortable treating paediatric patients and desire more paediatric training, particularly simulation and exposure to children. There is insufficient evidence to demonstrate superior effectiveness of any particular training program. While the most effective education delivery method is unclear, it seems web-based learning can be as effective as traditional teaching. The efficacy of existing pre-established paediatric training programs needs to be investigated, alongside paediatric education in the initial training curriculum. Further research, particularly from outside the United States of America, is needed to identify and develop the most effective educational intervention to improve paramedic confidence with paediatric patients.