Between caring for patients on scene and navigating traffic during patient transport, Ambulance officers and paramedics deal with a lot, but how does that impact their handover process to emergency clinicians?
That is the question a new study made possible by the PA Research Foundation is hoping to answer, by funding a project led by Griffith University PhD candidate Daniel Malone who will work alongside experienced educators in paramedicine.
The study will test paramedicine students using simulations of the types of jobs they might attend in the real world as well as driving simulations. The students’ memory and will then be assessed to determine if their ability to retain key information required for an effective handover has been impacted by everything their brain has had to process.
“If you're thinking about just the task of handover and retaining that information until they can deliver it at handover or record it in some kind of device, they have to retain that in their memory. There's so many things going on that take up their ability to process and retain information that are external to the actual handover,” Daniel said.
“It's quite a full on and sometimes emotionally charged environment, they're getting information that's sometimes maybe irrelevant or relevant from bystanders, the patient, family, friends, and other sources.
“There's so much going on that's putting strain on their cognitive capacity that the information that is relevant for handover could be quite susceptible to being forgotten, especially in cases where there is quite a high amount of cognitive workload.”
With handovers being the first point of contact for emergency clinicians to learn about the patient’s condition, the ability of paramedics to deliver the most clinically vital information is an important factor in patient safety and outcomes.
With studies having shown that patient safety can be negatively impacted by clinicians missing out on certain information during handover, Daniel hopes his study will be the building block upon which studies in mental workload management could be built.
“There is existing research that shows when clinical details are either missing or miscommunicated, that can be detrimental to patient safety,” he said.
“Future directions from the study would hopefully be, if you know the impact of load, you could then explore some kind intervention for better management of mental workload, or a mnemonics project where you create things that help you remember better, like acronyms and rhymes. Or even look at the viability of the use of recording devices.”
The study will focus on student paramedics as experienced paramedics are already better wired to handle mental workload more effectively through years on the job. The project will also be testing the mental workload impact on the ambulance officer who undertakes the caring role while the ambulance is in transit.
“The best place to start is with a student sample because as you have more experience with scenarios that would dampen the impact of cognitive load, essentially the more experience that you have the better you’d be at managing sources of cognitive load,” Daniel said.
“And with an experienced sample, you get the variance in the amount of time that different job training scenarios officers have been exposed to, so just to get a baseline we thought it would best to start with students.
“From there, in future studies, you can look at the differences between novices and experts and how they perform the tasks, and then you can look at training the novices to get to where the experts are faster based on those differences.
The young researcher who’s background is on cognitive psychology, said it was encouraging that the Foundation provides funding for the often overlooked and underfunded area of emergency medicine studies.
“I have access to a driving simulator, but I don't know how to run a patient clinical simulation, so we're going to employ someone to do research assistant hours that knows how to do those,” he said.
“It's awesome that they have provided funds for us to be able to do this full scenario because otherwise it would be impossible. It's a really great thing. It's opened doors to something I wouldn't have been able to do without some funding.”
Daniel Malone
