How are paramedic student notions of ‘self-identity’ formed/negotiated as part of the enculturation process within professional clinical practice?

This study explores how undergraduate paramedic students at one UK University develop and/or negotiate their sense of professional identity within the emergency pre-hospital workplace.

A subjective ontology with a qualitative interpretive methodology has been adopted which encompasses some of the theories of seminal phenomenologist Martin Heidegger. This includes the concept of ‘Dasein’ and the temporal nature of an individual’s sense of ‘self’. Twelve university paramedic students were recruited via non-probability purposive sampling, and face-to-face semi-structured interviews undertaken. Data analysis follows the Miles and Huberman (1994) model, with initial descriptive codes being followed by more inferential pattern codes. A-priori codes were based upon an exploration of the literature, with additional codes arising inductively from the data.

Key findings include the possible presence of a ‘hidden curriculum’ which may be detrimental to the preparedness of students for the workplace. Students are also likely to be drawn towards the cultural values synonymous with the pre-hospital workplace and are more likely to thrive if they have sponsorship from established staff. When experiencing stress, they are likely to seek solace with ambulance staff and their peers rather than external others. Social media messaging platforms also seem to be ubiquitously used for accessing peer support. There are suggestions of positive cultural change in relation ambulance staff and students who are female or who have BME backgrounds.

Recommendations incorporate the need to better prepare students for learning within the pre-hospital workplace. This includes investigating the presence/impact of a ‘hidden curriculum’, acknowledging that their supernumerary status may affect perceptions of inclusion, being flexible in relation to how and where students undertake clinical learning, and providing guidance on how best to ensure equality of inclusion within informal support networks. Paramedic education providers, policymakers and employers could also explore the implementation of a Reverse Mentoring programme for paramedic students from BME backgrounds.