Student paramedic perceptions of patient safety incident reporting during practice placements: a qualitative survey study

Background: National oversight reports have highlighted ongoing challenges in fostering psychologically safe reporting environments within parts of the NHS ambulance sector (National Guardian’s Office, 2023)

Aims: To explore student paramedics’ perceptions of incident reporting during practice placements, including perceived barriers and facilitators to reporting safety incidents.

Methods: An online qualitative questionnaire was distributed to undergraduate paramedic students who had completed at least one period of practice placement (Levels 4–6). Responses were analysed using reflexive thematic analysis supported by NVivo.

Findings:
Forty-five completed questionnaires met inclusion criteria. Three themes were developed: professionalism and moral duty of care; relationships and support; and fear of repercussion and judgement. Students described strong ethical intent to report, particularly severe harm, but uncertainty about processes for low-harm events and reliance on supportive mentors and psychologically safe teams.

Conclusion: Reporting intentions were shaped by the interaction between professional values, placement relationships, and perceived psychological safety. Clearer reporting guidance for students and more consistent placement support may strengthen learning-focused reporting cultures.