Of the total number of attendees (n = 33), the majority (n = 25) responded to the survey and provided feedback on their experience. Table II. describes the demographic aspects of the survey. Participants self-identified as female (n = 17) or male (n = 8); the majority were employed on a full-time basis (n = 17). Academics less than 34 years of age (n = 11) and with no more than 5 years of experience in academia (n = 14) had the highest representation. Masters (n = 6) or PhD qualifications (n = 3) were few.
Table II. Demographic description*
Age | 18–24 | 25–34 | 35–44 | 45–54 | 55–64 | 65+ |
| | 11 | 3 | 9 | 1 | 1 |
Gender (self-ascribed) | Male | Female | Non-binary | Self-described | Prefer not to say | |
| 8 | 17 | | | | |
University Employment Status | Casual | Part-time | Full-time | Fix term contract | Continuous Employment | |
| 3 | 4 | 17 | 1 | 7 | |
Years an academic | 0–5 | 6–10 | 11–15 | 16–20 | 20+ | |
| 14 | 6 | 3 | | 2 | |
Qualifications held (total number) | Diploma | Bachelors | Graduate Certificate | Graduate Diploma | Masters | PhD |
(Multiple options) | 4 | 17 | 7 | 1 | 6 | 3 |
*Excludes lead facilitators |
Theme 1 - Identity, purpose, and professional identity for paramedic academics
Participants discussed the dichotomy of emotions felt during the transition to academia from clinical practice; described by one participant as a career rupture, feeling as though he had “…left one thing without fully leaving and entered another career without fully parting…” (Participant 1). Some participants expressed a need to continue to maintain clinical currency by working as a casual ‘on-road’ (a literal but self-limiting reference to communities in need of emergency care) and expressed reluctance to lose the professional identity of being a clinician while they were yet to fully identify as an academic, bona fides notwithstanding.
Many participants stated that support and guidance from colleagues around university and course policy and procedures had helped to understand the intricacies of how universities work. Regular team meetings and mentoring sessions helped decipher the never-ending list of acronyms and complexities hidden in ‘academic code.’ Finally, taking the initiative to be involved in academic education sessions in the wider academic community enabled participants to witness the experience of seasoned academics. The final session ‘how individuals, supervisors and the discipline can facilitate growth in the profession, revealed the concepts in Table III.
Table III. Response to facilitation of growth
How do we facilitate growth at an individual level? | ● Facilitate entry points for new academics in a casual capacity, including casual involvement in research projects. Advertise these opportunities. ● Advocate for the paramedic academic career option more to students - promote honours as a ‘test’ in academia. ● Support a dual role – conjoint clinical and academic appointments. |
How do we facilitate growth of supervisors? | ● Remove barriers - develop individual work plan – research fraction to facilitate growth of the individual and increase time allowances. ● Advertise research profiles of individuals to provide for research mentors. ● Advocate for research intensive academic positions. ● Network more with industry to develop collegiality and collaboration. |
How do we develop growth of the paramedicine discipline? | ● As a collective, recognise our worth and focus on improving growth of the profession. ● Demystify the role of academics in industry. ● Remove barriers that silo academia from the rest of the profession. ● Step up and let education drive the profession more - stop taking a back seat. |
Overwhelmingly, feedback on this session was positive. Recommendations from the group included conjoint appointments that provided opportunities to work in the tertiary sector and as a clinician obviating the crisis of identity, and fractional workload that are conducive to supporting teaching and research. An ambivalent finding is that the casualisation of paramedicine academia may be enabling of paramedicine programs in the short term but counterproductive to its sustainability.
Theme 2 - Transformative pedagogy to promote social consciousness and justice.
This facilitation sought to inform understanding of how transformative pedagogy may promote social justice and practitioner responsiveness (Table 1). We approached this question through the development and field testing of original animation (as a pedagogic instrument) in paramedic education of sepsis management (as an intersecting clinical case) through the lens of transformative pedagogy. The animated case was designed to privilege intersectionality, rural health, equitable access, interprofessional education, and clinical practice. The patient role had the potential to be layered in the lesson plan with health literacy, parental and economic status, gender, and even vulnerability experienced by immigrant communities. The allocation of professional roles to historically disadvantaged actors challenged professional, racial, and gender stereotypes. The importance of interprofessional roles and the limitations of professional roles was stressed against rural health inequity.
Of the 30 participants who completed the pre-workshop survey (on beliefs and attitudes on video material). Most participants (n = 28; 93%) explicitly agreed videos are “important” or “very important” to their learning. Although 23% had occasionally used videos, 63% stated they use online videos to support their learning “most of the time” and 13% (n = 4) chose “always”. This showed explicit agreement related to video usage. Most of the participants (90%) explicitly believed it was important for educators to recognise online videos as integral to learning and there was also large agreement that videos should be incorporated within official learning material (80%). They were able to replay, enabling visualisation and explanation of topics, theoretical or abstract concepts, and skills. In this way, it reinforced lectures and readings. Visual learners are captivated, and information is connected to personal experience. Participants were engaged as practical application was efficiently demonstrated with intermittent pauses for group discussions to subjectify observations. It is also interesting to note that while 60% of participants explicitly agreed that the video material was engaging, motivated learning of the topic concerned and improved knowledge retention, 40% experienced a “moderate extent” of mental fatigue from the video material. For improvements to learning materials, participants recommendations included embedded reading, deeper engagement and discussion, feedback quizzes, retention of scaffolding, and multi-modal approaches. Participants volunteered that video material should be included into official course material for the following reasons: there is provocation of participation during the video presentation, it “breaks up the verbal barrage and shows where to get information if you prefer visual learning”, “combines visual and auditory means of learning”, demonstrates skills, videos are engaging unlike didactic style lectures, enhanced engagement and learning, and a video facilitates a case study by giving a quick overview and then facilitating knowledge consolidation to the point of completeness. Participants found video materials to be less mentally and physically fatiguing for both the facilitator and student by explaining the same point in diverse ways, prompting discussion, and connecting with students.
Of 22 post-facilitation survey respondents (with beliefs and attitudes specific to the sepsis case), 20 (91%) participants preferred the sepsis learning material with animations to traditional teaching. Participant feedback on the animations presented in the forum included: that they “…were useful for visual learners and helped aid discussions”, “really brought you into the topic”, “helped bring it to life”, “I liked how it followed the patient and had a multicultural approach”, “the pathophysiology animations were excellent…”, and “...good, well timed”.
Where 32% (n = 7) experienced no mental fatigue during the Sepsis learning material, 36% (n = 8) experienced a small extent of fatigue, 14% (n = 3) experienced fatigue to some extent and to a moderate extent equally. No participant claimed a substantial extent of fatigue. Reasons provided for the mental fatigue included: “distracted with personal issues,” “lack of sleep” and environmental factors (lighting and temperature). Mental fatigue, it seems, was not directly attributable to the animation; in fact, discussions may have provided a mental rest. In relation to importance of videos for learning, there was explicit agreement on importance from 91%; 55% found it important that the university/ teaching staff recognise online videos as part of their learning and teaching, with 86% stating that videos should be incorporated within learning material.
The measure of agreement between the pre-workshop and post-workshop survey questions was analysed using Cohen’s Kappa statistics. This analysis is presented below in relation to the relevant questions. “How important are videos for your learning?” A Kappa value of 0.58 with p value 0.02 indicated moderate agreement between pre- and post-workshop answers. This kappa value indicates there is moderate agreement in the sample and the p-value indicates sufficient evidence to conclude that the relationship exists in the wider population. The question: “How important do you think it is for the university/ teaching staff to recognise online videos as part of their learning and teaching?” derived a Kappa value of 0.28 with a p value of 0.16 indicating fair agreement between answers. This kappa value indicates a lack of association in the sample and this p-value finds there is insufficient evidence of association in the wider population. The weighted kappa (0.18) with p value of 0.51 indicated slight agreement between answers. The statement: “The learning material with animations improved knowledge retention” derived a Kappa value 1.00 with p value 0.05 indicating perfect agreement between answers before and after the facilitation. The kappa value indicates there is perfect agreement in the sample and the p-value indicates sufficient evidence to conclude that the relationship exists in the wider population.
The results from the pre-and post-participation survey, consistent with the participation in intermittent pausing of the video for discussion points, suggest video material enhances understanding, is engaging, motivates complex learning, and improves knowledge retention. Topics, such as sepsis within the context of equity and patient safety, that require an interdisciplinary response, is well facilitated by video animation.
Theme 3 - Constructivist pedagogy and paramedic teaching – defending the paradigm.
This section of our study explored the implementation of a constructivist approach to education in paramedicine, shedding light on the challenges and advantages of adopting this approach, and how it aligns with the overarching goal of nurturing professional capacity. Our research question is rooted in understanding the benefits and potential drawbacks of incorporating constructivist education in paramedicine and assessing its compatibility with the broader objective of developing proficient professionals.
The constructivist education session aimed to familiarise new paramedicine academics with the concept and skills necessary for developing assessment tasks aligned with learning outcomes and teaching resources. The session began with an informative introduction to constructive alignment, covering its definition, manifold benefits, and foundational principles. Participants were prompted to reflect on their teaching philosophies and identify key learning outcomes for their students. Subsequently, small interactive groups were formed to explore constructive alignment using a structured template. The primary task assigned was to create an assessment aligned with predefined learning outcomes. Each group presented their assessment tasks to the wider audience, fostering an open forum for feedback and discussion.
Participants shared common difficulties and engaged with the principles of constructive alignment. Many were thrust into roles of designing assessments just one month into their academic roles, sometimes adopting an improvisational approach due to time constraints. The majority had experience in designing assessments, with a quarter possessing formal teaching qualifications. The session served as a platform for them to deepen their understanding of constructivism and how it could shape their teaching philosophies. It was noted that many universities employed a constructivist approach to education, a terminology not entirely familiar to all participants. Discussions emerged about how constructive alignment can enhance student engagement, smooth transitions into the profession, and contribute to student retention rates.
Several concerns were raised, including the efficacy of viva voce as an assessment method and the stress it imposed on students. There was a call for aligning assessment methods with their intended purposes. An interesting comparison of assessment practices emerged, with universities typically aiming to assess students to a minimum standard, often a subject of variation among academics. However, some paramedic educators in NSW required competency pass marks as high as 85%. Participants discussed the differences between university and vocational settings. While vocational teaching focused on imparting specific knowledge and skills for practical application, the emphasis in universities was on cultivating criticality and independence of thought. This led to a belief that a broader range of content might require specific assessment in vocational settings, while university assessment should ideally focus on evaluating higher order thinking skills. An intriguing debate arose about the balance between producing ‘ready paramedics’ and nurturing critical thinkers.
The session concluded with participants acknowledging the evolving curriculum that increasingly emphasised critical thinking and decision-making. Despite the practical challenge of assessing every aspect of the curriculum at the university level due to time constraints, participants emphasised that everything taught was relevant to students' decision-making and clinical judgment. They recognised the value of skills that transcend direct assessment and contribute to a practitioner's overall competence. The belief was that universities should not solely be responsible for creating paramedics but should also take responsibility for shaping well-rounded global citizens. This discussion on assessment practices highlighted the complexities of evaluating students' knowledge and skills in paramedic education. The varying standards set by different institutions and educators reflect the ongoing debate about the purpose of higher education and what it means to be a capable professional.