Alison Day
Doctorate
Doctorate Title: Planning for chaos: developing the concept of emergency preparedness through the experience of the paramedic.
Doctorate Description: Emergency preparedness is often focused on organisational preparation and response, with little understanding of the individual experience. The published literature offers little more than opinion and a retrospective view, with few studies examining and understanding the individual lived experience. This study explores paramedics experience, examining their motivations, barriers and enablers for engagement and how they draw on knowledge and evidence to inform their clinical practice.
Design
A qualitative study, underpinned by an Interpretative Phenomenological Analysis methodology, enabling an indepth and idiographic understanding of lived experience within emergency preparedness.
Setting
The selection of the West Midlands Ambulance Trust, United Kingdom, was taken due to its geographical mixture of urban and rural areas.
Participants/Subjects
The sample for the study included indiviudals who were employees of West Midlands Ambulance Service, working as paramedics. Their selection includes the following rationale:- 1). paramedics are first-line responders in the pre-hospital environment so have an important perspective on preparedness. 2). Paramedics provided a broadly homogenous group in relation to their first-responder role for an unexpected emergency. A purposive approach was utilised in sample selection. Ethical approval was obtained from Warwick University Ethics Committee and West Midlands Ambulance Service.
Methods
The study was exploratory and interpretative, ensuring rich, in-depth data to reflect the IPA approach. Semi-structured interviews are the chosen data collection method. An interview schedule was based on three main areas. Firstly, my own personal experience as a nurse working in this area. Secondly, the literature review, as it identified gaps in the current knowledge base that required further exploration and thirdly, the peer review and self-evaluation around the interview questions. Thirteen interviews were carried out, ranging in time from 36 minutes to 1 hrs 14 minutes. These were self-transcribed and analysed using IPA, enabling exploration of idiographic experience in addition to social and cultural cognitions.
Results/Outcomes
The following indiviudal dimensions of emergency preparedness were identified:- role determination, personal resilience, uncertainty, practice based preparation, knowledge and evidence (practice and experience based and knowledge transfer), anticipation, safety and trust and willingness to work. These were developed into a conceptual model entitled The Dimensions of individual Emergency Preparedness (the DiEP model).
Implications
Current preparedness, with the focus at organisational level, is not sufficient for the individual health care worker or for an overall effective response. There is a need for a new form of emergency prepareness that works on an individual context, recognising the numerous personal factors that impact on preparation and response. Areas for development include initiation of a psychological preparation pathway within education, that includes individualised as well as generic content. Accounting for personal context and past experience within emergency preparedness training. Ensuring that educational content is adaptable and updateable to reflect the diverse and ever changing current threat, offering indivudal workers the feeling of control over their preparation and clinical practice. The development of a central repository containing key facts about past events and a standardised reporting template to allow the development of a practice-based evidence base to develop.
Details:
Type: PhD
University: University of Warwick
Primary Supervisor: Professor Sophie Staniszewska
Category: Other
Funding: Student fees paid by employer
Start Date: 2008
End Date: 2015
Status: Complete
Thesis
ThesisResearch Interests
Publications
Paramedic PhD is endorsed by:
