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The emergence of augmented reality (AR) and mixed reality (MR) modalities has increased the potential of simulation in paramedicine education. The integration of AR/MR into education programmes should be underpinned by sound learning design; however, little is known about their effective use. The purpose of this scoping review was to identify the application and integration of AR/MR within paramedicine education. The review searched MEDLINE, EMBASE, PsychInfo, CINAHL and ERIC up to February 2020 to identify peer-reviewed articles describing the application or integration of any AR/virtual reality (VR) in the context of paramedicine education. The search yielded 11 records for qualitative synthesis from 170 unique records. The quality assessment showed diversity, from good to very poor quality papers. Categories of AR/MR were identified: computer-based avatar worlds, headset-based VR and screen-projection immersive spaces. An application was diverse, with triage and management of mass casualty featuring prominently. One paper described cost-effectiveness, and none discussed issues associated with volume or frequency of exposure required to achieve sustained outcomes. This review identified a small and heterogeneous evidence base describing AR/MR in paramedicine education. Limited, weak evidence demonstrates outcomes of equal to or better than traditional simulation when using AR/VR in paramedicine education.

International work-integrated learning (WIL) is increasingly common in health-related programs in Australian universities. Paramedicine programs are beginning to explore international WIL in line with the globalization of paramedicine as a profession and the national higher education emphasis on outward bound learning experiences. Using qualitative methods, the present study reports the experiences of undergraduate paramedicine students undertaking inaugural WIL placements in either South Africa or New Zealand. The placements, of a 3-week duration, used a placement model that did not include an accompanying academic from the host institution. Key themes to emerge include appropriateness of WIL location, timing of international WIL within an undergraduate program, and the potential to be overwhelmed by the combination of an intense early clinical experience and demands of managing oneself on an unaccompanied placement experience. This research provides valuable information to assist development of international WIL programs in paramedicine courses and other clinical health disciplines.

The emergence of augmented reality (AR) and mixed reality (MR) modalities has increased the potential of simulation in paramedicine education. The integration of AR/MR into education programmes should be underpinned by sound learning design; however, little is known about their effective use. The purpose of this scoping review was to identify the application and integration of AR/MR within paramedicine education. The review searched MEDLINE, EMBASE, PsychInfo, CINAHL and ERIC up to February 2020 to identify peer-reviewed articles describing the application or integration of any AR/virtual reality (VR) in the context of paramedicine education. The search yielded 11 records for qualitative synthesis from 170 unique records. The quality assessment showed diversity, from good to very poor quality papers. Categories of AR/MR were identified: computer-based avatar worlds, headset-based VR and screen-projection immersive spaces. An application was diverse, with triage and management of mass casualty featuring prominently. One paper described cost-effectiveness, and none discussed issues associated with volume or frequency of exposure required to achieve sustained outcomes. This review identified a small and heterogeneous evidence base describing AR/MR in paramedicine education. Limited, weak evidence demonstrates outcomes of equal to or better than traditional simulation when using AR/VR in paramedicine education. [ABSTRACT FROM AUTHOR]

Objectives: Environmental cleanliness of emergency ambulances may be associated with increased risk of healthcare acquired infection (HAI). Surface cleanliness, measured using adenosine triphosphate (ATP) testing, has been demonstrated to correlate with potentially harmful levels of microbial pathogens. In most ambulance services, environmental cleanliness of ambulances and the equipment within them is the responsibility of paramedics. In 2016 NSW Ambulance introduced the Make Ready Model (MRM), in which ambulances are systematically cleaned by non-clinical support staff at the end of each shift. This prospective study aimed to 1) provide a baseline level of ambulance cleanliness; and 2) compare the MRM to a standard cleaning model (SCM). Methods: A prospective comparative study was conducted comparing cleanliness of ambulances in the SCM to those in the MRM. Adenosine-triphosphate (ATP) bioluminescence testing was performed in a pseudo-randomised sample of ambulances. Six 'high touch' areas within each ambulance were systematically sampled. Testing occurred without warning to operational staff. The primary outcome was 'overall bioburden' (OB)' measured in radiant light units ('RLU'). Non-parametric tests were used to assess differences in RLU values between each of the test points, while Poisson multivariate regression was used to compare median overall bioburden between the two groups, adjusting for the confounder variable of 14-day ambulance workload. Results: Sixty-eight ambulances were sampled, 32 from the SCM and 36 from the MRM. Median surface bioburden was significantly lower in the MRM for four of the six test points (preparation table, mobile data terminal, stretcher handles and steering wheel). For the primary outcome of overall bioburden, the unadjusted MRM OB was 35% lower than for the SCM group (RR 0.65 (0.64–0.66; p < 0.01)). After adjusting for the significant confounding variable of 14-day workload, the OB was 38% lower for the MRM group (ARR 0.68 (0.61–0.63; p < 0.001)). Conclusion: The innovative MRM cleaning system was associated with significantly improved cleanliness in frontline emergency ambulances. The magnitude of improvement in cleanliness suggests this cleaning model has the potential to make a major contribution to infection control strategies in paramedicine. Future research should focus on cost effectiveness of the MRM and its applicability to regional and remote ambulance service operations. [ABSTRACT FROM AUTHOR]

International work-integrated learning (WIL) is increasingly common in health-related programs in Australian universities. Paramedicine programs are beginning to explore international WIL in line with the globalization of paramedicine as a profession and the national higher education emphasis on outward bound learning experiences. Using qualitative methods, the present study reports the experiences of undergraduate paramedicine students undertaking inaugural WIL placements in either South Africa or New Zealand. The placements, of a 3-week duration, used a placement model that did not include an accompanying academic from the host institution. Key themes to emerge include appropriateness of WIL location, timing of international WIL within an undergraduate program, and the potential to be overwhelmed by the combination of an intense early clinical experience and demands of managing oneself on an unaccompanied placement experience. This research provides valuable information to assist development of international WIL programs in paramedicine courses and other clinical health disciplines. [ABSTRACT FROM AUTHOR]