Community ambulance response trolleys (CART): preparing students for the paramedic workplace


allied health personnel
simulation training

How to Cite

Clarkson G, Gangell H. Community ambulance response trolleys (CART): preparing students for the paramedic workplace. Australasian Journal of Paramedicine [Internet]. 2017Feb.5 [cited 2023Jan.30];14(1). Available from:


The curriculum of undergraduate paramedicine programs invariably includes clinical placement experiences. Engagement in learning in the workplace is however constrained by lack of familiarity with workplace cultural expectations. Strategies assisting students to understand workplace expectations have the potential to enhance engagement on placements and with workplace transition. This study examines whether one classroom practice initiative heightens students’ understanding of specific paramedic workplace expectations.
CART (a system developed to mimic equipment management strategies of the paramedic workplace) was introduced on one campus of an Australian university. Another university campus was selected as a comparison site and did not operate CART. CART campus students were assigned to a team and made responsible for maintaining and restocking all equipment utilised in practical classes, simulating strategies used within the paramedic workplace where a paramedic team shares responsibility for stocking and upkeep of equipment. Both cohorts completed a questionnaire exploring their experiences in the classroom and preparation for clinical placements.
The CART system had a positive influence on the ability of students to collaborate within the classroom and become familiar with industry expectations around equipment management. This increased confidence with transition to learning within the workplace environment.
The CART strategy was effective in mimicking workplace practices and expectation and evidence indicated that CART can assist students with their ability to transition into a vocational environment.


Council of Ambulance Authorities. Guidelines for the assessment and accreditation of entry-level paramedic education programs. 2014. Available at:

O’Brien K, Moore A, Dawson D, Hartley P. An Australian story: paramedic education and practice in transition. Australasian Journal of Paramedicine 2014;11:1–13

Levett-Jones TL. Facilitating reflective practice and self-assessment of competence through the use of narratives. Nurse Educ Practice. 2007;7:112–9.

Michau R, Roberts S, Williams B, Boyle M. An investigation of theory-practice gap in undergraduate paramedic education. BMC Med Educ 2009;9:23.

Joyce CM, Wainer J, Archer F, Wyatt A, Pitermann L. Trends in the paramedic workforce: a profession in transition. Aust Health Rev 2009;33:533–40.

Boyle M, Williams B, Cooper J, Adams B, Alford K. Ambulance clinical placements - A pilot study of students' experience. BMC Med Educ 2008;8:19.

McCall L, Wray N, Lord B. Factors affecting the education of pre-employment paramedic students during the clinical practicum. Australasian Journal of Paramedicine 2009;7(4).

Lave J, Wenger E. Situated learning: Legitimate peripheral participation. New York, NY: Cambridge University Press; 1991.

Wenger E. Communities of practice. Learning, meaning and identity. New York, NY: Cambridge University Press; 1998.

Waxman A, Williams B. Paramedic pre-employment education and the concerns of our future: What are our expectations? Journal of Primary Emergency Health Care 2006;4:1–10.

Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qual Res 2001;1:385–404.

Cope P, Cuthbertson P, Stoddart B. Situated learning in the practice placement. J Adv Nurs 2000;31:850–6.

Fox M, Winship C, Williams W, et al. Peer-assisted teaching and learning in paramedic education: a pilot study. International Paramedic Practice 2015;5:22–8.

Ford R, Webb H, Allen-Craig S, Goodwin V, D'Antonio J, Lofts C. A simulated wilderness exercise: the development of relational competence in paramedic students. ibid. 2015;5:14–21.

Boyle M, Williams B, Burgess S. Contemporary simulation education for undergraduate paramedic students. Emerg Med J 2007;24:854–7.

Hager P. Front-loading, workplace learning and skill development. Educational Philosophy and Theory 2004;36:523–34.

Hager P. Theories of workplace learning. 2011. In: The SAGE handbook of workplace learning [Internet]. London: SAGE Publications Ltd; p. 17– 32.

Newton JM, Billett S, Ockerby CM. Journeying through clinical placements - an examination of six student cases. Nurse Educ Today 2009;29:630–4.

Billett S. Critiquing workplace learning discourses: Participation and continuity at work. Studies in the Education of Adults 2002;34:56–67.

O'Meara P, Hickson H, Huggins C. Starting the conversation: What are the issues for paramedic student clinical education? Australasian Journal of Paramedicine 2014;11(4).

Thompson J, Grantham H, Houston D. Paramedic capstone education model: Building work ready graduates. ibid. 2015;12(3).

Edwards D. Paramedic preceptor: work readiness in graduate paramedics. The Clin Teach 2011;8:79–82.

Boyle M, Wallis J. The glut of graduate paramedics – What do we do with them? Australasian Journal of Paramedicine 2015;12(5).