Abstract
Introduction
Today in Australia, university degree programs provide the education pathway into the paramedic profession reflecting a more than 50-year process of transition from on-the-job first aid training. The formal organisation of paramedic education began in the early 1960s with the establishment of ambulance service training centres. The factors that contributed to this transition are poorly described when compared with that of paramedics in other parts of the world such as the United States and England. The history of Australian paramedic education is important to capture for the benefit of the profession in Australia and to situate it within a global context of modern emergency medical services. This paper examines the peer reviewed and grey literature to chart the transition of Australian paramedic education from vocational to higher education and uncovers signposts of change leading to this transition.
Methods
Following a systematic search of MEDLINE and CINAHL Plus databases, the university library collection, Google and the websites of Australian ambulance services, Paramedics Australasia (PA) and the Council of Ambulance Authorities (CAA), 31 reports, 12 journal articles and three texts are included in this review.
Results
Advances in emergency medicine, vocational education training sector reform in the 1970s and 1980s, reviews into ambulance services, health workforce reform and the efforts of PA and CAA contributed to the transition to university-based education, development of university paramedic program accreditation standards and, ultimately, progression towards registration and professionalisation. These signposts of change that chart developments in Australian paramedic education however, proved difficult to uncover in the literature.
Conclusion
Unexpectedly, this review finds peak Australian ambulance and paramedic professional bodies perceive difficulty in influencing policy direction that impacts the profession. Absence of thorough and detailed accounts of Australian paramedic education keeps hidden a unique and important history. We invite further research to preserve the history of paramedic education in Australia within the public domain, to assist the profession to understand what went before and to inform its future directions.
References
Brooks IA, Sayre MR, Spencer C, Archer FL. An historical examination of the development of emergency medical services education in the US through key reports (1966–2014). Prehosp Disaster Med 2016;31:90–7.
Brooks IA, Cooke M, Spencer C, Archer FL. A review of key national reports to describe the development of paramedic education in England (1966–2014). Emerg Med J 2016;33:876–81.
Wilde S. From driver to paramedic: a history of the training of ambulance officers in Victoria. Melbourne: Ambulance Officers’ Training Centre; 1999, p. 229.
Bain C, Jamieson K. Australian ambulance services: a survey of their organisation, funding, staffing, training and equipment together with a brief appreciation of emergency medical services including hospital casualty departments. Glebe, NSW: Australian Medical Association, Road Safety Committee; 1974, p. 242.
Touzel J. Ambulance Service Medical Officer. Circular to Ambulance Superintendents/Secretaries. Melbourne, Vic: Hospital and Charities Commission; 23 December 1976, p. 1.
Submission on clinical training: governance and organisation for the National Health Workforce Taskforce. Australian College of Ambulance Professionals; March 2009, p. 22.
Lennox G. Review of the ACT Ambulance Service: positioning the service to meet future challenges. Canberra: ACT Government; April 2010, p. 92.
Rogan D. For love of life: the story of the first decade of the NSW ambulance paramedics. Sydney NSW: Ambulance Publishing; 1986, p. 111.
Oxer H. A shocking affair – defibrillation: a short history. St John History. 2007 May–June;6:3–6.
Quirke B. From the principal education officer: the role of the AOTC. Outback Ambulance 1995;8:21,23.
Bowman K, McKenna S. The development of Australia’s national training system: a dynamic tension between consistency and flexibility. Adelaide, SA: NCVER; 2016, p. 56.
Archer F, FitzGerald G, Wilson G, Bielajs I. Convention of Ambulance Authorities proposal for an Interim Australian Ambulance Education Council; 7 October 1999, p. 36.
Pointon T. Profile: development of professional paramedic education at Flinders University, Adelaide, South Australia. J Emerg Prim Health Care 2004;2(1/2):4.
Burden C. From the general manager’s desk. Outback Ambulance 1983;1:3.
Crawford M. Associate diploma of emergency care. ibid. 1987;1:7.
Quirke B. Manager education and training services report. ibid. 2002;12:7,9.
Queensland Ambulance Service Audit Report. Queensland Treasury, Department of the Premier and Cabinet; December 2007, p. 244.
Woods S, Clark M, Fitzgerald G. Queensland Ambulance Service a case study in organisational reform. Brisbane QLD: Australian Centre for Pre-Hospital Care; 2002, p. 44.
Lord B. The development of a degree qualification for paramedics at Charles Sturt University. J Emerg Prim Health Care 2003;1(1/2):5.
Balon-Rotheram A. The development of professional qualifications for paramedics at Victoria University. J Emerg Prim Health Care 2003;1(3/4):1.
Joyce CM, Wainer J, Piterman L, Wyatt A, Archer F. Trends in the paramedic workforce: a profession in transition. Aust Health Rev 2009;33:533–40.
The Allen Consulting Group. Review of the Ambulance Services Act 1986. Final report. Melbourne, Victoria: Ambulance Services Branch, Corporate Strategy Division, Department of Human Services; April 1999, p. 105.
St John Ambulance Western Australia Annual Report 2003–04. Belmont: St John Commandery in Western Australia; 2004, p. 40.
Quirke B. Education and training report. Outback Ambulance 2011;23:4–6.
Council of Ambulance Authorities. CAA accredited courses Melbourne, Victoria. Available at: www.caa.net.au/paramedic-education/accredited-courses [Accessed 12 November 2017].
Productivity Commission. Australia’s Health Workforce. Canberra: Commonwealth of Australia, 2005, p. 435. Available at: www.pc.gov.au/inquiries/completed/health-workforce/report [Accessed 14 April 2017].
Comments on draft proposals Productivity Commission Health Workforce. Australian College of Ambulance Professionals; November 2005, p. 5. Available at: www.pc.gov.au/inquiries/completed/health-workforce/submissions [Accessed 25 June 2017].
Response to the Productivity Commission Paper on Australia’s Health Workforce. Council of Ambulance Authorities; 2005, p. 3. Available at: www.pc.gov.au/inquiries/completed/health-workforce/submissions [Accessed 14 April 2017].
O’Meara P, Walker J, Stirling C, et al. The rural and regional ambulance paramedic: moving beyond emergency response – report to the Council of Ambulance Authorities Inc. Bathurst NSW: Charles Sturt University, School of Public Health; March 2006, p. 80.
A healthier future for all Australians – Interim Report. Canberra, ACT: National Health and Hospitals Reform Commission; December 2008, p. 392. Available at: http://apo.org.au/node/2223 [Accessed 6 March 2017].
Submission to the National Health and Hospitals Reform Commission. Council of Ambulance Authorities; May 2008, p. 16.
Response to National Health Care Reform Commission Interim Report – A healthier future for all Australians. Australian College of Ambulance Professionals; March 2009, p. 2.
Clinical training: Governance and organization. Melbourne, Victoria: National Health Workforce Taskforce; February 2009, p. 30.
National health workforce innovation and reform: strategic framework for action 2011–2015. Adelaide, South Australia: Health Workforce Australia; 2011, p. 44.
Thompson C, Williams K, Morris D, et al. HWA expanded scopes of practice program evaluation: expanding the role of paramedics sub-project. Final Report. Wollongong, NSW: Centre for Health Service Development, University of Wollongong. July 2014, p. 132. Available at: http://ahsri.uow.edu.au/chsd/projects/esop/index.html [Accessed 3 March 2017].
Performance Review Ambulance Service of NSW. Sydney, NSW: Performance Review Unit, Department of Premier and Cabinet; June 2008, p. 128. Available at: www.ambulance.nsw.gov.au/Our-performance/Reviews-and-Inquiries.html [Accessed 2 June 2017].
Grantham H. Ambulance education – past, present and future. J Emerg Prim Health Care 2004;2(1/2):2.
Guidelines for the Assessment and Accreditation of Entry-level Paramedic Education Programs. Melbourne, Victoria: Council of Ambulance Authorities and Australasian College of Ambulance Professionals; May 2010, p. 31.
Paramedic Professional Competency Standards Development Report. Findon, South Australia: Council of Ambulance Authorities; 2010, p. 38.
Australasian Competency Standards for Paramedics. Paramedics Australasia; 2011, p. 11 p. Available at: www.paramedics.org/paramedics/competency-standards/ [Accessed 5 May 2017].
Standards Committee ACAP. Submission to the Review of Health Practitioner Regulation in Victoria. J Emerg Prim Health Care 2003;1(3/4):4.
St John Ambulance inquiry: Report to the Minister. Department of Health, Government of Western Australia, October 2009, p. 30. Available at: www.health.wa.gov.au/Reports-and-publications/St-John-Ambulance-Inquiry-Final-report-to-the-Minister-for-Health-2009 [Accessed 5 May 2017].
Options for regulation of unregistered health practitioners. Consultation Paper. Australian Health Ministers’ Advisory Council; February 2011, p. 88.
Options for regulation of paramedics. Consultation paper. Health Workforce Principal Committee, Australian Health Ministers’ Advisory Council; July 2012, p. 127. Available at: www.paramedics.org/content/2012/07/Consultation-Paper-Paramedic-Registration.pdf [Accessed 2 June 2017].
Options for regulation of unregistered health practitioners. Consultation response. Paramedics Australasia; April 2011, p. 18.
Public risk and paramedic regulation. Response to the Australian Health Ministers’ Advisory Council consultation paper: options for regulation of paramedics. Paramedics Australasia; September 2012, p. 52. Available at: www.paramedics.org/news-corporate/pa-submission-on-paramedic-registration/ [Accessed 2 June 2017].
Options for regulation of unregistered health practitioners. Final report. Australian Health Ministers’ Advisory Council; April 2013, p. 201. Available at: www.health.vic.gov.au/pracreg/options-for-regulation-of-unregistered-health-practitioners [Accessed 2 June 2017].
COAG Health Council. Announcements. Appointment of inaugural Paramedicine Board Communique. Adelaide, SA: COAG Health Council; October 2017. Available at: www.coaghealthcouncil.gov.au/Announcements/Announcements [Accessed 8 November 2017].
Ambulance Service of New South Wales. Becoming a paramedic. Health, NSW Government. Available at: www.ambulance.nsw.gov.au/employment/paramedic-positions/becoming-a-paramedic.html [Accessed 25 June 2017].
The forgotten health profession. Paramedics Australasia; September 2011, p. 12. Available at: www.paramedics.org/the-forgotten-health-profession-3/ [Accessed 25 June 2017].