Nonsense, normative or necessity: the purpose of repeating a modified internship for qualified paramedics to move between Australian states: perspective from one state service

Aaron Caudle, Lambert Schuwirth, Linda Sweet

Abstract


Introduction

If a paramedic moves interstate in Australia, they are often required to undertake a local state-specific internship in the state or territory they are moving to. The small differences in roles undertaken between the states and territories are not sufficient to explain this requirement. In order to better understand this expectation, the authors explored the national and organisational cultural factors that could explain its purpose.

Methods

Semi-structured interviews were conducted with six major stakeholders of an internship, and interpreted using organisational and national-cultural dimensions derived from the work of Hofstede, Waisfisz and Minkov.

Results

Seven core themes were identified, layered according to the stakeholders that have the greatest influence over the theme, and discussed using the study’s interpretive framework (cultural dimensions). These core themes describe the concerns the respondents had about elements of the paramedic internship, including the culture of the internship, attitudes, education, communication, the profession, the organisation, and recruitment and selection.

Conclusion

The insights gained into the cultural characteristics of the ambulance organisation help us to better understand the need for the internship. From a cultural perspective, paramedics need to be able to balance risk aversion (policy/procedure) with risk taking (unpredictable work demands); structure (militaristic) with independence (autonomy); a hierarchy-based power relationship and a competency-based power relationship and, finally, indulgence (socialisation for organisational acceptance) with restraint (becoming a professional). This balancing of judgement and actions is extremely complex, delicate and organisation-specific, thus explaining the importance for the individual organisation of having a prolonged observation period during which ‘a feel’ for these ‘balances’ can be obtained to ensure that the paramedic ‘fits’ into the specific organisation to become ‘one of us’.


Keywords


paramedic; internship; organisational culture; internship and residency; emergency service

Full Text:

PDF

References


Australian Health Practitioner Regulation Agency. Paramedicine Board of Australia: About 2019. Available at: www.paramedicineboard.gov.au/About.aspx

Australian Government. Report on government services 2016; Chapter 9, fire and ambulance services. In: Commission AP, editor, 2016.

Schneider Z, Whitehead D. Nursing and midwifery research: methods and appraisal for evidence-based practice. 4th edn. Elsevier Australia; 2013.

Hofstede G. Cultures consequences: comparing values, behaviors, institutions, and organizations across nations. 2nd edn. California: Sage Publications Inc; 2001.

Waisfisz B, Minkov M, Hofstede G. Constructing the best culture to perform. Finland: itim International; 2015.

Detert J, Schroeder R, Mauriel J. A framework for linking culture and improvement initiatives in organisations. Acad Manage Rev 2000;25:850-63.

Jippes M, Driessen E, Broers N, et al. Culture matters in successful curriculum change: an international study of the influence of national and organizational culture tested with multilevel structural equation modeling. Acad Med 2015;90:921-9.

Jippes M, Majoor G. Influence of national culture on the adoption of integrated and problem-based curricula in Europe. Med Educ 2008;42:279-85.

de Kort W, Wagenmans E, van Dongen A, et al. Blood product collection and supply: a matter of money. The International Journal of Transfusion Medicine 2010;98:e201-8.

Hofstede G, Neuijen B, Ohayv D, Sanders G. Measuring organizational culture: a qualitative and quantitative study across twenty cases. Adm Sci Q 1990;35:286.

Scott T, Mannion R, Davies H, Marshall M. The quantitative measurement of organizational culture in health care: a review of the available instruments. Health Serv Res 2003;38:923-45.

Borg M, Camilleri L, Waisfisz B. Understanding the epidemiology of MRSA in Europe: do we need to think outside the box. J Hosp Infect 2012;81:251-6.

Saldana J. The coding manual for qualitative researchers. 2nd edn. London: SAGE Publications; 2013.

National Health and Medical Research Council. National ethics application form for research proposals to human research ethics committees. Commonwealth of Australia; 2013. Available at: www.neaf.gov.au

Wilde S. From driver to paramedic: a history of the training of ambulance officers in Victoria. Melbourne: Ambulance Officers Training Centre; 1999.

Hofstede G, Hofstede GJ, Minkov M. Cultures and organizations: software of the mind: intercultural cooperation and its importance of survival. 3rd edn. USA: McGraw Hill; 2010.

Campeau A. The space-control theory of paramedic scene-management. Symb Interact 2008;31:285-302.




DOI: http://dx.doi.org/10.33151/ajp.16.674

Refbacks

  • There are currently no refbacks.




The Official Journal of Paramedics Australasia © 2019                           ISSN: 2202-7270

 

Crossref Member Badge