Perceptions and Knowledge of Self-Regulation of Paramedics in Australia
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Keywords

Professionalisation
Regulation
Identity
Registration
Self-Regulation

How to Cite

1.
Reed B, Cowin L, O’Meara P, Wilson I. Perceptions and Knowledge of Self-Regulation of Paramedics in Australia . Australasian Journal of Paramedicine [Internet]. 2021Dec.16 [cited 2022Aug.17];18. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/963

Abstract

Introduction

Since 2018, paramedics in Australia have been self-regulated under the National Registration and Accreditation Scheme (NRAS) for health professionals. While paramedics and other health practitioners are self-regulated in many jurisdictions internationally, there has been little study of the impact on practitioners of the introduction of new regulatory frameworks.

Method

Paramedics undertook a survey in the month leading up the commencement of self-regulation collecting both qualitative and quantitative data. The survey was completed by 419 participants. This paper explores the analysis of quantitative data. Key results were cross-tabulated with demographic factors.

 Results

Participants indicated they had good broad knowledge of the regulatory scheme but were less confident on more detailed aspects. Most believed that patient safety and practitioner accountability will improve with registration however results were less clear on changes in scope, remuneration or employment opportunities. Questions on identity indicated that the primary factors in paramedic identity construction were employment status, qualifications and scope with impending registration the least important factor. Overall, 59% of participants supported self-regulation, however 25% indicated they held negative views. When cross-tabulated with demographics, years of service and initial qualification (vocational vs university) showed relationships with support for regulation.

Conclusion

The introduction of self-regulation represents significant change to both the governance of paramedics and entry to the profession. Uncertainty By some is indicative of the unique nature and impact of the change. However, there is wide agreement that the scheme will increase safety and accountability which are the key aims of professional regulation.

https://doi.org/10.33151/ajp.18.963
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References

Gough S. Welcoming paramedics into the National Registration and Accreditation Scheme. Australasian Journal of Paramedicine. 2018 Nov 4;15(4).

Moritz D. The Regulatory Evolution of Paramedic Practice in Australia. J Law Med. 2018 Apr 1;25(3):765-81.

Waring J. Adaptive regulation or governmentality: patient safety and the changing regulation of medicine. Sociology of Health & Illness. 2007 Mar;29(2):163-79.

Knox S, Batt AM. Professionalization of Paramedics -The role of regulation and registration. Canadian Paramedicine. 2018;41(5):6-8.

Freidson E. The reorganization of the professions by regulation. Law and Human Behavior. 1983 Sep;7 1(2):279-90.

Irvine SD. Professionalism, professional identity, and licensing and accrediting bodies. In: Cruess RL, Cruess SR, Steinert Y, editors. Teaching Medical Professionalism: Supporting the Development of a Professional Identity. 2 ed. Cambridge, UK: Cambridge University Press; 2016. p. 201-16.

Bennett B. Australia's national registration and accreditation scheme for health practitioners: A national approach to polycentric regulation? Sydney Law Review. 2018;40(2):159-81.

World Health Organisation. Nursing and midwifery: a guide to professional regulation. Cairo, Egypt: World Health Organisation; 2002. [cited 2021 Apr 20]. 36 p. Available from: https://apps.who.int/iris/handle/10665/119665

Roberts MJD. The politics of professionalization: MPs, Medical Men, and the 1858 Medical Act. Med Hist. 2009 Jan;53(1):37-56.

Raach JH. English Medical Licensing in the Early Seventeenth Century. Yale J Biol Med. 1944 Mar;16(4):267-88.

Anon. Professional Registration. Nature. 1930 Oct;126(3182):637.

Fealy GM, Carney M, Drennan J, Treacy M, Burke J, O'Connell D, et al. Models of initial training and pathways to registration: a selective review of policy in professional regulation. Journal of nursing management. 2009 Sep;17(6):730-8.

Andersen LT. The history of occupational therapy: the first century. Reed KL, editor: Thorofare, NJ : SLACK Incorporated, 2017; 2017. 416 p.

Fornasier R. A century-long struggle towards professionalism. Key factors in the growth of the physiotherapists' role in the United States, from subordinated practitioners to autonomous professionals. Management & Organizational History. 2017 Apr;12(2):142-62.

Keating J. Milestones in the History of Chiropractic. Dynamic Chiropractic. 2006 Jul;24(15):35-7.

Bolton SP. National Registration and Accreditation Scheme for Chiropractors. Chiropractic Journal of Australia. 2010 Apr 3;40(1):45.

Bryce J, Foley E. Review of the national registration and accreditation scheme: Julianne Bryce and Elizabeth Foley Federal Professional Officers. (Professional). Australian Nursing & Midwifery Journal. 2014 Nov 1;22(5):17.

Beddoe L. Continuing education, registration and professional identity in New Zealand social work. International Social Work. 2015 Jan;58(1):165-74.

Beddoe L, Duke J. Registration in New Zealand social work: The challenge of change. International Social Work. 2009 Nov;52(6):785-97.

Coburn D. State authority, medical dominance, and trends in the regulation of the health professions: The Ontario case. Social Science & Medicine. 1993 Oct;37(7):841-50.

Gibbs V. The long and winding road to achieving professional registration for sonographers. Radiography. 2013 May 1;19(2):164-7.

Salter B. Who rules? The new politics of medical regulation. Social Science & Medicine. 2001 Mar 1;52(6):871-83.

Keaton SA, Bodie GD. Explaining Social Constructivism. Communication Teacher. 2011 Oct 1;25(4):192-6.

Liamputtong P. Qualitative Research Methods. 4th ed. Melbourne, Australia: Oxford University Press; 2013. 439 p.

Groves RM, Fowler FJ, Couper M, Lepkowski JM, Singer E, Tourangeau R, et al. Survey methodology. 2nd ed. Hoboken, N.J.: Wiley; 2009. 496 p.

Paramedics Australasia. Paramedics in the 2011 Census. Melbourne, Australia: Paramedics Australasia; 2012.

Council of Ambulance Authorities. Annual Report 2017/18. Melbourne, Australia: Council of Ambulance Authorities; 2018. [cited 2021 Arp 20]. 19 p. Available from: https://www.caa.net.au/files/CAA_Annual_Report_2017-18.pdf

Paramedicine Board of Australia. Registrant Data Table - September 2019. Melbourne, Australia: Paramedicine Board of Australia; 2019 [cited 2021 Apr 20]. Workforce data. Available from: https://www.paramedicineboard.gov.au/News/Statistics.aspx

Reed B. Professions and Professionalism. In: Moritz D, editor. Paramedic law and regulation in Australia. First ed. Pyrmont, Australia: Thomson Reuters (Professional) Australia; 2019. P. 107-126.

Wankhade P, Heath G, Radcliffe J. Cultural change and perpetuation in organisations: evidence from an English emergency ambulance service. Public Management Review. 2018 Jun 3;20(6):923-48.

Wankhade P. Different cultures of management and their relationships with organizational performance: evidence from the UK ambulance service. Public Money & Management. 2012 Sep 1;32(5):381-8.

Wankhade P, Radcliffe J. Organisational and Professional Cultures: An Ambulance Perspective. In: Wankhade P., Mackway-Jones K. (eds). Ambulance Services. Switzerland: Springer Cham; 2015: p. 65-80.

McCann L, Granter E. Beyond ‘blue-collar professionalism’: Continuity and change in the professionalization of uniformed emergency services work. Journal of Professions and Organization. 2019 Jul 10;6(2):213-32.

Wankhade P. Staff perceptions and changing role of pre-hospital profession in the UK ambulance services: An exploratory study. International Journal of Emergency Services. 2016 Noc 7;5(2):126-44.

Dempsey CM. The ambulance service culture: a UK paramedic's perspective. Australasian Journal of Emergency Care. 1999;6(2):17-23 7p.

McIntyre D. Technological determinism: A social process with some implications for Ambulance Paramedics. Australasian Journal of Paramedicine. 2003 Oct 6;1(3).

Hafferty FW. Socialization, professionalism and professional identity formation. In: Cruess RL, Cruess SR, Steinert Y, editors. Teaching medical professionalism: supporting the development of a professional identity. Second edition. ed. Cambridge, United Kingdom Cambridge University Press; 2016. P.54-67.

Ewing R, Smith D. Doing, Knowing, Being and Becoming: the Nature of. In: Higgs J, Titchen D, editors. Professional practice in health, education and the creative arts. Carlton, Australia: Blackwell Science; 2008. p. 16-28.

O'Meara P. So how can we frame our identity? Journal of Paramedic Practice. 2011 Feb 4;3(2):57- 1p.