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Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.

Paramedicine is a psychologically high-risk profession, with workers routinely exposed to fatalities and severe medical and emotional trauma. During their studies, paramedicine students undergo practical training with ambulance crews. Without experience, and often with limited emotional preparation, students are exposed to many of the same graphic and traumatic situations as working professionals. This qualitative social constructionist study explored the emotional impacts experienced during placement and students’ emotional preparedness to cope with the challenges of placement. Findings revealed a range of significant emotional impacts reported by the participants. Initial anxiety was found to intensify the response to distressing incidents involving fatalities, severe injuries, domestic violence, and suicide-related incidents. In some cases, students reported ongoing, lingering emotional effects. Most students also felt that they were inadequately prepared for the emotional challenges of placement. A common recommendation among the participants was the inclusion of formal mental health education and resilience training prior to placement. Given the prior absence of research exploring the lived experiences of paramedic students on placement, the current findings add important depth and a student perspective. The implications of this research highlight an urgent need for a greater focus on students’ emotional preparedness prior to placement training.

Received: December 07, 2016; Accepted: December 24, 2016 ABSTRACT Background: Primary dysmenorrhea is one of the most common gnaecological problems among adolescent females which interferes with daily activities, affecting their physical and emotional aspects and has a negative impact on quality of life. Conclusion: Self-medication practice for dysmenorrhea was more among medical students probably due to the knowledge of drugs, better awareness and greater access to drug information during their curriculum. [10] Hormonal therapy in the form of oral contraceptive pills is reserved for patients with suboptimal or lack of response to NSAIDs. [13] Non-pharmacological home remedies commonly used are warm beverages, heat application, vitamin B1 or magnesium supplements, low-fat diet and herbal treatment/6,14,15 Self-medication is termed as the use of medicines, specially designed and labeled for use without medical supervision and approved as safe and effective for such use. [...]this study was taken up to evaluate self-medication practice and to analyze the pattern of drugs use in primary dysmenorrhea among medical and paramedical students. MATERIALS AND METHODS A descriptive cross-sectional study was conducted in Bangalore Medical College and Research Institute, Medical and paramedical female students aged >17 years with dysmenorrhea who willingly gave the written informed consent were included in the study. Respondents completed the structured questionnaire which composed of questions regarding socio-demographic data, menstrual history, presentation of dysmenorrhea, and its impact on daily routine and social activities. The data were analyzed using descriptive statistics for demographic characteristics, menstrual history, dysmenorrhea, and its associated symptoms. The remedial methods used...

Background Emergency medical services (EMS) are among the professions with a high degree of responsibility and the frequency of critical situations. Existing research is largely quantitative and provides little insight into the specifics of critical incidents and the emotion regulation strategies used to manage them. Furthermore, little is known about the process by which an experienced paramedic is equipped with emotion regulation resources in the profession. Method In this study, we interviewed 12 experienced paramedics (at least 4 years of practice) and 10 urgent medical care students about the most intense acute stressors they encounter and the emotion regulation that these stressors trigger. Results Psychological distancing, attention management, cognitive framing and interpersonal self-regulation were used by both groups as means of emotion regulation. Identification with the professional role is a key aspect of maintaining a sense of psychological distance. A balance between distance and connectedness is sought. It is not so easy for paramedic trainees to achieve a sense of psychological distance from patients and relatives, and their attention may shift from the situation to themselves, leading to greater anxiety. Conclusion Emotions and emotion regulation are taboo subjects in paramedic community, but greater awareness of them might be beneficial in psychological adaptation to work.

Background Self-directed learning has been considered as an effective training method for students and professionals in the healthcare setting. This study aims to assess the level of self-directed learning readiness among paramedic students in Jordan and identify any associated factors. Methods This cross-sectional descriptive study utilized an online self-administered questionnaire. The study was conducted across three academic institutions in Jordan offering paramedic programs. A sample of paramedic students was assessed using the Self-Directed Learning Readiness Scale. All enrolled paramedic students at the three institutions were included as potential participants. Differences between group means were analyzed using a Student’s t-test and one-way analysis of variance, as appropriate. Results A total of 529 participants completed the questionnaire. The majority of participants were male (56.1%) with a mean age of 21.2 (SD ± 2.96). The overall mean score of the scale was 141.9 (SD ± 35.5) and a total of 302 (57.1%) participants had a high level of self-directed learning readiness (score > 150). Students with a high level of self-directed learning readiness were more likely to be male ( p  = 0.039) and have high academic performance levels ( p  = 0.006). Conclusions This study found that, although most participants achieved a high level of self-directed learning readiness, the overall mean score was among the lowest in the reported literature. Therefore, it is essential to develop improvement plans to encourage and enhance self-directed learning skills for both students and faculty members.

Background Academic stress is widely reported among students in higher education, particularly within health professions programmes that combine intensive academic workloads with early clinical exposure. While stress among medical and nursing students has been well documented, comparatively little is known about the nature and distribution of academic stress among emergency medical care (paramedic) students, particularly in low- and middle-income contexts. Method A cross-sectional survey was conducted among first- to fourth-year emergency medical care students at a South African university. Participants completed a web-based questionnaire comprising demographic items and the validated Student Stress Inventory (SSI), which assesses stress across physical, interpersonal, academic, and environmental domains. Descriptive statistics were used to summarise stress levels, and inferential analyses were conducted to explore differences by gender and year of study, as well as associations between stress domains. Results Most participants reported moderate academic stress, with stress distributed across academic, physical, interpersonal, and environmental domains. No statistically significant differences in overall stress were observed by gender or year of study. Moderate positive associations were identified between academic stress and both the physical and environmental stress domains. Conclusion These findings provide contextually grounded evidence of academic stress patterns in paramedic education and contribute to the international discourse on student well-being in health professions education. Understanding the multidimensional nature of academic stress may inform the design of supportive curricula and institutional strategies aimed at promoting student well-being across diverse educational contexts.

Simulations are an integral part of paramedic education. Technological advancements have introduced three‐dimensional virtual reality patient simulations (3DVRS), offering a low‐cost, accessible alternative. This study compares the impact of 3DVRS and traditional simulation on paramedic students. Students selected from a convenience sample of 11 cohorts in 10 accredited programs distributed across the United States were allocated to 2 groups using a stratified random sampling. One group received simulations via 3DVRS, the second used traditional in‐person simulation. Students were exposed to 6 scenarios over 2 h from the National Association of Emergency Medical Technicians (NAEMT) Advanced Medical Life Support (AMLS) program. Altered mental status scenarios were selected a priori by the research team containing approximately 30 potential differential diagnoses. A 50‐item posttest was administered using validated cognitive items provided by Fisdap. A multicenter prospective randomized trial of 174 paramedic students was undertaken from April until August of 2022. The traditional simulation group was comprised of 88 students and the 3DVRS group had 86 students. A Mann–Whitney U test (U = 4064.5, n1 = 88, n2 = 86, p = 0.396) detected no statistical difference between two distributions or median exam score (70%), the range of values and interquartile range (IQR) for both groups: TS IQR = 64–75 (range, 32–82); 3DVRS IQR = 64–76 (range, 34–86). No difference in exam scores using 3DVRS versus traditional simulation was detected. Paramedic programs may have an effective new option when incorporating simulation with 3DVRS, potentially reducing financial and real‐estate resources required with in‐person simulations. Larger studies are needed to truly evaluate the impact and usability of virtual reality on paramedic education.

: Assessing non-technical skills (NTSs) in prehospital care is susceptible to rater subjectivity. While Artificial Intelligence (AI) can be used to score conversation transcripts, it emphasizes formal linguistic features, whereas humans integrate scene context, leading to potentially divergent evaluations. We examined the validity of NTS assessments generated by AI (ChatGPT-4o) from prehospital simulation data by comparing them with ratings from paramedic faculty. We hypothesized that AI-based ratings would provide evaluations of team NTSs that are comparable to faculty ratings and would enable us to describe the direction and magnitude of score differences between AI and faculty across the five NTS domains. : Sixty-four first-year paramedic students performed 5 min prehospital scenarios. Five NTS domains were scored independently by AI and faculty using a three-level rubric (5, 3, or 1 point per domain): (i) communication and interpersonal manner, (ii) order and completeness of information gathering, (iii) detail of follow-up questioning, (iv) context-appropriate actions, and (v) time management. Score differences were analyzed with Wilcoxon signed-rank tests with Holm correction and Bayes factors (BF10). Agreement was quantified with weighted Gwet's agreement coefficient 2 (AC2). : Three domains-communication, context-appropriate actions, and time management-showed significant differences ( < 0.001), with strong evidence for differences (BF10 > 22); median differences favored AI. Evidence of a difference was insufficient for the other two domains. Across all domains, agreement remained below the prespecified substantial threshold (AC2 ≥ 0.60). The primary hypothesis was not supported. : In prehospital simulations, AI-only NTS assessment is not yet an adequate substitute for human raters. Although AI evaluates linguistic aspects, its agreement with expert ratings was insufficient. Future work should evaluate hybrid approaches leveraging the strengths of both AI and human judgment.

The objective of this review is to examine the current literature related to interpersonal communication skill development within undergraduate paramedicine. Interpersonal communication is a vital paramedic skill, with evidence demonstrating it leads to improved patient outcomes and satisfaction and reduces medical errors. Interpersonal communication is a core capability set by paramedicine regulatory bodies, and it is the responsibility of accredited universities to ensure graduates are ready for industry and possess all required skills and attributes. In order to be included in this scoping review, all articles were required to meet a pre-determined ‘population, concept, context’ (PCC) framework. The population was undergraduate paramedic students within the context of their undergraduate paramedicine programs, and the concept was interpersonal communication education/teaching/training. In June 2021, a search was conducted using CINAHL, Medline, Emcare and ERIC. The articles had to be written in English and published between 2011 and 2021 and non-research sources were excluded. 176 articles were identified in this search and after screening for duplicates and relevancy, 15 articles were found to be eligible. The literature highlighted 4 key themes, including graduate perception of ‘work readiness’, and a variety of learning experiences including alternative work integrated learning (WIL), interactions with specific patient groups and professional learning experiences. The literature demonstrated that interpersonal communication skills are fostered through human interactions, WIL and simulation, within undergraduate paramedicine programs. Findings from the literature review indicate that practising communication through human interactions, afford an increase in confidence, awareness of ability and empathy, and an increased awareness of preconceived biases. Intraprofessional and interprofessional simulation teaching methods demonstrate the potential to build students confidence in communication and awareness of what is required to function well in a team.

Background Globally, antimicrobial resistance (AMR) is a complex public problem, which is mainly fuelled by inappropriate use of antimicrobials. Rational use of antimicrobials is the main strategy for the prevention of AMR, which can be achieved by changing the prescribers’ behavior and knowledge. Hence, this study aimed to assess knowledge and attitude of paramedical students regarding antimicrobial resistance, which helps to rationalize the use of antimicrobials. Methods An institutional based cross-sectional study was performed on 323 graduates paramedical students at the University of Gondar, Ethiopia. Participants were invited to complete a self-reported structured questionnaire on hard copy. The data were summarized using summary statistics such as the median. Furthermore, Kruskal Wallis test, at the level of significance of 0.05, was conducted to compare group difference. Results Among 360 eligible paramedical students, 323 (90%) of them participated and most of them were males 202 (62.5%). Nearly 96% of the participants perceived that antimicrobial resistance is a catastrophic and preventable public problem but about half of the participants (55%) had a poor level of knowledge. It was also found that there was a statistically significant knowledge and attitude difference across the department ( p -value< 0.0001) and ( p  = 0.002), respectively. Furthermore, those participants who had a good level of knowledge had greater attitude rank as compared to those who had a moderate and poor level of knowledge ( p -value< 0.0001). Conclusion Majority of the participants viewed antimicrobial resistance as a preventable public problem if appropriate strategies are formulated. Nonetheless, most of them had a poor knowledge regarding antimicrobial resistance, and their knowledge and attitude significantly vary across their field of study. This result implicates that improving the students’ level of knowledge about antimicrobial resistance might be an approach to flourish their attitude and to rationalize their antimicrobial use.