Exploring barriers and facilitators to paramedic engagement in prehospital research

Abstract

Background Paramedic engagement is crucial for the success of prehospital research studies. The Head injury evaluatiOn and aMbulancE Diagnosis (HOME) study aims to examine the feasibility of a diagnostic-test accuracy study to assess using the Canadian CT Head Rule in the prehospital setting to improve prehospital triage. However, significant recruitment challenges led to undertaking this qualitative study, aiming to identify barriers and facilitators to paramedic research engagement. Methods A qualitative study was conducted using semi-structured interviews with 13 paramedics with varying experience, both participants and non-participants in the HOME study, to understand their perspectives. Interviews were recorded, transcribed, and analysed using an accepted thematic analysis approach, with data saturation guiding sample size. Results Four themes were identified. The first, Paramedic Perspectives on the HOME study, highlighted potential benefits for practice and patient care and identified recruitment challenges, including the unpredictable nature of paramedic work, geographical restrictions to recruitment, and poor awareness among hospital staff. The second, Personal and Professional Constraints Impacting Engagement, identified barriers such as time constraints due to demanding work schedules, burnout from high-intensity work, and mixed attitudes toward clinical studies, influenced by factors such as generational differences and past research experiences. The third, Considerations for Research Engagement Among Paramedics, explored factors influencing paramedics’ decisions to participate in research, including personal interest in the study topic, its relevance to their practice, flexibility in engagement, and ethical concerns about patient care. The fourth, Strategies for Enhancing Paramedic Research Engagement, suggested offering incentives for participation, enhancing interaction and recognition, and improving communication and organisational support. Conclusion With unpredictable workloads, a complex prehospital environment and multiple demands on their time, paramedics face substantial barriers to research engagement. This can be mitigated by remunerating and rewarding participation, adopting flexible approaches to training and research design and optimising communication and organisational support. https://emj.bmj.com/content/41/Suppl_3/A4.2 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/