Which Cardiac Experiences Are Best for Paramedic Student Success? Do Hospital Exposures Do More Harm Than Good?

Introduction—Clinical placements are increasingly hard to obtain, and optimizing paramedic student learning experiences is critical. This study explores the relationship between paramedic students’ exposure to cardiac patients during field, clinical and laboratory settings and odds of success on final comprehensive cognitive exams.

Methods—A retrospective analysis of student records in the Fisdap, an online database for EMS and health care education, was conducted using paramedic students with at least one score on a comprehensive cognitive exam. Success on comprehensive cognitive exams was defined as achieving a score at or above the suggested Angoff method of determining a passing score. Logistic regression models were fitted (alpha=0.05) using predictor variables: adult cardiac patients in field, and clinical and laboratory settings encountered before taking examinations (see Figure 1). Ethics approval was granted by the University of the Sunshine Coast, Australia.

Results—A total of 1,290 student records with 157,971 cardiac patients and 2,150 Fisdap comprehensive cognitive exams (1094 PRE3, 489 PRE4, 567 CUE) attempts were analyzed. Field encounters of cardiac patients increased the odds of passing all three comprehensive cognitive exams: PRE3 Overall (OR 1.051), PRE3 Cardiac (OR 1.037) and CUE (OR 1.032). Laboratory simulation encounters also increased the odds of passing comprehensive cognitive exams: PRE4 Cardiac (OR 1.031) and CUE (OR 1.028). Clinical encounters had no observed effect on passing PRE3 and PRE4 and decreased the odds of passing the CUE (OR 0.964) (see Figure 1).

Conclusion—Field and laboratory cardiac patient encounters improved the odds of paramedic students passing comprehensive cognitive exams. Hospital clinical encounters either had no effect or a detrimental effect on odds of success. Paramedic programs should consider prioritizing field and laboratory cardiac patient encounters. Further research is needed to determine the utility of hospital placements.