Case study: SECAmb Research Paramedic shares his path in research for Allied Health Professionals Day
In Your Path in Research - a series that uncovers the research community across the National Institute of Health Research Clinical Research Network Kent, Surrey and Sussex region - we speak with Pete about the role of a research paramedic.
When did you become a paramedic and when did you start your research journey?
I joined the ambulance service in 1998 and became a paramedic in 2004. Before that, I was always going to be a research scientist and I was a research assistant for a year after my first degree (which was not paramedic related). I did not continue within this career path though, as I did not want to be fully laboratory-based; I wanted some life experience and so went into clinical practice for 20 years. I eventually undertook a Master’s degree in order to go into specialist paramedic practice as a paramedic practitioner, a role which is more focused on urgent community care provision as opposed to critical care. My dissertation module involved a research study and subsequently having developed some meaningful research, it made me want to return to working in research and now I could bring my experience of clinical practice along too. I have now been working within the SECAmb research and development team since 2018.
What does a research paramedic do?
We work on a range of activities and one is to work collaboratively with other organisations to conduct large-scale national trials within the trust. Currently I've been facilitating the CRASH-4 trial - Intramuscular tranexamic acid administration for the treatment of symptomatic mild traumatic brain injury in older adults: a randomised, double-blind, placebo-controlled trial. I have been localising the training packages for paramedics so that they are specific to SECAmb and keeping all the relevant paperwork updated including the investigator site files.
Previously, I’ve completed a successful grant application to the College of Paramedics for a small national survey, which I led on for the department. I subsequently did the analysis, published and disseminated results at research conferences. The study was on the role of ambulance paramedics in the timely identification of patients with end of life care needs and it was included on the NIHR portfolio.
I also contribute to the review of research proposals for governance approval within the trust and as part of our engagement work I visit universities to promote research activity. I encourage students to do research as an element of their upcoming careers once they graduate as paramedics.
Why is it important for research to take place within ambulance trusts?
Ambulance based clinical practice takes place in a unique environment (people’s homes and public places) and we need to be careful about using evidence produced in other environments and transferring it to ours. We need to do research that is suitable for our patient population. For someone who doesn't work in an ambulance trust, it's very difficult to understand the issues we encounter within our clinical practice, just the same as it is for us to fully understand what happens in other specialties. If we can do research within our own environment then it is important for us to do it.
What do you enjoy about working in research?
I enjoy working in research because it benefits clinical practice, as you are contributing to the evidence supporting it. There is not a typical day and that's what I love about working in research. As a paramedic you may be comfortable in someone’s home and in the back of an ambulance, but you may not feel very comfortable in a meeting of healthcare managers or speaking at an academic conference. This is what I found challenging initially but I have enjoyed doing something different and building a new skill set.
What challenges do you encounter in research?
It is sometimes difficult to get people excited about research as it can be a slow process. Staff may have been involved in a study three years ago and the results have still not been published and so demonstrating impact can sometimes be difficult. There are a lot of administrative elements involved, which people who are not used to research may not understand why those processes are in place.
What advice would you give to other paramedics considering going into research?
My advice to other paramedics is to just give research a go and participate in studies conducted within your trust. There are studies which specifically fund research paramedic support so you could apply for those roles, working on one or two studies to gain experience and then decide if a research career is right for you. All graduate paramedics need to be encouraged to use their experience of clinical practice to look into the evidence base supporting it, and if they discover holes and gaps, to question how it might be improved and perhaps develop projects to address that. It is also useful to keep up to date with what is being published in the field of prehospital research. There is a fantastic Library and Knowledge Service for NHS Ambulance Services in England (LKS ASE) who produce a very useful prehospital emergency services current awareness update of recently published articles. You do not need to read every article but it is worth dipping in and out to see which ones you are interested in.