Huellas espaciales de la violencia en la memoria local

Unsurprisingly, the learners themselves have a significant impact on how paramedics experience working in the role. Paramedics fulfil a range of non-clinical duties when they are at their ambulance station, including maintaining a state of readiness of their vehicles and equipment. This was raised by participants in the context of orienting learners to the professional culture as well as to the organisation. In the modern tertiary educational environment, it was suggested that university students on professional experience placements resist participation in these tasks. This resistance was presented by participants as a matter of learner initiative, affect and engagement which were all were common points mentioned by participants. This ranged from the predictable elements of a disengaged learner having a negative impact on paramedics through to a highly engaged learner acting to motivate the paramedic working with them.

The presence or absence of initiative and student motivation was described as a factor that affected how paramedics viewed their learners. Kerrie described a situation in which she had given her learner a task to check the ambulance, however in doing so the learner did not take, what to Kerrie was an obvious step, to replace an oxygen cylinder, an empty D size as she described it:

… so they might check the car [the ambulance] but in checking the car they have not changed the empty D size or they haven’t umm they checked the car because that was what you told them to do they come back and they say "well this [the Oxygen] is down" and you say “did you replace it” and they say “no”... things like going into a job where

155 you only have two hands and you grab two kits, but there are four kits

to go in, but they don't grab the other kits [laughs] you know… [Kerrie] Resistance to non-clinical tasks or functions viewed by paramedics as an element of their professional identity can not only affect the relationship between the learner and the paramedic(s) they are working with, but can also affect future professional

experience placements, or potentially internships in the case of university students. Paul described an event that had occurred in a different region in his state; in this incident the university student was known to Paul and had subsequently undertaken a placement in his region:

[the crew] went out to wash the truck and they said [to their student]

"come on, it is end of shift let’s go wash the truck" and he [the

student] said "that’s not my role, I am not here for that" so I know that that crew just shut down, he got no further apart from just tick the box, where if a student is keen and they show initiative, within their skill level, people are really keen to help them along. (Paul)

This lead Paul to provide further commentary on his perspective on why university students were there; why they were studying paramedicine and what their motivations were:

my first impression is their umm, not initiative, but their keenness on the industry, you know if someone came up and said “yeah I am doing this because I couldn't get into such and such”, you know I am thinking "well this is my first choice" you know, I respect people that see it as their first choice too, but knowing that the new, latest generation... They start a uni course and that might not be the one that they finish with. (Paul)

156 The phenomenon of learners’ resistance to non-clinical tasks was not limited to

university students; Richard outlined an example of a vocational learner objecting to non-clinical tasks. The manner in which Richard described his discussion with a learner on this point highlights his frustration and the irritation he felt towards the learner when he asked them to help wash the ambulance:

"No, that's not my job. They didn't teach us that at [the education centre]. I'm not doing that. I'm not cleaning the truck. We didn't get that listed on my skills. That's not in my skills book. I don't do that."… And, I said, "Yes, you do. We all do. We all clean the truck. In fact, we all mop the floors in the bathrooms as well and we change the toilet roll and we'll do that. We all live together and we have to share this environment." [to which Richard suggested the learner responded]

"No, not doing it - not doing it - not my job."… and, I said, "So, when we get to a job and you have to wipe the person's bottom because they've got faeces all over them, what are you going to do then?"

[learner] "I'm not going to do it." [Richard] "So, you have to have skill

[skill / competency sheet] in everything we do? We have to have skill to breathe? We have to have the skill for you to open the door to come into the station? Do we have to have the skill for you to walk in and sit down on the couch? Do we have to have the skill for you to go and get a cup of tea and watch the tellie? Do we need the skill for every single thing for you? No? Is that how your life is? If you don't want to be on the job, leave now. Goodbye, you know? Don't be here. That's part of the job.” (Richard)

157 This type of experience reported by paramedics extended beyond the resistance to participating in or performing non-clinical tasks, to such things as how learners engaged with the paramedics overall, and how they engaged with learning activities during ‘down time’ between cases. Samantha explained:

…it is difficult to work with them and difficult to get the point across, to get them engaged… because some of them won't talk which is a pain… so I think that is something you need to really be aware of the type of person because everyone is different, and you sort of need to put aside any preconceived ideas and try different methods to get through to them really you know working as a team… The negative ones are like the previously mentioned, just not talking, they go and sit in the corner and do their study, weren't interested in doing…

whiteboard scenarios or real scenarios or anything like that, just disengaged, moody and just generally difficult to deal with. (Samantha)

These types of learners, whether they are disinterested, disengaged, overconfident or shy and unable to bridge the communication gap, results in the paramedics working with them disengaging as well, as Terry and Paul explained.

it’s always driven by the student as well. A lot of the mentors will say “if student doesn’t come to me and tell me what they want I’m not doing anything”. There’s a lot of that and you get a lot of students who don’t. (Terry)

158

[if students] ask lots of questions I will answer them, if they show no interest then the interest tends to dwindle off a bit with me as well. (Paul)

It is important to highlight, however, that while participants reported difficulty engaging with learners, they also reported positive experiences with highly motivated and

engaged learners as Kerrie described:

…but on the other side, we have had some great probationers / trainees come through that I have had the pleasure of working with, uni grads they have been great, they are fun, young, keen interacted well with everyone on the station. (Kerrie)

While participants highlighted the potential de-motivating aspects of working with learners that are not engaged, they also emphasised the positive impact of working with learners that are engaged and have a degree of enthusiasm for paramedicine has on them. As Richard explained, learners like these serve to improve their motivation as well as performance in working with learners:

…so if it was a good level of engagement and enthusiasm, I loved it, it was great, I was enthusiastic myself. Helped me be a better preceptor. But when there wasn't that, it sort of disappointed me as well.

(Richard)