Background

High professional competence is crucial for ambulance personnel, as expected by patients, relatives, and organizations. Prehospital advanced trauma and medical care demand exceptional competence. Specialized training programs i.e., AMLS, ATLS, and PHTLS are widely adopted internationally. Integrating “beyond-5G and 6G technologies” can significantly enhance realism, increase the number of simulated patient cases, and improve prehospital nursing education by providing real-time data and advanced communication capabilities. This integration supports the development of critical thinking and decision-making skills and ensures that ambulance personnel are well-prepared to handle a wide range of emergencies, ultimately improving patient outcomes and overall service efficiency. The aim of this study is to evaluate the impact of integrating high-fidelity simulation with “beyond-5G and 6G technologies” in prehospital nurse education.

Methods

Students will practically carry out multiple high fidelity simulation cases in a road ambulance. The cases are communicated and distributed from the learning site to the ambulance using “beyond-5G and 6G technologies”. Data are gathered using the Paramedic Global Rating Scale and System Usability Scale. Students’ experiences of reality and learning will also be explored in individual (n=15) interviews.

Results

The study is expected to demonstrate that integrating realistic high-fidelity simulation with “beyond-5G and 6G technologies” can improve clinical and decision-making skills in prehospital nursing students. The study is also expected to be able to relate effective simulation methods to different simulated scenarios and contribute to more effective prehospital nurse education.

Conclusions

High-fidelity simulation with “beyond-5G and 6G technologies” could be a valuable addition to future prehospital nurse education.

As the adoption of Fifth Generation (5G) systems increases, efforts towards Sixth Generation (6G) systems have already started across research, standardization, and stakeholder fora. 6G is expected to support applications with immersive capabilities, with specific use case requirements from different verticals playing a critical role in solution development. Unlike current solutions in the education vertical that uses immersive technologies such as Augmented/Virtual/eXtended Reality (AR/VR/XR), which rely on pre-recorded content and  lack engagement, 6G can enhance remote education by enabling real-time, AR/VR/XR-enriched interactions among students and instructors. This paper presents ongoing activities within the 6G-PATH EU project, towards the design, implementation, and testing of a 6G use case for healthcare personnel remote education/training, which aims to facilitate real-time, AR/VR/XR-enhanced interactions among healthcare trainees and instructors.

Introduction

High professional competence (Cheetham& Chivers, 1998) of personnel in ambulance services is something that patients, relatives, and the ambulance organizations themselves expect. Prehospital advanced trauma care requires high levels of professional and clinical competence, with high stakes decisions and judgements often being made with limited information or in less than ideal conditions (Wilson et al., 2015). The importance of trauma specific training is well established by the proliferation of trauma care education programs eg. BTLS, ATLS, PHTLS. The perceptions of prehospital providers regarding the competencies required to adequality care for trauma patients has been questioned ie. whether students learning is correctly focused on the competencies required in practice. It has been argued that student perceptions of self-efficacy and competence can positively influence learning, leading to greater effectiveness of competency based assessments (van Dinther et al., 2014).

Aim

The aim is to describe the perceptions of South African paramedic and Swedish prehospital emergency nurse students towards competence in prehospital trauma care and compare their alignment to the Global Rating Scale and Ambulance Nurse Competence Scale instruments commonly used for competency based assessments. 

Method

The student will employ a cross sectional descriptive survey design with using an online questionnaire. Responses will be compared to validated instruments: the Global Rating Scale (Tavares et al, 2013) and the Ambulance Nurse Competence scale (Nilsson et al, 2022). The study populations consist of paramedic students from South Africa and prehospital emergency nurse students from Sweden. Analysis techniques will include descriptive and inferential methods.  

Result

The results may indicate that the differences between paramedics and nurses are not substantial, but they may also reveal specific distinctions. Furthermore, it can provide a greater understanding of students' perspectives on competency in the prehospital field, which both education programs can benefit from in terms of curriculum and didactic growth.

Prehospital användning av blodprodukter vid allvarliga trauman kan minska mortalitet och morbiditet. I olika länder och inom olika prehospitala system skiljer sig möjligheterna att administrera blodprodukter. Skillnaderna beror bland annat på resurser, personalens kompetens, risker, nytta samt varierande behov i olika miljöer.Syfte: Syftet med den preliminära litteraturöversikten var att studera prehospital administration av blodprodukter vid allvarliga trauman.Metod: Litteraturöversikt bedömdes som en lämplig metod för att samla kunskap om prehospital administrering av blodprodukter. Inklusionskriterier vid databassökningarna var att artiklar skulle ha prehospitalt fokus (militära och civila), omfatta administration av blodprodukter och traumatiska blödningar, vara publicerade år 2012 eller senare samt vara peer-reviewed. Litteraturöversikter exkluderades. Vid preliminära sökningar i databaser identifierades 509 unika artiklar.Resultat: Resultatet baserades på 10 artiklar från fem länder och omfattade militär och civil kontext. Artiklarna beskriver olika typer av allvarliga trauman där blodprodukter använts. Indikationer för att ge prehospitala blodprodukter var: påverkade vitalparametrar enskilt (n=8) eller kombinerat med bedömning av trauma (n=3), transporttid (n=1), shock index (n=1), laktat (n=1) eller ISS-score (n=1). Att ge blodprodukter prehospitalt var associerat med högre överlevnad men överlevnaden var också beroende av det prehospitala omhändertagandet, tidsfaktorer, typ av trauma och resurser. Konklusion: Prehospital administration av blodprodukter vid allvarliga trauman har potential att öka överlevnaden hos patienter. Genom en systematiskt genomförd litteraturöversikt kan tydligare kunskap framkomma. Argument för och emot prehospital användning av blodprodukter kan tydliggöras och litteraturöversikten kan bidra med underlag som tar hänsyn till alternativ, risker, nytta, kostnader, kompetens och tidsfaktorer för ambulansorganisationer som överväger att införa blodprodukter.

The overall aim of this thesis was to explore nurses’ professional competence with a focus on scope of practice, content, utilization, and development within the ambulance service in Sweden.

Methods: Integrative review (I), qualitative (II, III) and quantitative methods (IV) were used. The integrative review was based on 25 studies. The qualitative studies were based on interviews with 13 (II) and 16 prehospital nurses (III), and data was analyzed using content analysis (II) and grounded theory (III). In the quantitative study (IV), 105 nurses answered a digital questionnaire and descriptive and analytical statistics were used in the analysis. 

Main findings: Advanced nurses’ and paramedics’ assessments, treatments, and referrals were safe and of high quality and were characterized by a high degree of autonomy. Patients were satisfied with the care provided, reduced waiting times, and the avoidance of unnecessary transportation to hospital (I). Broad medical and nursing competence was required, and personality traits and contextual awareness were emphasized as unique competences (II). Prehospital emergency nurses reported higher levels of professional competence compared to registered nurses or other specialist nurses. No differences were identified between nurses with master’s or bachelor’s degrees, and clinical experience was a predictor of nursing competence (IV). At the start of their careers, the ambulance service represented a developing environment for nurses. When focus, education, roles, responsibilities, and requirements remained the same, continued competence development risked stagnation (III).

Conclusions: Personality, clinical competence, prehospital experience, and contextual competence were emphasized. Academic competence was neglected and not demanded. This thesis provides new knowledge that can contribute to the continued development of the ambulance service and to a more efficient utilization of the full spectrum of nurses’ professional competence.  

Ambulance services are included in changing healthcare systems where nurses have a central role in providing safe and high-quality care. Therefore, it is crucial that prehospital nurses’ professional competence meets the needs of patients and the ambulance service. The overall aim of this thesis was to explore nurses' professional competence with a focus on scope of practice, content, utilization, and development in the ambulance service. Advanced nurses’ assessments, treatments and referrals were safe, of high quality and characterized by a high degree of autonomy. Within Swedish ambulance services, prehospital emergency nurses reported higher competence than registered nurses and other specialist nurses. No differences between nurses with a master's or bachelor's degree were identified, and clinical experience was an important predictive factor for nurse competence. Ambulance services were a developing environment for nurses during the first years. When focus, training, roles, responsibilities, and requirements remained the same over time, continued competence development risked stagnation. This thesis provides new knowledge that can contribute to the continued development of the ambulance services and to a more efficient utilization of nurses' competence.

Aim To explore and present an overview of scope of practice among registered nurses and paramedics with an advanced level of education in pre-hospital and in-hospital emergency care. Design An integrative literature review. Method Studies published between 2006 and 2018 were retrieved by searching the databases CINAHL, PubMed, Scopus and Web of Science. Studies were selected by three independent researchers, and data were synthesized using thematic analysis. Results The 25 studies identified focused on in-hospital (n = 15) and pre-hospital emergency care (n = 10) and included 13 professional titles originated from seven countries. The thematic analysis disclosed four themes; "Versatile care," "Safe care based on precision and accuracy," "Autonomous performance within boundaries" and "Beneficial towards patients and society." Advanced paramedics' and advanced nurses' services are characterized as safe, of high quality and of public benefit. Their services are being used in everyday practice as well as directed to certain categories of patients.