An Examination of University Paramedic Students' Enculturation into the Ambulance Service

Abstract

This study explores student paramedics’ enculturation into a traditional NHS ambulance service trust. The research illustrates the many challenges and dichotomies which face neophyte paramedics as they go from a University classroom setting into their day-to-day clinical work placements. The challenges they face are not the result of individuals alone, rather they result from an inherent subculture ingrained within the organisational structures of the ambulance service and paramedic profession. This ethnography contributes to the social science literature on health and social care by presenting a sociological perspective of student enculturation, from the university classroom into an often chaotic working environment of the ambulance service.

In this research, the way cultural meanings, institutionalised rules, professional identity and working practices determine the working behaviours in the subculture of paramedic practice are uncovered, as individual situations and experiences are contextualised. Drawing on the work of seminal authors and experts in the field, this research explores the subculture along with the hidden curriculum which gives rise to it, as it seeks to understand how and why this appears to hamper and impede the pedagogy experienced by students. This is not the pedagogy taught and encouraged in university, rather a pedagogy which arises out from the intricacies and nuances of the traditional working environment of the paramedic.

The research steers the reader through a complex interplay of subcultural integration between experienced paramedics and students. The work draws on the peculiarity of the language, behaviours, values and working practices of paramedics and students to illustrate the subculture and hidden curriculum which is inherent in their day-to-day working practices. How students transpose what they learn in the university classroom setting to their clinical work placements is examined and unpacked to help illuminate how students contextualise the knowledge formally taught in the university learning environment, to that of the practice setting.

Supported by a plethora of fieldnotes and interviews with students and paramedics, along with my reflective and reflexive accounts collected over a period of eighteen months, this research informs and contributes to the unfolding developments within the paramedic profession. The work acquaints the reader with a rich meaningful insight into the working customs and practices not seen by members of the public or portrayed by media representations.