Building Personal Resilience in Paramedic Students
Gregory Anderson, Glenda Kerr, Steven Mills, Ron Bowles and Jennifer Armstrong, Justice Institute of British Columbia

INTRODUCTION/BACKGROUND

DISCUSSION

Recent research suggests that paramedics may be at increased risk for
developing work-related health issues. Paramedics appear to have an
increased prevalence of early retirement based on medical grounds, a
greater frequency of musculo-skeletal injuries, and an increased
prevalence of post-traumatic stress disorder (PTSD) and anxiety (Sterud
et al.,2006). However, to date educational programs for paramedics
appear “somewhat preoccupied with the technical and physical aspects of
varying trauma management” (Williams, 2013: p207) while the stress
and/or PTSD that can impair one’s ability to function in such complex
environments, significantly impacting work performance and quality of life
(Lopez, 2011), has been overlooked. Gayton and Lovell (2012) advocate
for increased attention paid to the development of resilience skills in
paramedics and paramedic students. Without skills to mitigate and
manage workplace trauma, paramedics are at risk for developing trauma
related mental health problems.

Rescue workers were found to have a pooled prevalence of post traumatic
stress disorder (PTSD) of 10%, being highest in paramedics (14.6%)
(Berger et al., 2012) . In Australia, Streud et al. (2006) reported the
incidence of PTSD in paramedics to be greater than 20%. It seems clear
from the limited research to date that the stressors associated with
ambulance work may lead to increased mental health concerns, short and
long term disability (LeBlanc et al., 2012).

The present study examined the impact of a short, self-paced online
resiliency training program to help students training to be Primary Care
Paramedics mitigate the risks associated with working in a trauma
informed work setting. The online curriculum aimed at teaching resiliency
skills, building personal resiliency resources to be used through their
practicum placements and further employment. It was hypothesized that a
short-duration, self-paced course would increase students’ resiliency
throughout the program, including their practice education experience on
ambulances and in hospital emergency departments.

Age and gender

Gender

Control

Experimental

(no.)

(no.)

Male

28

60

Female

29

21

Total

57

81

(yrs.)
Age

Total

(yrs.)
25.3

25.6

Mean pre and post scores for the control and
experimental group
Control Group
Pre
Post
Self-reliance
29.30 30.03
Meaning
28.65 28.91
Equanimity
27.59 28.42
Perseverance
28.75 29.12
Existential Aloneness 30.02 29.85
Total Score
144.07 146.33

Experimental Group
Pre
Post
29.00 37.00
28.06 31.53
27.02 34.00
28.22 33.27
28.25 36.68
140.56 173.36

RESULTS
In total, 81 students participated in the experimental group, and 57 in the
control group. Prior to the intervention there were no significant
differences in total resilience or any of the sub-scales (P>0.05). Following
the resiliency training and the practicum experience the experimental
group scored better in total resilience and each of the sub-scores (P<0.05).

APPLICATION
The possibility that such training could have positive effects on preventing,
reducing and/or mitigating the risks of working in a trauma-informed work
environment may have broad application in recruit and incumbent training
in various first responder and receiver occupations.

CONCLUSION
Results demonstrated a significant improvement in the paramedic students’
resiliency following the online training. These positive results suggest that
resiliency education during paramedic training programs have significant
impact on students who are placed into on-the-job pre-employment training.
The possibility that such training could have positive effects on preventing,
reducing and/or mitigating the risks of working in a trauma-informed work
environment could result in important improvements in the quality of life of
first responders, and reduce short and long term disabilities associated with
post-traumatic stress.

METHODS
Using a randomized control trial, cohorts of students were randomly
assigned to either the experimental (with the online course as an
intervention) or control group. Two cohorts were randomly assigned to
receive the online course intervention designed to build capacity for
resilient behaviour, while two cohorts acted as the control group. Cohorts
were campus based, and students were not at the same location for
training, reducing any contamination of data. Resilience was measured in
all participants using version 3.20 of the Resilience Scale developed by
Gail Wagnild (2011).

This research examined the efficacy of resiliency training on strengthening
personal resilience in students training to be Primary Care Paramedics. By
developing and delivering online curriculum aimed at teaching resiliency
skills and introducing appropriate resources to paramedic students, it was
hypothesized that this training would increase students’ resiliency
throughout the program, including their practice education experience on
ambulances and in hospital emergency departments. The positive results
indicate that paramedic students’ resilience during their practice education
experience can be increased by a short resiliency-training curriculum.

The mean pre and post scores were not
significantly different pre and post practical
experience on the ambulance in the control group,
while scores were significantly higher in the
experimental group following the 4-8 hour resilience
training and practical experience. There were no
significant differences in the age, gender
distribution, years experience or level of education
prior to Primary Care Paramedic training.

Partially funded by the Canadian Mental Health Association, Campus Capacity Development Grant

KEY REFERENCES
Berger et al., (2012). Social psychiatry and psychiatric epidemiology, 47(6), 1001-1011.
Gayton, & Lovell (2012). Traumatology, 18(1), 58.
LeBlanc, et al., (2012). Prehospital and disaster medicine, 27(04), 369-374.
Sterud et al., (2006). BMC Health Services Research, 6(1), 82.
Wagnild, G. M. (2011). The Resilience Scale User's Guide: For the US English Version of the
Resilience Scale and the 14-item Resilience Scale
Williams (2013). Nurse education in practice, 13(3), 207-212.

JUSTICE INSTITUTE OF BRITISH COLUMBIA