An Institutional Ethnography of Paramedic Education across Canada – Moving Beyond the Tyranny of the Bio-Psycho-Medico in the Classroom
In the past, individual “ambulance attendants” typically received on-the-job vocational training “post-employment.” As a profession became more institutionalized, a shift in education occurred to a “pre-employment” model that often took place in higher education institutions. However, there has been limited research, sociological or otherwise, that has chronicled the processes of becoming a paramedic.
Methodology:
This study is organized as an institutional ethnography, a sociological theory/methodology that seeks to explore the “everyday” of individuals and how their everyday is socially organized. More specifically, this study explores the work of “becoming a paramedic” and aims to explicate how this work is socially organized. To date, more than 50 in-depth interviews with paramedic students, instructors, preceptors, and others whose work connects to the education and training of paramedics have been conducted with participants across Canada. Data was also garnered from completion of a 105-hour Emergency Medical Responder course and over 300 hours of participant observations of the in-class portion of Primary Care Paramedic training.
Findings:
This presentation reports on findings from an institutional ethnographic study that explores: 1). The work that goes into becoming a paramedic; 2). How key discourses organize what paramedics are taught; 3). How “key competencies” are taught and certified in educational settings. I focus specifically on the ways in which the tyranny of the bio-psycho-medico is enacted formally and informally in and outside of the the classroom and the consequences of this enactment.
Conclusion:
This research builds off of new and emerging institutional ethnographic studies on health professions education by exploring the socially organized site of the education and training of paramedics. This study adds to the literature on medical sociology broadly, and the training of health professionals specifically, by looking at an increasingly important occupational group – paramedics – that to date has garnered little sociological attention.