Becoming a paramedic: the experiences of newly qualified paramedics in navigating a changing professional, social and personal identity.

Abstract

Introduction The transition process for newly qualified paramedics may be emotionally turbulent. Evidence suggests as they socialise into the workforce they face issues around confidence, anxiety and attrition. These difficulties may lead to poorer resilience. This study sought to understand the experiences of newly qualified paramedics as they transition into the ambulance service workforce. Methods The study used a longitudinal mixed-methods convergent design, with a social constructionist underpinning. Quantitative and qualitative data were collected simultaneously and triangulated to more fully interpret participants' experiences. Data was collected at three time periods over one year. A convenience sample of 18 newly qualified paramedics from one ambulance trust was used. The Connor- Davidson Resilience 25-point scale questionnaire (CD-RISC25) was administered and analysed using descriptive statistics. Semi-structured interviews were conducted simultaneously and analysed using Charmaz's constructivist grounded theory approach. Findings There was a range of resilience scores with individuals displaying different pathways through the transition process. The mean CD-RISC scores were T1: 74.7 (SD 9.6). T2: 73.8 (SD 9). T3: 75.4 (SD 6.8). Factors related to social support were consistently scored highly, and factor relating to determinism were consistently scored lower. Qualitative data constructed a process whereby participants were navigating a changing identity across three spheres simultaneously: professional, social and personal identity. Participants who found the process particularly turbulent generally displayed lower resilience scores. Conclusion This study emphasises the importance of identity in the transition of newly qualified paramedics. It emphasises the social process and uses social identity theory as a theoretical framework for understanding the challenges faced. Interventions which support the newly qualified paramedic in navigating and understanding this change in identity may improve resilience and self-efficacy. Pre- registration curricula needs to consider issues of identity in preparing students for realities of work. Interventions such a peer supervision has supported this in other healthcare professions. Further research is needed to understand the impact of these interventions.