Evaluation of Paramedic Views of Their Role in Ambulance Based Clinical Trials: An Interview Study

Abstract

Abstract Background: Prehospital ambulance-based research is a relatively new and growing field, with paramedics increasingly being asked to take on a new research role. We sought to understand paramedic perceptions of this role with particular emphasis on the ethical challenge of gaining consent and enrolling patients onto clinical trials in this setting. Methods: We undertook semi-structured interviews with paramedics who were actively involved in recruiting and consenting patients to UK trials. Participants were questioned on their views about the ethical considerations in clinical trials including different consent processes and perceived barriers to research. Participants were chosen because they had enrolled at least one patient to a clinical trial within the 12 months prior to the interview taking place. Results: Fifteen paramedics from East Midlands NHS Ambulance Trust UK (EMAS) were interviewed. Analysis highlighted seven themes: barriers and facilitators to participation; benefits of research; consent methods; future trials; managing patient participants; problems with consent; and reasons why paramedics participate (or not). Paramedics were generally comfortable with gaining consent for research and most did not see this as an additional burden. However, excessive paperwork and the prolonged handover times needed for paramedics to participate in research were seen to be problematic. All paramedics interviewed felt that research was important for advancing their practice and ensuring better outcomes for patients as a result of evidence-based practice. Conclusions: Our findings highlight the need for future trials to consider how to minimize impact on the operational practice of paramedics through the use of existing processes that reduce additional paperwork and time pressures on paramedics.