The difference between a clinical technician and clinical practitioner is in the scope of practice: the need for a bioscience understanding in paramedicine

Abstract

“Only teach me what I need to know!” This commonly heard refrain is often spoken by allied health students while studying preclinical sciences (physiology, anatomy, pharmacology). Here we use a clinical scenario undertaken by second-year Bachelor of Paramedic Practice students of acute coronary syndrome to demonstrate the difference in clinical decision making when using a clinical reasoning approach to treatment rather than relying exclusively on a practice guidelines approach. We hope to demonstrate that understanding basic bioscience concepts, such as the Frank-Starling mechanism and the anatomy and physiology of the autonomic nervous system, are key to providing good clinical care in response to ambiguous patient symptoms. Students who understand these concepts underlying their patient care guideline will make better clinical decisions and better provide quality of care than students who follow the guideline exclusively. We aim this as a practical demonstration of the value of detailed understanding of human bioscience in allied health education. As health care providers transition from “technician” to “practitioner,” the key distinguishing feature of the role is the ability to practice independently, using “best judgment” rather than clinical guidelines (alone). Evidence suggests that complex case management requires detailed bioscience understanding.