The Nature of Paramedic Practice in Rural and Remote Locations: A Scoping Review
Bibliographic record
Abstract
Introduction Access to emergency healthcare services and specialist care – particularly paramedic services – is more restricted in the rural and remote areas of Australia, and this disparity is amplified further as remoteness increases. This review aims to investigate the availability of current research regarding both the expanding nature of paramedicine roles in rural environments, and the impacts of rurality on the quality of out-of-hospital care provided to patients. Methods Arksey and O'Malley's six-step methodological approach was used to perform a scoping review to assess the availability of literature. Key words including paramedic*, regional, rural, remote and role were inputted into the search engines Scopus, CINAHL and PubMed. Titles and abstracts of the 864 results were screened by all authors and inclusion/exclusion criteria applied, resulting in 13 remaining articles. Results The final 13 articles comprised differing data collection types and methodologies from nine separate studies conducted in either Canada, Australia, the United Kingdom, the United States, Saudi Arabia or Qatar. Approximately 2.5 million patients, 534 paramedics, 331 other healthcare professionals and 35 case studies were included in the total combined results of these studies. Conclusion Rural communities demonstrated increased mortality rates in out-of-hospital patients due to several factors including rostering, specialist service locations and limited resource availability. Factors which were beneficial to the outcomes of patients in rural settings included enhanced paramedic scopes of practice, the implementation of community paramedicine programmes and wider roles within the community for paramedics. A lack of research on the exact nature of these changing roles in rural paramedicine is evident.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.007 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".