| کلیدواژههای انگلیسی مقاله |
Education, Emergency medical services, Qualitative study, Students, IntroductionThe emergency medical services (EMS) system has a significant contribution to the management of emergency incidents and disasters ( 1, ). EMS technicians assess and manage the patients&,rsquo conditions, support their lives, and provide them with first aid services in prehospital settings. Besides, they have other responsibilities such as ambulance driving and EMS documentation ( 2, , 3, ).EMS technicians&,rsquo knowledge, skills, and experience have significant effects on the patient outcomes and survival ( 4, ). Their wise and timely decisions can ensure the patients&,rsquo safety and health, facilitate their recovery, and reduce the risk of complications ( 5, ). A former study highlighted that appropriate education and adequate professional experience were the basic requirements for appropriate decision making in emergency situations and noted that EMS technicians should never use the trial-and-error method in their missions ( 6, ).EMS students&,rsquo ae educated both theoretically and practically. In theoretical education, they receive education about basic sciences and specialized courses on prehospital EMS. In practical education, they develop their skills and experience through providing care to patients and victims in real prehospital and hospital settings. Given the significant roles of EMS in patient outcomes, the educational program of EMS students should improve not only their knowledge and practical skills, but also their communication and critical thinking skills ( 7, ).Studies into EMS education in Iran were mostly conducted on EMS graduates. Two quantitative studies in this area reported that EMS graduates had inadequate professional competence and weak professional performance ( 8, , 9, ). A qualitative study into the perspectives and experiences of EMS graduates and instructors also reported different problems and challenges in EMS education, including inappropriate teaching methods, theory-practice gap, and incomprehensiveness of the EMS curriculum ( 10, ). Studies conducted on EMS graduates have suggested that more studies should be conducted on students. On the other hand, researchers, as teachers in EMS field, have witnessed the existence of educational problems among the EMS students. However, although students are a good source for identifying problems in education, our literature search showed that there was no study on the challenges of EMS education from their perspectives. Therefore, the present study was conducted to address this gap. The aim of the study was to explore the educational challenges in medical emergency EMS students. MethodsThis qualitative study was conducted using conventional content analysis which is a research method for the subjective interpretation of textual data through systematic coding and categorization ( 11, ). The study was conducted from May to October 2019.ParticipantsParticipants were fourteen undergraduate EMS students in Hamadan University of Medical Sciences, Hamadan, Iran. Inclusion criteria were agreement for participation and studentship in prehospital EMS for at least one year. In other words, the participants were selected from the third and fourth-semester students who had received both theoretical and practical education. Sampling was done purposively with EMS students who met the inclusion criteria considering maximum variation sampling. Data collectionFor data collection, semi-structure interviews were held by the first author. Interview questions included, &,ldquo May you please explain about educational courses and learning activities at the university&,rdquo ? &,ldquo May you please explain about clinical training courses and learning activities in the hospital and EMS stations?&,rdquo Then, according to the answers, the interview questions were directed towards the purpose of the study and the educational problems were explored. Also, follow-up questions such as &,ldquo What do you mean by this?&,rdquo , &,ldquo Can you explain more about this?&,rdquo and &,ldquo How did you feel then?&,rdquo were used for further clarification. Interviews were held in the participants&,rsquo preferred time and place and lasted 45&,ndash 60 minutes. All interviews were recorded and transcribed verbatim.Data analysisThe conventional content analysis approach explained by Graneheim and Lundman was used for data analysis. The five steps of this approach are immediate transcription of each interview, reading interview transcript for understanding its main ideas, identifying meaning units and primary codes, categorizing similar codes, and identifying the latent content of the data ( 12, ). Immediately after each interview, it was transcribed using the Microsoft Word software and the transcript was read for several times. Then, meaning units were identified and coded, and the codes were grouped into categories according to their similarities. During data analysis, the categories were further developed, combined, refined, and grouped into larger categories.TrustworthinessGuba and Lincoln&,rsquo s criteria ( 13, ) were used to ensure the trustworthiness. Credibility was ensured through prolonged engagement with the data and member checking in such a way the transcripts were made available to participants along with the initial codes, and some of the codes were modified to clarify the meanings of the sentences. Confirmability was ensured through peer checking by three faculty members and they confirmed all the steps of data extraction and analysis. To ensure dependability, each of the research team members independently coded the data, and then they discussed their findings to reach agreement. Sampling with maximum variation and detailed description of the study methods were also used to ensure transferability.Ethical considerationsThe Ethics Committee of Hamadan University of Medical Sciences, Hamadan, Iran, provided ethical approval for the study (code, IR.UMSHA.REC.1397.906). Before interviews, the participants were informed about the study aim, voluntariness of participation, and their right to unilaterally withdraw from the study they were also asked to sign the informed consent form of the study.ResultsAll participants were male with an age range of 25&,ndash 34 and an average work experience of four years. Nine participants were married and five were single. Eight participants were in the third semester and six of them were fourth-semester students.The participants&,rsquo experiences of the challenges of EMS education were grouped into four main categories, i.e. shortcomings of the clinical education environment, lack of qualified EMS instructors, deficit of the curriculum, and theory-practice gap (Table 1,).Main categoriesSubcategoriesShortcomings of the clinical education environmentAllocation of most practical courses to hospital environmentLimited experience in real prehospital settings |