Reflecting on every case

As I mark my first year anniversary as a paramedic for the Scottish Ambulance Service provides a good opportunity to reflect on the past year. Murdoch (2019) wrote about decision-making in paramedic practice, referring to Brenner's Novice to Expert continuum—particularly on how this is applied to newly qualified paramedics.

In April 2022, as a new NQP, I was definitely a novice. Although I had completed my university education, my experience was limited, with Brenner's definition of novice clearly describing me at this time. However, with increased exposure and learned behaviours through experience, people can move up through this continuum over time.

The NQP programme in Scotland is relatively new, compared with the programme in England—the main emphasis being on supported clinical decision-making. Our first 6 months as an NQP give us the opportunity to work with another paramedic to gain experience and increase our confidence. I would argue that as a new NQP, we are already passed the ‘Novice’ level in some areas, sitting somewhere around ‘Advanced Beginner’—though there are undoubtedly some aspects of the job that I still feel ‘novice’ in. Brenner acknowledges pattern recognition as a useful tool to advance from Novice to Expert. In order to gain experience, I am at the mercy of dispatch colleagues. After 1 year, there are still come cases that I have not attended. This raises the question: can I be proficient or competent in one area and be a novice or advanced beginner in another?