title: A Survey to Determine Decision-Making Styles of Working Paramedics and Student Paramedics.
abstract: OBJECTIVE
  Two major processes underlie human decision-making: experiential (intuitive) and rational (conscious) thinking. The predominant thinking process used by working paramedics and student paramedics to make clinical decisions is unknown.
  
  
  METHODS
  A survey was administered to ground ambulance paramedics and to primary care paramedic students. The survey included demographic questions and the Rational Experiential Inventory-40, a validated psychometric tool involving 40 questions. Twenty questions evaluated each thinking style: 10 assessed preference and 10 assessed ability to use that style. Responses were provided on a five-point Likert scale, with higher scores indicating higher affinity for the style in question. Analysis included both descriptive statistics and t tests to evaluate differences in thinking style.
  
  
  RESULTS
  The response rate was 88.4% (1172/1326). Paramedics (n=904) had a median age of 36 years (IQR 29-42) and most were male (69.5%) and primary or advanced care paramedics (PCP=55.5%; ACP=32.5%). Paramedic students (n=268) had a median age of 23 years (IQR 21-26), most were male (63.1%) and had completed high school (31.7%) or an undergraduate degree (25.4%) prior to paramedic training. Both groups scored their ability to use and favourability toward rational thinking significantly higher than experiential thinking. The mean score for rational thinking was 3.86/5 among paramedics and 3.97/5 among paramedic students (p<0.001). The mean score for experiential thinking was 3.41/5 among paramedics and 3.35/5 among paramedic students (p=0.06).
  
  
  CONCLUSIONS
  Working paramedics and student paramedics prefer and perceive that they have the ability to use rational over experiential thinking. This information adds to our current knowledge on paramedic decision-making and is potentially important for developing continuing education and clinical support tools.
authors.affiliation: *Emergency Health Services,Dartmouth,NS.
authors.forename: J L
authors.initials: JL
authors.lastname: Jensen
authors.affiliation: ‡McMaster University Family Medicine Residency Program,Hamilton,ON.
authors.forename: A
authors.initials: A
authors.lastname: Bienkowski
authors.affiliation: *Emergency Health Services,Dartmouth,NS.
authors.forename: A H
authors.initials: AH
authors.lastname: Travers
authors.affiliation: §Ottawa Hospital Research Institute,Ottawa,ON.
authors.forename: L A
authors.initials: LA
authors.lastname: Calder
authors.affiliation: *Emergency Health Services,Dartmouth,NS.
authors.forename: M
authors.initials: M
authors.lastname: Walker
authors.affiliation: ¶Centennial College,Toronto,ON.
authors.forename: W
authors.initials: W
authors.lastname: Tavares
authors.affiliation: †Department of Emergency Medicine and Division of EMS,Dalhousie University,Halifax,NS.
authors.forename: P
authors.initials: P
authors.lastname: Croskerry
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000523:psychology*; D003430:Cross-Sectional Studies; D003657:Decision Making; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D009674:Nova Scotia; D011594:Psychometrics; D011795:Surveys and Questionnaires; D013850:Thinking
keywords: decision making; emergency medical services; paramedics