title: Paramedics' views on their seizure management learning needs: a qualitative study in England.
abstract: The UK ambulance service often attends to suspected seizures. Most persons attended to will not require the facilities of a hospital emergency department (ED) and so should be managed at scene or by using alternative care pathways. Most though are transported to ED. One factor that helps explain this is paramedics can have low confidence in managing seizures.
  
  
  
  With a view to ultimately developing additional seizure management training for practicing paramedics, we explored their learning needs, delivery preferences and potential drivers and barriers to uptake and effectiveness.
  
  
  
  Semistructured interviews were conducted with a purposive sample of paramedics from the English ambulance service. Interviews were transcribed and thematically analysed.
  
  
  
  A diverse sample of 19 professionals was recruited from 5 different ambulance NHS trusts and the College of Paramedics.
  
  
  
  Participants said seizure management was neglected within basic and postregistration paramedic training. Most welcomed additional learning opportunities and identified gaps in knowledge. This included how to differentiate between seizure types and patients that do and do not need ED. Practical, interactive e-learning was deemed the most preferable delivery format. To allow paramedics to fully implement any increase in skill resulting from training, organisational and structural changes were said to be needed. This includes not penalising paramedics for likely spending longer on scene.
  
  
  
  This study provides the first evidence on the learning needs and preferences of paramedics regarding seizures. It can be used to inform the development of a bespoke training programme for paramedics. Future research should develop and then assess the benefit such training has on paramedic confidence and on the quality of care they offer to seizure patients.
authors.affiliation: Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
authors.forename: Frances C
authors.initials: FC
authors.lastname: Sherratt
authors.affiliation: Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
authors.forename: Darlene
authors.initials: D
authors.lastname: Snape
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Goodacre
authors.affiliation: North West Ambulance Service NHS Trust, Bolton, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Jackson
authors.affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Clinical Sciences Centre, Liverpool, UK.|Aintree Health Outcomes Partnership, University of Liverpool, Clinical Sciences Centre, Liverpool, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Pearson
authors.affiliation: Department of Molecular and Clinical Pharmacology, University of Liverpool, Clinical Sciences Centre, Liverpool, UK.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Marson
authors.affiliation: Department of Psychological Sciences, University of Liverpool, Liverpool, UK.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Noble
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D004634:Emergency Medical Technicians / Q000193:education / Q000523:psychology* / Q000592:standards; D004635:Emergency Medicine / Q000193:education; D004739:England; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D012640:Seizures / Q000628:therapy*
keywords: ACCIDENT & EMERGENCY MEDICINE; EDUCATION & TRAINING (see Medical Education & Training); QUALITATIVE RESEARCH