From reluctant doctoral student to professor

Prehospital Emergency Care is a fairly recent area of research. Compared to other forms of research into medical care, his field is quite restricted, but this does not entail that it is of minor importance. Traditionally, this kind of research has not been conducted by nurses but by doctors. At present, however, the research has become more closely linked to clinical issues. The focus has also been on decision making.

“We know that decision-making processes are of decisive importance to patients. That is, the decisions taken by hospital staff regarding where to place a patient and how the caring process should be initiated. Twenty years ago, in connection with ambulance care, patients were usually taken straight to an emergency ward. Today, on their first encounter with a patient, the ambulance staff can make early assessments of the type of care required. This places a lot of responsibility on the shoulders of an ambulance nurse. An erroneous assessment can lead to delayed care for instance for someone who has had a stroke,” Magnus Andersson Hagiwara explained.

Change of field

Magnus Andersson Hagiwara’s road to becoming a researcher within the field of ambulance care was not a straight route. His mind was set on being a forester and he pursued studies in it. After completing them, he worked as a lumber jack before doing his military service as a paramedic.

“This was where I discovered that I had a talent for healthcare. After doing my military service, I trained to be a nurse and completed my education in 1993. A few years later I trained to be an ambulance nurse. From from 2005, having qualified staff in ambulances has become mandatory.

In 2006, he started working part-time as a teacher in the ambulance nurse training programme at the University of Borås, combining this with clinical work in the ambulance sector.

Combining research and ambulance care

One day, Magnus Andersson Hagiwara was asked whether he would be interested in applying for a position as a doctoral student. The proposition was made by Björn Ove Suserud who was in charge of the training of ambulance nurses at the University of Borås. At the time, Magnus was not really interested and declined the offer. However, when the question was raised again, and with the suggestion that his studies for a doctoral degree could be carried out part time in combination with ambulance activities, he consented to the idea. The ambulance was his place of work until 2014, the year he obtained his doctorate. This made him one of the first ambulance nurses in Sweden to defend a doctoral thesis within the area of prehospital care.

The topic of his thesis was ways of assisting ambulance staff with their decision making. Part of this decision support is now being used within ambulance care also in the UK. He is very happy to have had the opportunity to combine his clinical activities with research work.

“An ideal situation would have been maintaining the clinical side of things   while doing research, but it is difficult to make that work time wise.”

Magnus Andersson Hagiwara continued his academic path as a Lecturer. Today, together with his colleague, Hanna Maurin Söderholm, he is also the leader of the research platform PreHospen – Centre for Prehospital Research, which is the largest of its kind in Sweden.

“From the point of view of patient safety, patient assessments made by ambulance staff means some risk. In several of our projects, we have studied different groups of patients. An example of a project aimed at improving prehospital assessments is ViPHS – Video support in the Prehospital Stroke chain. Video support has been installed in twelve ambulances. When the ambulance staff have patients whom they suspect have had a stroke, they call up the regional stroke emergency centre and are able to examine the patient together via video.

At present, Magnus Andersson Hagiwara also has started a project aimed at developing instruments for the scrutiny of doctors’ journals in order to be able to trace inconsistencies. The aim of the project is to find an instrument that can be used by ambulance organisations to ensure the safety of patients.

Magnus Andersson Hagiwara supervises a handful of doctoral students working on various projects. One of these concerns trauma patients who are taken to trauma centres. Another of these concerns patients who are not taken to hospital, but to alternative types of care institutions. An additional project will cover clinical decision making, during ambulance assignments, which is to lead to decision making within the prehospital care chain.

Challenges of doing research

What are the challenges of doing research? Magnus Andersson Hagiwara answers us:

“Within prehospital care, conducting successful clinical studies is not easy. It is difficult to conduct controlled and random studies in ambulance settings. Ethical rules constitute another challenge. For example, asking a patient to give their consent to participate in a study is not always easy. Another challenge is disseminating out research results so they can be made use of in practice within ambulance care. This takes time.

Receiving external monetary aid is another challenge. The research carried out into prehospital care is much less extensive than other forms of research into the medical sector, and all are competing for the same funding.

Many people have an unclear perception of what ambulance care involves and do not consider it as an extremely important part of medical care. However, one must consider that 70 percent of all stroke patients are transported to hospital by ambulance. The ambulance is thus the first vital part of the care chain.

He explains what has inspired him to do research:

“Prehospital care is an area of development and it is my great interest. There are innumerable research questions that have as yet remained unanswered. Within PreHospen, we have several plans for research projects which could be put in motion.

This includes, for example, collecting research material which, today, is spread out among diverse universities, and recording it in one place. Such unique material could keep several students busy", he concluded.

Magnus Andersson Hagiwara

Position:  Professor of Prehospital Emergency Care since 2021
Resides: Lives with his family and dog outside Ulricehamn
Leisure activities:  Hiking, kayaking, skiing, and hunting.
Enjoys: Hiking and camping in different places close to nature.
Dislikes: All obstructions in the world of research, hierarchies, and limiting opinions within science
How I would like my colleagues to understand me: As humble, as maintaining an openness within the research group, and ensuring that all contributions are handled with respect.

Further reading

Research into prehospital care is conducted within the research area of the Human Perspective in Care.

Research into the area of prehospital care covers everything: from people becoming acutely ill and injured, the members of society who come to people’s aid, to when a patient is transferred to a medical institution. Included are ambulance care, emergency centres, rescue services, military care, emergency care at sea, and mountain rescuing.

Researcher Profile

PreHospen – Centre for Prehospital Research 

Research Area: the Human Perspective in Care