Clinical reasoning in the emergency medical services

Clinical reasoning is described as a process by which the EMS clinician gathers and values information to understand the situation they encounters during an ambulance mission but also to make decisions related to these situations.

Start date: 2017-09-01

End date: 2023-11-10

The project is a doctoral thesis where the clinical reasoning of emergency medical service clinicians are studied through four research studies. The first study, which are a systematic literature review compiles the previously published research within the research field. This provided an overview of the field and creates the very foundation for the project and the other studies.

In the second study, clinical reasoning are explored in the clinical context. EMS clinicians have been observed during their clinical work to document various aspects of clinical reasoning and potential influential factors. Data were collected through participatory observations, interviews and audits of patient journals and various organizational documents i.e., guidelines. The main focus of the study are on what happens in the moment during the ambulance mission, a micro perspective.

In the third study, there are a meso perspective and the focus lies on the organizational prerequisites for clinical reasoning. The study is partly based on material from the previous study in addition with interviews with managers and administrative staff who in various ways takes part of the EMS clinicians prerequisites for clinical reasoning. Furthermore, we also address the prerequisites for these managers to support the EMS clinicians.

In the fourth study we strive to create a model of the EMS clinicians situational awareness and how it takes form during the situations in the ambulance mission. We strive to understand what is required for the EMS clinicians to understand what is going on in the situation, but also what they need to anticipate future events in the near vicinity of time.