Integration of healthcare simulation activities into the paramedic education curriculum: an embedded case study analysis of the decision-making process
Authors:   , Spain Andrew E. 
Published: February 2023

To date, there has been no known research completed on decision-making processes for integrating healthcare simulation activities into the paramedic curriculum. With a growing body of research that demonstrates simulation as a valuable methodology in healthcare education, it is important to understand how to appropriately integrate simulation activities into the curriculum. There is a need to gain insight and understanding into how decisions are made to integrate simulation. This research focused on the community college setting for paramedic education programs. It used a single embedded case study approach to investigate the research questions. The embedded case study selected is a high-performing paramedic program, as determined by reported data regarding national exam pass rates and hiring rates. The selection of a single higher-performing case study is appropriate as it can inform good practice through an analysis of a representative case. Data was collected through interviews and document review. The interviews included the program director, who is the individual responsible for making decisions for the paramedic education curriculum, and other key individuals in the program who play different parts of the decision-making process. Data analysis was performed using Salda�a's (2021) steps of deconstructing and reconstructing data, performed to support the pattern matching and explanation building methodology of Yin (2009). Patterns were matched to the theoretical constructs in the information utilization theory in decision making (Bess and Dee, 2012), and the contextual influences on curriculum design model (Lattuca and Stark, 2009). The findings give a rich insight into the various factors impacting the decisionmaking process which in turn supported answering the research question. The findings SIMULATION INTEGRATION INTO CURRICULUM provide a snapshot of the complexity of the influences and constructs which form the decision-making context for the subject program. The themes identified were: � Organizational and Program Characteristics � Components to Develop Collaboration � Areas of Growth in Practice � Feedback � The Influence of Environmental Factors on the EMS Program These themes will likely resonate with those in other paramedic education settings beyond community colleges. Additionally, the data provided insight into the decision-making constructs used by the program director. For example, information gathered by the program director to create potential alternatives is extensive, and they investigated many alternatives to decide which option best suits the program and learner needs. The implications of this study range from potential actions at the program level to consideration of full policies at the national level. The use of the two theoretical constructs for this study proved useful. Implications include how these theories might be expanded to be more applicable, specific to this research construct. This study provides the basis for future research projects for continued expansion of our understanding of curriculum design, given the appropriate use of healthcare simulation in paramedic education.