Gathering Evidence for Modifying Paramedic Practicum with Simulation A Pan-Canadian Survey

Abstract

Clinical practicum placements are a cornerstone of paramedic education, yet Canadian programs consistently face challenges in securing sufficient, high-quality placements due to workforce shortages, increasing student enrolment, and logistical constraints. Simulation-based education (SBE), particularly high-quality simulation (HQS), has demonstrated effectiveness as a partial replacement for clinical time in other health professions, but its role in paramedicine remains underexplored. This study conducted a national needs analysis to assess current perceptions, gaps, and opportunities for integrating HQS into paramedic training as a supplement or replacement for practicum.
A cross-sectional survey was distributed across Canadian paramedic programs and professional networks between March and June 2025. Fifty-seven respondents representing multiple provinces and diverse professional roles completed the survey. Quantitative data were analyzed using descriptive and inferential statistics, and qualitative data were thematically analyzed.
Findings revealed that while practicum remains highly valued, significant gaps exist, including inconsistent preceptor engagement, variable case exposure, and limited opportunities to assess rare, high-acuity, low-occurrence (HALO) events. Respondents reported that simulation is already widely used (88%), though fewer institutions are implementing HQS (63%). Simulation was most valued for teaching technical skills, assessment and diagnostics, and communication. A plurality of respondents agreed that HQS could replace some practicum time, with an ideal curriculum balance approximating 50% SBE and 50% practicum. However, real patient interactions, cultural complexity, and communication under stress were consistently viewed as irreplaceable. Barriers identified included student buy-in, instructor readiness, and resource constraints.
This study provides the first pan-Canadian evidence of educator and stakeholder perspectives on using HQS to modify paramedic practicum. Results suggest that HQS has significant potential to address gaps in practicum by standardizing learning opportunities and enhancing competency development. Future research should examine targeted competencies and best practices for systematically integrating HQS as a partial practicum replacement.