Paramedic Health and Wellbeing Research Unit (PHAWRU)

Background

December 2018 saw the commencement of National Registration for paramedics as registered health professions in Australia.  This was in recognition of the complexity of the tasks they undertake on a daily basis and the education and training required to hold such a position.  The Paramedicine Board of Australia noted that the role of a paramedic has grown drastically over the last two decades as “paramedics are now working in a range of roles and environments, using sophisticated treatments and technology, to provide world class services to Australian communities.”1

With the professionalisation of paramedicine, the evidence base from which clinical practice is guided has also developed. Professional paramedicine bodies support research through grants, special interest groups, journals and conferences. Most universities include research units in their undergraduate degrees and many offer post graduate research training degrees. With the largest number of PhD qualified paramedics internationally, Australia is leading the way in paramedic-led research, while still seeking strong collaborations with other medical and health professionals and researchers. This collaborative approach has led to success in the development of nationally funded Centre’s of Research Excellence, initially with the establishment of the Australian Resuscitation Outcomes Consortium (Aus-ROC) and recently with the Centre of Research Excellence in Prehospital Emergency Care.

Although these research centres have excelled in improving patient outcomes, no research unit currently focuses on the health and wellbeing of paramedics.  Recent media has emphasised the high suicide and post-traumatic stress disorder rates among paramedics, high rates of musculoskeletal injuries and frequent exposure to occupational violence. The shift-work nature of paramedic rosters, the isolated clinical setting and repeated exposure to trauma are thought to add to the stress and fatigue experienced by many paramedics. Concerning pilot data has also seen similar results in paramedic students. There is an understanding that we need to prioritise the health and wellbeing of our paramedics to ensure they can provide a quality service to their patients. This research unit is seen as a foundation for a larger research centre that prioritises the needs of the paramedic and paramedic student, to the same level as we do their patients.

Mission

The PHAWRU acknowledges that paramedic and paramedic student health and wellbeing are central to a successful Ambulance Service sector. We promote research that focusses on the needs of the clinician. Therefore we: draw on knowledge, skills and experience from a diverse range of medical and health fields; conduct research with the aim of identifying concerns of the paramedic from their time as a student through to specialist roles; and collaborate with clinicians and ambulance services to ensure relevance and validity in the research we undertake.

The PHAWRU will be hosted within the Department of Community Emergency Health and Paramedic Practice, School of Primary and Allied Health Care, Monash University.

Vision

The PHAWRU envisions a healthy paramedic and volunteer workforce that can provide optimal care to the community. To help achieve this we strive to:

  • understand the causes of health and wellbeing challenges for paramedics and paramedic students;
  • develop projects that result in translatable outcomes;
  • constantly engage with the paramedic workforce to support them throughout their careers; and
  • provide an evidence base for international best care health improvement strategies

Our Team

Dr Kelly-Ann Bowles

Dr Kelly-Ann Bowles is the Director of Research and the Higher Degree Research and Honours Co-ordinator in the Department of Community Emergency Health and Paramedic Practice.  She is also the Director of Research for the School of Primary and Allied Health Care. She has a Human Movement Science background, with her PhD focusing on the area of Biomechanics.  Kelly has worked in elite sports institutes as well as academic research facilities, all with the aim of allowing people to participate in sport and/or physical activity to the best of their ability. She currently has over 40 publications with over 1850 citations and an h-index of 20, with the vast majority of her publications in Quartile 1 publications including journals such as the British Medical Journal, PLOS Medicine, Medicine and Science in Sports and Exercise and Annals of Rheumatic Diseases.  Kelly has supervised PhD students to completion and currently supervises HDR students over a variety of health professions including physiotherapy, pharmacy and paramedicine. She has spent much time mentoring allied health and medical clinicians in research skills development and will be the inaugural Director of PHAWRU.

Prof Brett Williams

Professor Brett Williams is Head of the Department of Community Emergency Health and Paramedic Practice and has been an academic leader in prehospital educational research, scholarship and mentorship for over 15 years.  Brett has won numerous national university teaching awards and has published over 200 peer-reviewed publications, presented conference work over 130 times, 10 book chapters and recently co-edited 2 textbooks.  Brett is committed to developing and finding the next generation of paramedic PhD scholars, professionalising paramedic care, building capacity for paramedics nationally and internationally and developing a contemporary paramedic curricula. Brett has published papers in top medical and health care-related, and measurement journals internationally and his work has attracted over 4000 citations in the past 5 years. In PHAWRU Brett’s experience will ensure that the outcomes achieved in this research unit will be embedded in to the education of the next generation of paramedics and well as leading research into the health and wellbeing of our student cohorts.

Assoc Professor Maxine Bonham

Associate Professor Maxine Bonham is a registered nutritionist and course convenor of the undergraduate Bachelor of Nutrition Science program at Monash University.  Maxine has approximately 20 years experience in nutrition research - work that has resulted in more than 70 publications (H index of 22)  of which over 60% have been in high quality peer-reviewed journals (>1800 citations). She has been successful, to date, in generating grant income in excess of 4.5 million AUD$. A number of the studies Maxine has been involved with have resulted in translation of research findings into the public health arena. Maxine has a strong research reputation investigating the role of diet and appetite in shift workers and their impact on metabolic risk factors for type 2 diabetes and cardiovascular disease. This work is supported by National Heart Foundation and NHMRC funding. Her experience will be vital to the PHAWRU as we continue to investigate the effect of the paramedic work structure on diet and attempt to find interventions that can improve the short term and long term health of our paramedics.

Dr Joanne Caldwell

Dr Joanne Caldwell has extensive experience in thermal and exercise physiology. She is currently unit convener for Exercise Physiology and Metabolism within the Department of Physiology at Monash University. She has 22 publications in journals such as European Journal of Applied Physiology, Medicine and Science in Sports and Exercise and Physiological Measurement. Her work has received over 500 citations with an h-index of 11. Joanne also has significant expertise in the development of Physical Employment Standards for physically demanding occupations and most notably worked with Defence Science and Technology Group to develop new standards for the Army and Royal Australian Air Force. This level of expertise is vital to PHAWRU as a focus of our research is upon the physical demands of Intensive Care Flight Paramedics (MICA) to improve job readiness and physical performance.

Dr Luke Perraton

Dr Luke Perraton is a musculoskeletal and sports Physiotherapist and lecturer in the Physiotherapy Department at Monash University. He has eighteen years’ experience in Physiotherapy clinical practice, education and research in the areas of orthopaedics, musculoskeletal health and primary care. He in an early-career researcher with 24 peer-reviewed publications (more than 600 citations) and has presented at over 20 conferences and professional development events. Luke is currently supervising ten undergraduate research projects and four higher-degree research students. His research interest is musculoskeletal health; specifically, muscle and joint function after injury and surgery, and movement analysis. In PHAWRU Luke will lead the musculoskeletal research arm focusing on the health of current paramedics, student paramedics and the physical needs of those aiming to undertake a paramedic career.

Dr Rosalind Case

Dr Rosalind Case is a clinical psychologist with over 20 years experience in the health sector. Rosalind is a Senior Research Fellow at the Florey Institute of Neurosciences and Mental Health and also holds an adjunct Research Fellow appointment in the Department of Epidemiology and Preventive Medicine at Monash University. Rosalind’s research primarily focuses on the neurocognitive and mental health outcomes of injury and illness, with a current focus on out-of-hospital cardiac arrest.

As a clinician, Rosalind has worked across a wide range of settings in both Australia and New Zealand, including hospitals, prisons, outpatient mental health services and more recently in private practice. She is experienced in the development, delivery evaluation of evidence-based psychological assessments and interventions for a wide range of psychological issues. In PHAWRU Rosalind will head the Mental Health arm, focusing on the health of current paramedics, student paramedics and the psychological needs of those aiming to undertake a paramedic career

Prof Shantha Rajaratnam

Professor Shantha Rajaratnam is Deputy Head of the Monash School of Psychological Sciences, Deputy Director of the Turner Institute for Brain and Mental Health, Leader of the Sleep and Circadian Medicine Laboratory at Monash and Chair of the Monash Sleep Network, which combines scientific and clinical expertise in sleep research within Monash University and its affiliated hospitals. He is dual trained in Psychology and Law.  He has more than 20 years of experience in studying circadian biology and medicine, in particular the circadian regulation of sleep-wakefulness. He is a registered psychologist, Chartered Psychologist in the UK and Associate Fellow of the British Psychological Society. His research interests include the influence of the circadian timing system on sleep and health; effects of melatonin and melatonin agonists on sleep and circadian rhythms; effects of light on the human circadian system; development of evidence-based alertness management programs for shift workers; health and neurocognitive consequences of sleep loss and sleep disruption; and legal issues relating to sleep loss and impaired alertness. He has over 70 publications including original reports in leading medical journals such as Lancet and JAMA. In PHAWRU, Shantha will lead the Sleep research arm as we continue to investigate the role paramedic rosters and work structures have on a clinicians sleep patterns, and the follow on effect this may have on their safety in the workplace and overall quality of life.

Prof Karen Smith

Professor Karen Smith is the Director of the Ambulance Victoria Centre for Research and Evaluation, Australia.  She is also an adjunct Professor with the Department of Epidemiology and Preventive Medicine and the Department of Community Emergency Health and Paramedic Practice at Monash University.

Karen co-founded and chairs the Victorian Cardiac Arrest Registry (VACAR) which contains information for all patients in Victoria, who suffer cardiac arrest and receive ambulance attendance.    This registry supports a large research program focused on improving the system response to cardiac arrest patients and driving survival improvements. Karen also co-founded the Victorian State Trauma Registry (VSTR) at Monash University and sits on the Steering Committee. Karen is a Chief Investigator on the National Health and Medical Research Council (NHMRC) funded Australian Resuscitation Outcomes Consortium (AUS-ROC) Centre for Research Excellence established in 2012 and the NHMRC funded Centre for Research Excellence in Pre-hospital Emergency Care established in 2016. She has also been a Chief Investigator on large randomised, clinical trials (RCT) and is currently a chief investigator on a number of key RCTs.  Her interest in pre-hospital research is vast and she supervises and mentors numerous post graduate students, many of whom are paramedics.  She has attracted over 17 million dollars in funding and has published over 185 papers in peer reviewed journals.

Ms Shayna Gamble

Shayna is an experienced Paramedic with a background and interest in health and wellness, and is the Paramedic Representative member on the PHWRU Management Committee.  Shayna has a background in Exercise Science, having completed a Bachelor of Applied Science (Human Movement) before working for several years in Health Promotion facilitating the delivery of health and wellbeing programs to employees of corporate organisations.  Shayna completed a Bachelor of Emergency Health (Paramedic) at Monash University in 2008 and has been an Advanced Life Support Paramedic with Ambulance Victoria for 11 years.  During this time she has also acted in Clinical Instructor, Clinical Practice Development Officer and Peer Responder roles within the organisation.  Shayna is currently working as an operational ALS Paramedic with Ambulance Victoria whilst studying a Masters of Specialist Paramedic Practice at Monash University.

Ms Megan Jepson

Ms Megan Jepson is a highly credentialed exercise physiologist who has worked in the public and private health systems. She has worked as a Research Assistant across the Paramedics and Physiotherapy Departments since 2015 and has been involved in all stages of research development. In PHAWRU Megan will continue to work on a diverse range of projects that aim to improve the health and wellbeing of paramedics, supporting staff and research students.

Dr Alex Wolkow

Dr Alex Wolkow is a NHMRC ECF Peter Doherty Research Fellow, at the Turner Institute for Brain and Mental Health within the Monash School of Psychological Sciences. His research focuses on the interaction between sleep, stress and health in high risk occupations, with the goal of promoting the health of workers and advancing our understanding in the mechanistic role sleep plays in mental health conditions. As an early career researcher, Alex has published 19 peer-reviewed articles, supervised numerous honours students, collaborated internationally on sleep and mental health research projects and his work has influenced health practices in the emergency service sector. In PHAWRU, Alex is leading a longitudinal project examining sleep patterns and mental health in paramedics as they transition into their early career.

Mr Ben Meadley

Mr Ben Meadley has extensive experience in prehospital critical care and is an operational Intensive Care Flight Paramedic (MICA) with Ambulance Victoria. He has a keen interest in paramedic wellbeing, prehospital critical care, prehospital ultrasound and advanced clinical assessment. Ben has been heavily involved with the development and implementation of contemporary clinical practice guidelines both locally and internationally, with a focus on the areas of paramedic-led HEMS and road-based prehospital critical care. With a background in Human Movement and Paramedicine, Ben is currently undertaking a PhD through the Department of Community Health and Paramedic Practice with his project investigating the physiological and nutritional factors associated with paramedic wellbeing, as well as specialist paramedic task performance.

Mr Matt Rogers

Mr Matt Rogers is a Graduate Paramedic with NSW Ambulance, completing an undergraduate Bachelor of Clinical Practice (Paramedic) at Charles Sturt University receiving a Dean’s Award for Academic Achievement during this time. Matt has a background in strength and conditioning, health and wellness for the general population. Matt is currently undertaking an honours degree at Monash University through the Department of Community Emergency Health and Paramedic Practice. Matt’s research interests include paramedic education, paramedic health and wellbeing, paramedic practice in austere environments, leadership, psychology, performance and physiological limits and standards.