Between Incident Reports and Examination Stress: Reading and Writing Difficulties in Paramedic Education

Abstract

Background, Research Question: Written language skills are a fundamental prerequisite for professional competence in emergency medical services. Paramedics are required to accurately record, interpret, and legally document medical information under conditions of time pressure. Reading and spelling difficulties (RSD) may substantially impair these demands, thereby affecting both training success and patient safety. Despite these high requirements, empirical evidence on the experiences of trainees with reading and spelling difficulties in paramedic education remains limited. The aim of this study was to systematically assess perceived burdens, resources, and support needs of trainees with RSD in paramedic training.

Methods: This study employed a quantitative, cross-sectional online survey design. A total of 23 trainees in their third year of paramedic education from several vocational schools in Baden-Württemberg, Germany, participated. Data were collected using a self-developed questionnaire comprising closed items rated on a four-point Likert scale and supplementary open-ended questions. The questionnaire addressed reading and writing demands, examination situations, operational documentation, team interaction, and both utilized and desired support measures. Quantitative data were analyzed descriptively, and open responses were thematically summarized.

Results: The study findings reveal a consistent burden profile across key domains. Frequently reported challenges included difficulties in reading complex medical texts, reduced reading speed, and an increased need for repetition. Time pressure, particularly during written examinations, acted as a major amplifying factor. Operational documentation constituted an additional burden, especially with regard to orthographic accuracy and concerns about professional appearance. Perceptions of social acceptance within teams varied. Digital support tools, structured documentation systems, and transparent examination conditions were identified as particularly helpful. Moreover, participants expressed a strong need for increased awareness among educators and clinical instructors.

Discussion: The findings suggest that reading and spelling difficulties represent a relevant yet underestimated influencing factor within the specific context of paramedic education. The results are consistent with international evidence from nursing and medical education and highlight the importance of structural and didactic support strategies.

Conclusions: Early sensitization of educational staff, targeted use of digital support tools, and transparent regulations regarding reasonable accommodations may reduce training-related burdens, enhance educational success, and help minimize potential risks to patient safety.