Students’ views on the need for hostile environment awareness training for South African emergency medical care students

C Vincent-Lambert, R Westwood


Background. South Africans experience high levels of contact crime, including assault, robbery and hijacking. Emergency medical services (EMS) are frequently called to the scene of such incidents. Their presence in these potentially hostile environments increases the risk of South African (SA) paramedics and paramedic students becoming victims of crime and violence. A 2015 study showed that ~66% of SA EMS staff reported being assaulted while on duty. During a 10-month period in 2016, Western Cape Province recorded >40 incidents of physical violence against their EMS personnel. Questions are being asked about how well prepared EMS staff are to operate in potentially hostile environments. 

Objectives. To explore emergency medical care (EMC) students’ experiences of violence and crime and their views on the need for hostile environment awareness training (HEAT) as part of their undergraduate degree programmes. 

Methods. A self-designed, non-validated, cross-sectional online survey questionnaire was used to document the experiences, views and opinions of 113 undergraduate EMC students from 4 SA universities. The questionnaire consisted of 24 closed-ended questions with pre-set Likert scale options focusing on documenting participants’ experiences, views and opinions regarding hostile environments and the need for HEAT. 

Results. A high percentage of participants (92%) indicated feeling unsafe while engaging in clinical learning shifts; 63% specified that they had personally witnessed violence against EMS crews, and 32% indicated that they had been assaulted while on duty. Unsurprisingly, 81% of the respondents felt that there is a need for inclusion of HEAT in the undergraduate curriculum. 

Conclusions. Participation in clinical learning shifts in the current SA prehospital EMS environment increases the risk of exposure to potentially hostile environments. Consequently, students feel unsafe and support the inclusion of HEAT as part of their undergraduate degree programmes.

Authors' affiliations

C Vincent-Lambert, Department of Emergency Medical Care, Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, South Africa

R Westwood, Department of Emergency Medical Care and Podiatry, Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, South Africa

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Cite this article

African Journal of Health Professions Education 2019;11(1):12-15. DOI:10.7196/AJHPE.2019.v11i1.1054

Article History

Date submitted: 2019-04-03
Date published: 2019-04-03

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