Mental Workload and Handover in Paramedics and Paramedicine Students Following Simulated Emergency Responses: Pilot...

Clear and accurate handover from paramedics to emergency department staff is crucial to patient outcomes, but mental workload experienced throughout an emergency response may impair paramedics' ability to retain key clinical details for handover. This pilot study used a mixed factorial design to examine whether mental workload experienced throughout a simulated emergency response and clinical experience influences handover performance and physiological responses in paramedics and paramedicine students.

Ten paramedicine students and 6 experienced paramedics completed 2 full-scale simulated cases from dispatch, response drive, patient care, patient transport, and handover, under high and low mental workload conditions. Participants delivered verbal handovers at the conclusion of each case. Heart rate and heart rate variability were recorded across all phases as exploratory measures of physiological arousal. Subjective workload and handover performance were assessed after each scenario.

A significant workload by experience interaction was observed for handover performance, although follow-up comparisons were not statistically significant. Descriptively, students recalled fewer case-relevant details at handover after a high-workload case, whereas experienced paramedics appeared unaffected, and a moderate effect size was observed for students. Physiological data indicated greater autonomic arousal during patient care than other phases; however, movement and postural differences across phases may have contributed to this pattern, limiting attribution to the mental workload manipulation.

These preliminary findings highlight the need for further research with larger samples and suggest paramedicine training may benefit from supporting students in developing strategies to manage mental workload and retain key information during high-demand emergency responses.