Researching Paramedic Student Personalities: This Time, Let's Talk About NeuroticismBy Rachael Rosen

October 16, 2014

Warning Signs: Increased Neuroticism is Associated with Poor Professional Behavior during Paramedic Student Contacts

Mike BowenFisdap’s Director of Testing Mike Bowen worked alongside David Page, a paramedic educator at Inver Hills Community College, author and national speaker, and Luke Stanke, a psychometrician, on an award-winning research project that looked at the affective domain through the lens of personality traits.

In the research project, “Warning Signs: Increased Neuroticism is Associated with Poor Professional Behavior during Paramedic Student Contacts” Bowen examined the relationships between students’ neuroticism scores on the Fisdap Entrance Exam and their preceptors’ ratings of their professional behavior, as outlined in the National Registry of EMTs (NREMT) Psychomotor Competency Portfolio Project (PCPP) and recorded in Fisdap. The results showed a positive correlation between paramedic students' level of neuroticism and their preceptors' rating of their professional behavior. In other words, students with a high degree of neuroticism were likely to show signs of unprofessional behavior. 

This research begs some further questions. How does neuroticism, as a personality trait, impact the paramedic’s interactions with patients, preceptors, or partners? And if a paramedic students tests for signs of neuroticism, will they be a good paramedic? How can educators work with these students to assess their fit for paramedicine and help them coach them through paramedic school and their internship?

I met with Mike Bowen to ask him some questions about the research his team did and learn more about the takeaways from this research, which he reminded me is in its infancy.

RR: Why did you decide to do research on this topic?

MB: First because no one else had done it. We had to start at the very beginning. We took a look at high performers in the EMS profession and thought about what traits they possess, and then how you can assess those to tease out who’s going to be highly proficient. This type of research has been done in a lot of other professions--police officers, for example. Think about it. With police, they have guns, which can kill people. Just like the medications we carry or the treatments we provide, which can kill people. We asked ourselves, Why isn’t EMS education more proactive about assessing students’ affective behaviors before exposing them to real patients?

So, yeah, we want to look at this potential for nefarious behaviors. Along with finding positives. How do we look for things that aren’t on the surface? Things you can’t see on a resume or in an interview. They could be latent traits.

But you can be conscious of these traits but that doesn’t mean you can get rid of them. In adverse conditions--like a stressful or difficult call--what are the traits that may come out? Anxiety? Depression? It would be great if we can catch those signs in the early stages of EMS education.

RR: Did any of the results surprise you?

MB: I was surprised at the neuroticism results because neuroticism actually wasn’t associated with more negative traits. It’s associated negatively with professional behavior. But not team leadership as of yet. We did look at data that hinted at prolonged internships but not a significant amount of dismissals or failures. Most students in our sample learned to be more professional, eventually.

Agreeableness was another surprise. Agreeableness has as social harmony aspect and being agreeable means you inherently want to communicate with people. We looked at other research to better understand the expression of agreeableness in the clinical definition, as opposed to our conventional sense of the meaning. In the clinical sense, agreeableness is more broad and very closely related to empathy.

RR: What was the trickiest part of the research process?

MB: It was challenging to investigate a topic and present this data when no one, to our knowledge, in our profession had ever done it before. That made it really hard to link EMS research to the affective domain or these soft skills.

We also wanted to be careful about how we present this information. We don’t want people to inadvertently read too much into it. We are not psychologists. We don’t want to make too broad or general a statement about neuroticism.

RR: What do you think educators can take away from this research and apply in their classrooms?

MB: The Entrance Exam is a great assessment tool and the M5-50 was designed for normal people. The way we display the Entrance Exam results, we show neuroticism on a scale, and a normal result will appear at one end. So any movement toward the middle of the scale shows a tendency toward neuroticism. Any bump on the scale is a flag. So, as the educator, you should try to sit down with that student and have a conversation. Why do they want to be a paramedic? Why are they in school right now?

And definitely think about what other resources at your school you can get involved. Talk to other faculty or counselors at your school. Or maybe it's someone from the school’s psychology department or human resources.

Essentially what you’re trying to find out is if the person is depressed, anxious, or well suited to handle stress?

RR: Your team won the Best Research Award for this research at the NAEMSE Symposium in Reno. What does that mean to you?

MB: It’s good motivation to continue the research and study more. Winning the award helped us feel like we’re on the right track and that other educators see value in the work. It’s also nice to see that other educators are interested in seeing the whole picture of the student--not just whether they know the skills and medicine--but how are they going to behave professionally?

RR: What's next for this research topic?

MB: We hope to do further investigation into the other aspects of a paramedic’s education that neuroticism may impact. For example, we are looking at the length of the internship and if it’s longer for students who have higher neuroticism scores.

Also, our initial research looked at a small sample size. We saw strong, positive correlation in our data, but we’d like to include more schools and more people to see if the results hold true.

Another thing we’re looking at investigating is empathy. We added a previously validated empathy scale to our affective domain assessment in the Entrance Exam and this is currently in pilot. We’d like to see how this factors in. How is empathy related to agreeableness? And how are those characteristics related to patient outcome? Professionalism? Patient rapport?

Take a closer look! Download a PDF of the research poster.

Neuroticism-Poster-FINAL.pdf13.18 MB

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