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Should an alternative to the Glasgow Coma Scale be taught to paramedic students?
  1. Christian Winship,
  2. Brett Williams,
  3. Malcolm J Boyle
  1. Monash University, Department of Community Emergency Health and Paramedic Practice, Victoria, Australia
  1. Correspondence to Dr Brett Williams, Department of Community Emergency Health & Paramedic Practice, Monash University, PO Box 527, Frankston 3199, Victoria, Australia; brett.williams{at}


Background The accurate assessment of a patient's conscious state using the Glasgow Coma Scale (GCS) is an important skill for paramedics as it may determine the patient's initial and ongoing management. The objective of this study was to determine if undergraduate paramedic students from a large Australian University were able to accurately interpret a variety of conscious states.

Methods A prospective double-blinded observational pilot study requiring students to interpret the conscious state of four adult patients using the GCS by viewing a simulation DVD package.

Results There were 137 students who participated in the study, of whom 65% (n=87) were female students. The results demonstrated that undergraduate paramedic students were unable to accurately interpret a number of patient conscious states with only 20% and 37% of students able to accurately identify the GCS of patients 2 (GCS=12) and 3 (GCS=7). The motor component of the GCS appeared to be the component where the least accurate interpretation occurred, with only 47% of students being able to accurately identify the criteria that patient 3 displayed. Participants were however able to accurately interpret the GCS of both patient 1 (GCS=14) (86%) and patient 4 (GCS=15) (92%).

Conclusion This pilot study demonstrates that undergraduate paramedic students from an Australian university were unable to accurately interpret a patient's conscious state if their GCS score was <14. These findings have provided academic staff with important information for considering alternative teaching and learning strategies and approaches in conscious state assessment in current paramedic curricula.

  • Glasgow Coma Scale
  • undergraduates
  • paramedics
  • sensitivity
  • specificity
  • acute coronary syndrome
  • prehospital care
  • clinical management
  • education
  • intensive care

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  • Competing interests None.

  • Ethics approval The ethics approval was provided by Monash University Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.