Background Whilst there is evidence to suggest paramedics experience significant stress when working in the ambulance setting little is known about the experiences of first year paramedic students. This research aimed to: (i) identify whether levels of stress, anxiety and depression experienced by first year paramedic students changed after ambulance placement compared to a control group, and (ii) identify the main perceived and actual sources of stress around ambulance placement.

Methods A before-and-after quasi-experimental design was used to compare whether the experience of ambulance placement altered the levels of stress, anxiety and depression in an experimental group that attended an ambulance placement (n = 20) and the control group who did not (n = 10). Online surveys encompassing the Depression, Anxiety and Stress Scale (DASS-21) and qualitative questions about sources of stress were concurrently deployed to both the experimental and control groups before and after the ambulance placement. Participants were first year paramedic students working in Queensland Ambulance Service, Australia.

Results There was a significant reduction in levels of stress in participants after undertaking their first ambulance placement (Mdn = -4.00) when compared to a control group (Mdn = 0.00), U = 52.5, p = .035, n ² = 0.15. Responses to survey questions suggest anticipation about experiencing death and dying of patients was the most frequently reported stressor of student paramedics before undertaking ambulance placements, however insecurity about knowledge, competence and fear of failure was the most frequently experienced stressor reported after completing ambulance placements.

Conclusions The findings from this study suggest that the fear of the unknown may be worse than the reality. Anticipatory stress is the foremost problem for first year paramedic students attending their first ambulance placement. Placement pre-briefing should focus on educational interventions to build knowledge and skills competency to reduce stress levels and fear of failure.