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Thinking styles of Australasian paramedics and paramedicine students

Toby Keene (Research School of Psychology, Australian National University, Canberra, Australia)
Kristen Pammer (The University of Newcastle, Callaghan, Australia)
Eryn Newman (Research School of Psychology, Australian National University, Canberra, Australia)
Bill Lord (Monash University, Melbourne, Australia)

International Journal of Emergency Services

ISSN: 2047-0894

Article publication date: 5 July 2023

Issue publication date: 23 November 2023




Paramedics play important roles in healthcare, yet little is known about their decision-making. There is evidence that thinking style is associated with individual preference for intuitive or deliberative decision-making.


Australian and New Zealand paramedics (n = 103; mean age: 38.7; mean 12 years’ experience; 44% female) and paramedic students (n = 101; mean age: 25.7; 59% female) completed a thinking style survey measuring active open-mindedness (AOT), close mindedness (CMT), preference for intuitive thinking (PIT) and preference for effortful thinking (PET). Participants also completed the 7-item Cognitive Reflection Test (CRT) to assess ability to override an attractive but incorrect intuition.


With prior exposure to the CRT controlled, regression analysis found increasing AOT and decreasing age predicted cognitive reflection across all participants (R2/R2 adjusted: 0.198/0.157; F(10, 192) = 4.752, p < 0.001). There were moderate correlations between CMT, age and paramedic experience. There was no difference between paramedics and student performance on the CRT, though more students reported prior exposure to the items (33.7 vs 16.5%; Chi-square (2) = 8.02, p = 0.02). Those who reported prior exposure to the CRT scored significantly higher than those who had not (5.08 [1.44] vs 3.87 [1.70]; F(2, 201) = 14.34, p < 0.001).


Self-reported AOT was associated with cognitive reflection and indicates a role for open-mindedness in paramedics to support decision-making.



The authors acknowledge and thank the participants for their time and contributions to this study, and those organisations and individuals who promoted it.

Funding: This research is supported by an Australian Government Research Training Program (RTP) Scholarship.


Keene, T., Pammer, K., Newman, E. and Lord, B. (2023), "Thinking styles of Australasian paramedics and paramedicine students", International Journal of Emergency Services, Vol. 12 No. 3, pp. 371-383.



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