Senior emergency medical care students’ readiness and confidence to practice paediatric pain management

Background: Paediatric pain is frequently under-managed in prehospital care despite the known consequences. Practitioner-related factors, during transition from student to independent practice, influence pain management decisions. Aim: This study aimed to explore and describe the elements influencing senior undergraduate emergency medical care students’ self-reported attitudes, perceived readiness to practise and confidence in managing paediatric pain in South Africa and to identify self-reported barriers and enablers shaping their approach to paediatric pain management. Setting: The study was conducted among exit-level emergency medical care students at a South African university. Methods: A qualitative, descriptive and exploratory design was employed. Using purposive sampling, semi-structured interviews were conducted with ten final-year Emergency Medical Care students registered at a South African university within two months of graduation. Interviews were audio-recorded, transcribed verbatim and analysed inductively using reflexive thematic analysis. Results: The authors generated two themes. Theme one: Attitudinal dissonance, reflected a disconnect between beliefs about paediatric pain management and confidence in practice. Scepticism towards pain expression, fear of harm and protocol reliance contributed to practice hesitancy. Theme two: Fear and uncertainty, highlighted perceived educational gaps and limited clinical exposure, which reduced participants’ perceived practice readiness. Conclusion: Emergency medical care students’ self-reported paediatric pain management is shaped by the interaction of attitudes, emotional responses and educational structures within prehospital training. Contribution: The study provides South African prehospital education-specific insight into factors influencing paediatric pain management and supports the need for curriculum refinement and enhanced learning and teaching methods to improve student preparedness and patient care.