Addressing urban-centric bias in paramedic education: a pilot evaluation

Background: Urban-centric bias may leave paramedic students underprepared for the diverse populations, contexts and healthcare needs encountered outside metropolitan settings, yet limited evidence exists on educational strategies to address this issue. Aim: This study aimed to: explore whether a short educational intervention may influence students' awareness of urban-centric bias; and propose approaches for UK paramedicine education. Methods: A pilot, mixed-methods, pre/post evaluation involved paramedic students (n=11) using an anonymous online survey. Quantitative Likert-type items assessed awareness of urban-centric bias and perceived relevance to practice, while open-ended questions explored insights, cultural competence and anticipated application to practice. UK policy and professional guidance were used to inform discussion and curriculum reform proposals. Results: Mean self-rated awareness increased from 2.82 to 4.00; this change was not statistically significant. Given the very small sample (5.9% response), findings are descriptive and exploratory. Conclusion: These results indicate that recognising urban-centric bias can be taught. Aligning curricula with diversified non-ambulance/community placements and UK policy may support equity-oriented preparedness. Five discussion-informed proposals for UK programmes are proposed.