title: A qualitative assessment of practitioner perspectives post-introduction of the first continuous professional competence (CPC) guidelines for emergency medical technicians in Ireland.
abstract: BACKGROUND
  In November 2013, the Irish Regulator for emergency medical technicians (EMTs) introduced the first mandatory requirement for registrants to demonstrate evidence of continuous professional development (CPD)/continuous professional competence (CPC). This qualitative study assessed the experience of practitioners with CPC-related materials provided to them by the Regulator in addition to identifying perceived or encountered practical challenges and suggested improvements six months following introduction of the requirement.
  
  
  METHODS
  Five fora were utilised, comprising two distinct groupings: a group of student EMTs (n = 62) and four discrete groups of qualified EMTs (total n = 131) all of whom had commenced the newly-introduced CPC process. All 193 volunteers were members of the Civil Defence (an auxiliary/voluntary organisation) and represented a nationwide distribution of personnel. Responses were categorised as 'perceived' challenges to CPC, relating to student EMTs, and 'experienced' challenges to CPC, relating to qualified EMTs. Responses also included suggestions from both groups of EMTs on how to improve the current system and guidance material. Audio/visual recordings were made, transcribed and then analysed using NVivo (version 10). A coding framework was developed which identified unifying themes.
  
  
  RESULTS
  All participants agreed that CPC for pre-hospital practitioners was a welcomed initiative believing that CPC activities would help ensure that EMTs maintain or enhance their skills and be better enabled to provide quality care to the patients they might encounter. Two specific areas were identified by both groups as being challenging: 1) the practicalities of completing CPC and 2) the governance and administration of the CPC process. Challenging practicalities included: ability of voluntary EMTs to gain access to operational placements with paramedics and advanced paramedics; the ability to experience the number of patient contacts required and the definition of what constitutes a 'patient contact'. With regard to the governance and administration of CPC, it was suggested that in order to enhance the process, the Regulator should provide: an outline of the CPC audit process; examples of cases studies and reflective practice; templates for portfolios; and should establish a central hub for CPC information.
  
  
  CONCLUSIONS
  These groups of Irish EMTs appeared keen to participate in continuous professional competence activities. In addition, these EMTs identified areas that, in their opinion, required clarification by the Regulator related to the practicalities of CPC and the governance and administration of CPC. More information, dissemination of sample requirements and further effective engagement with the Regulator could be used to refine the current CPC requirements for EMTs.
authors.affiliation: Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland. shane.knox@hse.ie.|Health Services Executive, National Ambulance Service College, Dublin, Ireland. shane.knox@hse.ie.
authors.forename: Shane
authors.initials: S
authors.lastname: Knox
authors.affiliation: Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland. suzanne.dunne@ul.ie.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Dunne
authors.affiliation: Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland. walter.cullen@ul.ie.
authors.forename: Walter
authors.initials: W
authors.lastname: Cullen
authors.affiliation: Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland. colum.dunne@ul.ie.
authors.forename: Colum P
authors.initials: CP
authors.lastname: Dunne
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D004496:Education, Continuing / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education / Q000592:standards*; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D036301:Qualitative Research