Informing a Canadian paramedic profile: framing concepts, roles and crosscutting themes.
Paramedicine is a rapidly evolving health profession with increasing responsibilities and contributions to healthcare. This rapid growth has left the profession with unclear professional and clinical boundaries. Existing defining frameworks may no longer align with the practice of paramedicine or expectations of the public. The purpose of this study was to explore the roles paramedics in Canada are to embody and that align with or support the rapid and ongoing evolution of the profession.



We used a concurrent mixed methods study design involving a focused discourse analysis (i.e., analysis of language used to describe paramedics and paramedicine) of peer reviewed and grey literature (Phase 1) and in-depth one-on-one semi-structured interviews with key informants in Canadian paramedicine (Phase 2). Data from both methods were analyzed simultaneously throughout and after being merged using inductive thematic analysis.



Saturation was reached after 99 national and international grey and peer reviewed publications and 20 in depth interviews with stakeholders representing six provinces, seven different service/agency types, 11 operational roles and seven provider roles. After merging both data sets three framing concepts, six roles and four crosscutting themes emerged that may be significant to both present-day practice and aspirational. Framing concepts, which provide context, include variable contexts or practice, embedded relationships and a health and social continuum. Roles include clinician, health and social advocate, team member, educator, professional and reflective practitioner. Crosscutting themes including patient safety, adaptability, compassion and communication appear to exist in all roles.



The paramedic profession is experiencing a shift that appears to deviate or at least place a tension on traditional views or models of practice. Underlying and evolving notions of practice are resulting in intended or actual clinical and professional boundaries that may require the profession to re-think how it is defined and/or shaped. Until these framing concepts, roles and crosscutting themes are fully understood, tested and operationalized, tensions between guiding frameworks and actual or intended practice may persist.
Centennial College, School of Community and Health Studies, 941 Progress Ave. Station A, P.O. Box 631, M1K 5E9, Toronto, ON, Canada. wtavares@centennialcollege.ca.|York Region Paramedic Services, 80 Bales Dr. E. R.R.#1, L0G 1V0, East Sharon, ON, Canada. wtavares@centennialcollege.ca.|Ornge Transport Medicine, 5310, Mississauga, L4W 5H8, ON, Canada. wtavares@centennialcollege.ca.|Paramedic Association of Canada, 201-4 Florence St., K2P 0W7, Ottawa, ON, Canada. wtavares@centennialcollege.ca.|McMaster University, 1200 Main St., L8N 3Z5, Hamilton, ON, Canada. wtavares@centennialcollege.ca.
Walter
0000-0001-8267-9448
W
Tavares
Justice Institute of British Columbia, 715 McBride Blvd, V3L 5T4, New Westminster, BC, Canada.|Society for Prehospital Educators of Canada, 101-265 Carleton Dr., T8N 4J9, St. Albert, AB, Canada.
Ron
R
Bowles
Alberta College of Paramedics, 2755 Broadmoor Blvd., T8H 2W7, Sherwood Park, AB, Canada.
Becky
B
Donelon
D000488:Allied Health Personnel / Q000592:standards*; D002170:Canada; D002983:Clinical Competence; D004517:Education, Professional; D006302:Health Services Research; D006801:Humans; D010380:Peer Review; D036301:Qualitative Research; D013192:Staff Development
Allied health personnel; Community paramedic; Competency profile; Education; Emergency medical services; Health services; Paramedic; Primary care; Roles framework