Paramedic self-regulation and clinical leadership (2000-2016)
| Citation | Design | Country | Focus of paper | Major findings (strengths and weaknesses) |
|---|---|---|---|---|
| Wankhade and Wankhade (2016) | Ethnographic study - semi-structured interviews and observations | UK | Challenges for the paramedic professionalization agenda related to increased work intensity | Evidence for specialist paramedic roles. Highlighted the complexity of decision-making processes to minimize risk to patients |
| Williams et al. (2015) | Survey of student paramedics | Australia and New Zealand | Exploration of paramedic students’ views on paramedic professionalism | Paramedic students are strong advocates of paramedic professionalism and support the need for regulation |
| Hodge (2014) | Semi-structured interviews with consultant paramedics | UK | Place of consultant paramedics in an emerging clinical leadership framework | Consultant paramedics are a key part of the clinical leadership team for the paramedic profession |
| Colbeck (2014) | Commentary | Australia | International comparisons of paramedic delegated practice and authority to practice regulatory systems | Authority to practice regulations vary within the Anglo-American paramedic model. Delegated practice from physicians is not universal in modern paramedic services |
| Fitzgerald (2014) | Rhetorical genre theory | Canada | Efforts to introduce paramedic self-regulation in Ontario, Canada | Hidden values and assumptions (medical dominance) have delayed the adoption of a paramedic self-regulation model in Ontario |
| O’Meara (2014) (Non-refereed) | Commentary | Canada | Examined self-regulation of paramedicine in terms of professional autonomy, job satisfaction and quality of care | Self-regulated paramedics have the means to influence and ultimately to determine their own scopes of practice, set their own research agenda, and articulate a distinct professional identity |
| Brady (2013) | Commentary | UK | Professional regulation of paramedics in the UK | Critical of the associated roles of the Health Care Professions Council and the Joint Royal Colleges Ambulance Liaison Committee |
| Lyndon-James (2013) | Focus groups and purposive interviews of members of the public | Australia | Considered whether paramedicine is a profession | National registration is an essential component in gaining recognition by the broader healthcare industry Tertiary education is synergistic to national registration and has the potential to enhance the quality of service delivery |
| McCann et al. (2013) | Ethnographic study | UK | Paramedic professionalization project | Overall impact of the project on working lives of paramedics is muted because of limited power over paramedic employers |
| Stanley (2014) | Mixed methods comparative study between nurses and paramedics | Australia | Compares the results of two studies, 6 years apart, into the attributes and characteristics of clinical leaders | Both nurses and paramedics identify with leaders’ values and follow them if reflected in the leaders’ actions |
| Newton (2012) | Commentary | UK | Future of the ambulance service in the UK | Paramedics are a “disruptive technology” and improved paramedic education that focuses on clinical assessment and decision-making provides the best value for a positive impact on patients |
| First (2012) | Review | UK | Transition of the paramedic workforce from a trade to a profession | The development of professionalism amongst paramedics is more likely to be a bottom-up evolution than a top-down revolution |
| Newton (2011) | Commentary | UK | Considers the future for paramedics in terms of extended practice | Position Statement from the College of Paramedics on the designation of paramedics |
| Walker et al. (2010) | Letter | UK | Announcing the launch of the Report of the National Steering Group on Clinical Leadership in the Ambulance Service | There should be improved opportunities for career progression, with scope for ambulance professionals to become clinical leaders |
| Sibson et al. (2009) | Commentary | UK | Discussion of establishment of a National Steering Group on Clinical Leadership | Appropriately trained clinical leaders with experience and influence are needed in paramedic services |
| Woollard (2009) | Descriptive | UK | Explores influences on paramedic professional behaviors in the context of clinical governance and self-regulation | How collective behavior and beliefs of paramedics are viewed externally will determine whether paramedicine is seen as a profession |
| McPherson et al. (2006) | Systematic review | New Zealand | Synthesis of evidence on extended roles for allied health, including paramedics | Critical that most of the work on extended scopes of practice for paramedics have focused on specific skill acquisition |
| Scott and Carney (2004) | Editorial | UK | Practitioner in emergency care (PEC) concept | Identified problems implementing practitioner model |
| Doy and Turner (2004) | Short report | UK | Development of emergency care practitioner (ECP) program run by an Ambulance NHS Trust | Cultural change and development of an infrastructure to support new clinical decision-making and referral pathways is vital to ensure the success of ECPs |
| O’Meara (2003) | Soft systems methodology | Australia | Development of a paramedic practitioner model of care | Paramedic practitioner model has potential is in rural settings |
| Citation | Design | Country | Focus of paper | Major findings (strengths and weaknesses) |
|---|---|---|---|---|
| Ethnographic study - semi-structured interviews and observations | UK | Challenges for the paramedic professionalization agenda related to increased work intensity | Evidence for specialist paramedic roles. Highlighted the complexity of decision-making processes to minimize risk to patients | |
| Survey of student paramedics | Australia and New Zealand | Exploration of paramedic students’ views on paramedic professionalism | Paramedic students are strong advocates of paramedic professionalism and support the need for regulation | |
| Semi-structured interviews with consultant paramedics | UK | Place of consultant paramedics in an emerging clinical leadership framework | Consultant paramedics are a key part of the clinical leadership team for the paramedic profession | |
| Commentary | Australia | International comparisons of paramedic delegated practice and authority to practice regulatory systems | Authority to practice regulations vary within the Anglo-American paramedic model. Delegated practice from physicians is not universal in modern paramedic services | |
| Rhetorical genre theory | Canada | Efforts to introduce paramedic self-regulation in Ontario, Canada | Hidden values and assumptions (medical dominance) have delayed the adoption of a paramedic self-regulation model in Ontario | |
| Commentary | Canada | Examined self-regulation of paramedicine in terms of professional autonomy, job satisfaction and quality of care | Self-regulated paramedics have the means to influence and ultimately to determine their own scopes of practice, set their own research agenda, and articulate a distinct professional identity | |
| Commentary | UK | Professional regulation of paramedics in the UK | Critical of the associated roles of the Health Care Professions Council and the Joint Royal Colleges Ambulance Liaison Committee | |
| Focus groups and purposive interviews of members of the public | Australia | Considered whether paramedicine is a profession | National registration is an essential component in gaining recognition by the broader healthcare industry Tertiary education is synergistic to national registration and has the potential to enhance the quality of service delivery | |
| Ethnographic study | UK | Paramedic professionalization project | Overall impact of the project on working lives of paramedics is muted because of limited power over paramedic employers | |
| Mixed methods comparative study between nurses and paramedics | Australia | Compares the results of two studies, 6 years apart, into the attributes and characteristics of clinical leaders | Both nurses and paramedics identify with leaders’ values and follow them if reflected in the leaders’ actions | |
| Commentary | UK | Future of the ambulance service in the UK | Paramedics are a “disruptive technology” and improved paramedic education that focuses on clinical assessment and decision-making provides the best value for a positive impact on patients | |
| First (2012) | Review | UK | Transition of the paramedic workforce from a trade to a profession | The development of professionalism amongst paramedics is more likely to be a bottom-up evolution than a top-down revolution |
| Commentary | UK | Considers the future for paramedics in terms of extended practice | Position Statement from the College of Paramedics on the designation of paramedics | |
| Letter | UK | Announcing the launch of the Report of the National Steering Group on Clinical Leadership in the Ambulance Service | There should be improved opportunities for career progression, with scope for ambulance professionals to become clinical leaders | |
| Commentary | UK | Discussion of establishment of a National Steering Group on Clinical Leadership | Appropriately trained clinical leaders with experience and influence are needed in paramedic services | |
| Descriptive | UK | Explores influences on paramedic professional behaviors in the context of clinical governance and self-regulation | How collective behavior and beliefs of paramedics are viewed externally will determine whether paramedicine is seen as a profession | |
| Systematic review | New Zealand | Synthesis of evidence on extended roles for allied health, including paramedics | Critical that most of the work on extended scopes of practice for paramedics have focused on specific skill acquisition | |
| Editorial | UK | Practitioner in emergency care (PEC) concept | Identified problems implementing practitioner model | |
| Short report | UK | Development of emergency care practitioner (ECP) program run by an Ambulance NHS Trust | Cultural change and development of an infrastructure to support new clinical decision-making and referral pathways is vital to ensure the success of ECPs | |
| Soft systems methodology | Australia | Development of a paramedic practitioner model of care | Paramedic practitioner model has potential is in rural settings |