Exploring the Field: Towards a Program of
Research in Paramedic Education
R. Bowles, C. van Beek, G. Anderson

INTRODUCTION:
This study was conducted as part of an ongoing project to develop
a program of research for the Health Sciences Division (HSD) at
the Justice Institute of British Columbia. The project identified three
to five areas which the HSD will strategically engage in, actively
seeking partnerships and funding for. A second goal involved
identifying areas of “opportunistic interest” – potential topics or
projects that the Division might engage in if external funding or
opportunity presented itself. The third objective was to develop
topics and projects that faculty and students could use for
developing research and scholarly activity as part of their ongoing
courses.

Opportunities for Paramedic Education Research
Social/Cultural:
Health policy
Role of paramedics
Conducting paramedic research
Effectiveness of EMS/
EMS Education
Linking theory &
practice

Sociological:
Culture of paramedicine
Change
Interprofessional
practice
Communication
Lifespan of a medic
Education:
Competency
Simulation/practicum
Table 1: Opportunities for
Paramedic Education Research..

METHODS:
The two-stage study employed mixed methods. Stage 1 was a
focused review of English language academic databases (e.g.
PubMed, Medline, Academic Search Complete) with the goal of
identifying the range of existing research literature on and about
EMS. The second stage consisted of semi-structured interviews
with key stakeholders in Canadian EMS to explore current and
future needs for EMS research.
The initial literature search yielded over 2000 articles. Inclusion
criteria were English language articles whose primary focus was
on EMS (and its related terms) from 1962 to 2012. Articles were
excluded that were set in other health care settings or in which
EMS personnel was not a central focus of the article. In total, 1618
articles were included in the study. Articles were coded by primary
research topic, discipline, setting, and research paradigm.
Interviews were transcribed then underwent both critical and
thematic analysis. Participants’ descriptions of issues and research
needs were thematically analyzed and also categorized against
the coding framework used in the literature review. The results
were used to identify potential gaps and opportunities for strategic
engagement (Table 1; Figure 1).

Figure 1: Comparison of research areas identified in literature and by stakeholders

Describing the field of EMS/Paramedic Practice
No single “best” term for the field
EMS, Paramedicine, Prehospital
No consensus on the role of EMS
ALS, code 3 for an arrest: Safety net for the HC system
Core themes defining paramedicine:
Type of care, Location of care, Transport, Practitioner
Table 2: General findings of stakeholder interviews.

The stakeholder interviews were also analyzed to explore current
conceptions of EMS and paramedic practice. Core terms were
extracted from the transcripts, then mapped thematically to look for
relationships, similarities, and differences. Thematic analysis was
used to explore how descriptions of paramedic practice, the

Figure 2: Terms describing EMS and Paramedicine

current and future roles of paramedicine, and its perceived
boundaries interact to develop a model for describing contested
visions of what constitutes the field of paramedicine.

FINDINGS:
This study uncovered a rich set of issues and areas for research
that can contribute to the description, definition, and ongoing
development of the paramedic profession.
Figure 1 contrasts research found in the literature with research
needs expressed by Canadian EMS stakeholders. The green
arrows indicate research areas of greatest opportunity, while red
arrows indicate areas where educational research is either already
well-represented or where there is less interest from stakeholders.
Stakeholder interviews raised several intriguing themes (Table 2).
There was little consensus on the role and boundaries of
paramedic practice. At one extreme, EMS was seen as providing
emergency care and transport of the critically ill and injured. At the
other was an expansive view of paramedicine as the safety net for
a stressed health care system. Similarly, participants identified a
wide ranging list of terms for EMS or paramedicine (Figure 2).
From the interviews, four themes emerged for characterizing the
field: type of practitioner, location of practice, nature of care, and
transport (Figure 3).

IMPLICATIONS:
Paramedicine, or EMS, is a young field and emerging profession
that has yet to definitively establish its boundaries and roles.
Stakeholders in EMS education have varying opinions on the core
functions of EMS and, thus, how education can best support the
field.
Existing literature on EMS focuses on clinical interventions and
operational case studies, while stakeholders are most interested in
research that will show the effectiveness of EMS at the practitioner
and system level. As an educational institution, the JIBC’s Health
Science Division has opportunities to participate in research that
can help define the field and identify effective educational practices
that can lead to change in the culture and practice of
paramedicine.

Figure 3: Describing paramedic practice:.

JUSTICE INSTITUTE OF BRITISH COLUMBIA