DEFINING & DESCRIBING PARAMEDIC PRACTICE IN CANADA
Bowles, R. R.1, Acker, J. 2, Harms, K. 1, Poirier, P. 3, Oettinger, D. 4, Price, P. 5, Meyers, R. 6, & Anderson, Gregory S. 1
1Justice Institute of British Columbia, 2BC Emergency Health Services, 3Paramedic Association of Canada, 4Paramedic Chiefs of Canada, 5Regional Paramedic Programs of Eastern Ontario, 6Canadian Standards Association Group

BACKGROUND
Paramedicine is a rapidly evolving profession, with paramedics taking on new roles
in a variety of non-traditional practice settings. As expectations have grown, so have
paramedics’ capabilities and education. Yet, there is surprisingly little aggregated
and available data to inform paramedicine’s growth. Health care in Canada is in the
provincial jurisdiction, and there is considerable variation in scopes of practice,
regulatory mechanisms, integration with other health and emergency services, and
operational practices. Little infrastructure and few processes exist to gather and
interpret data at the national level.
The CPIS Standards Research Project is a mixed methods study designed to
identify core concepts, models, and taxonomies defining and describing paramedic
practice in Canada with the intention of informing development of standards for a
national Canadian Paramedic Information System.
The project consists of two phases: an applied research phase, conducted through
Justice Institute of British Columbia (JIBC) that includes review of academic and
professional literature, along with workshops and interviews with key informants and
stakeholders to develop a conceptual framework for describing Canadian paramedic
practice; and a second phase, in which the research team will employ Canadian
Standards Association (CSA) Group’s accredited stakeholder consultation and
consensus building process to develop a published set of national standards based
on this conceptual framework.

METHODS
This mixed methods research project is descriptive and exploratory, with the intent of
defining and describing key aspects of paramedic practice. The project rests on
social constructivist foundations, seeing knowledge and understanding of the roles
and practices of paramedicine as negotiated between various stakeholders,
practitioners, and system users. The methodology calls upon traditional literature
review methods, content and document analysis, narrative analysis (Reisman,
1993), and thematic analysis consistent with procedures used in grounded theory as
described by Chamaz (2014) and Corbin & Strauss (2014).

DISCUSSION
This project is in its start up phase, with data gathering commencing in April, 2019.
The outputs of this research will inform the growing body of research in paramedicine
by providing a comprehensive review of key concepts, terms, and models describing
the field; in effect, establishing foundational data terms and sets to guide research
efforts. The resulting Standards will form the foundation for subsequent work to
develop a national-level information system for the aggregation and access of data
on Canadian Paramedic practice.

KEY REFERENCES
Charmaz, K. (2014). Constructing grounded theory. Sage.
Corbin, J., Strauss, A., & Strauss, A. L. (2014). Basics of qualitative research. sage.
Riessman, C. K. (1993). Narrative analysis (Vol. 30). Sage.
Sample definitions derived from: World Health Organization. (n.d.) Primary Health Care.
https://www.who.int/news-room/fact-sheets/detail/primary-health-care and WHO: About Us.
http://www.emro.who.int/about-who/public-health-functions/health-promotion-disease-prevention.html

ACKNOWLEDGEMENTS:
The project is a partnership between BC Emergency Health Services (BCEHS),
Justice Institute of British Columbia (JIBC), Canadian Standards Association Group
(CSA), Paramedic Association of Canada (PAC), Regional Paramedic Programs of
Eastern Ontario (RPPEO), and Paramedic Chiefs of Canada (PCCC). The project is
funded by the Canadian Safety and Security Program, a federal program led by
Defence Research and Development Canada’s Centre for Security Science (DRDC
CSS) in partnership with Public Safety Canada.

Researchers will review paramedic-related literature to extract key terms, phrases,
research questions, research variables, concepts and models, and descriptions of
practice. In addition, researchers will conduct interviews, focus group sessions, and
workshops with key individuals and stakeholder groups with the goal of identifying
participants’ information needs through examination of the “problems on their
desks,” the information they require to address these problems, and availability or
lack of access to this information.
Researchers will create an evolving set of knowledge structures with key terms and
definitions (e.g., “Patient Care Domains” consisting of: Acute Care, Urgent Care,
Definitive Care, Primary Health Care, Preventative Care, etc., each with definitions
and descriptions). The resulting frameworks and documents will be validated
through formal consultation with stakeholders and further refined through CSA’s
accredited standards development process.

JUSTICE INSTITUTE OF BRITISH COLUMBIA