Factors impacting the decision-making processes of qualified paramedics moving to a specialist role in community paramedicine

Factors impacting the decision-making processes of qualified paramedics moving to a specialist role in community paramedicine

Community paramedicine continues to evolve as a stream of paramedic specialisation. However, little is known about the transition from a 'traditional' role to that of an Extended Care Paramedic (ECP) or Community Paramedic (CP). Moreover, few studies have explicitly examined the rationale for the articulation of an experienced practitioner to an advanced practice role. This research illuminated the events or circumstances participants identified as necessary prior to the active engagement in the transition process.

Methods
ECPs (n=25) from two Australian jurisdictions and CPs (n=11) from a Canadian provincial health service, participated in a qualitative study exploring their experiences of transition. The data from the three study sites was pooled and interpreted using constructivist grounded theory methodology.

Results
Qualified Paramedics entered a junctional point in their careers in which the reasons for pursuing a career in community paramedicine were rationalised. The decision-making process involved satisfying two career 'wants': seeking new career options and improving patient outcomes. Subsequently, the paramedic’s perception of the community paramedicine role determined whether the paramedic entered the active phases of transition.

Conclusion
This study is the first of its kind to qualitatively examine the transition from one clinical specialist stream to another. The findings of this study have the
potential to inform the selection criteria of prospective ECP/CP candidates and be utilised as a workforce recruitment tool for community paramedicine programs.