The National Occupational Competency Profile (NOCP)-the competency framework for paramedics in Canada-is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare, and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title, abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into 11 emerging concepts related to competencies: inclusion, diversity, equity, and accessibility (IDEA) in paramedicine; social responsiveness, justice, equity, and access; anti-racism; healthy professionals; evidence-informed practice and systems; complex adaptive systems; learning environment; virtual care; clinical reasoning; adaptive expertise; and planetary health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, the development of group discussions, and competency identification.

Introduction: When paramedics are dispatched, it is expected that every patient receives the same level of care regardless of variable factors. Homelessness is a growing social issue across Canada that is particularly prevalent in urban areas. The quality of healthcare delivered to individuals experiencing homelessness may be influenced by negative attitudes held by healthcare professionals. There is an absence of literature quantifying the perspectives of paramedics towards homelessness; therefore, the focus of this study was to identify the attitudes of paramedic students towards homelessness and to continue the conversation in regards to the evolving educational needs of paramedic students. Methods: This study employed a longitudinal design of a convenience sample of first year paramedic students in a college program in Ontario, Canada. The Health Professional's Attitude Towards the Homeless Inventory (HPATHI) was distributed to participants before and after placement and clinical exposure. The questionnaire includes 19 statements which participants respond to on a Likert scale. Mean scores were calculated, and statements were categorized into attitudes, interest, and confidence. Data were collected post-placement on interactions with persons experiencing homelessness. Results: A total of 52 first year paramedic students completed the HPATHI pre-placement and 47 completed the questionnaire post-placement. Mean scores for attitudes (pre 3.64, SD 0.49; post 3.85, SD 0.38, p=0.032), interest (pre 3.91, SD 0.40; post 3.84, SD 0.39,p=0.51) and confidence (pre 4.02, SD 0.50; post 3.71, SD 0.67, p=0.004) were largely positive, but there was a demonstrated decreasing trend in confidence with, and interest in, working with those experiencing homelessness. Participants reported an average of 60 hours of placement, during which 15 participants (32%) reported interactions with people experiencing homelessness. Conclusion: First year paramedic students demonstrate overall positive attitudes towards those experiencing homelessness, and the mean score for attitudes improved over the surveys. However, there were demonstrable decreases in confidence and interest over time, which may be related to the type and frequency of interactions during clinical placement. Paramedic education programs may benefit from the inclusion of focused education on homelessness, specific clinical experiences, and education related to social determinants of health.

The National Occupational Competency Profile (NOCP) – the competency framework for paramedics in Canada – is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title and abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into eleven emerging concepts related to competencies: Inclusion, Diversity, Equity, and Accessibility (IDEA) in paramedicine; Social responsiveness, justice, equity and access; Anti-racism; Healthy Professionals; Evidence Informed Practice and Systems; Complex Adaptive Systems; Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, development group discussions, and competency identification.

The National Occupational Competency Profile (NOCP) – the competency framework for paramedics in Canada – is presently undergoing revision. Since the NOCP was published in 2011, paramedic practice, healthcare and society have changed dramatically. To inform the revision, we sought to identify emerging concepts in the literature that would inform the development of competencies for paramedics. We conducted a restricted literature review and content analysis of all published and grey literature pertaining to or informing Canadian paramedicine from 2011 to 2022. Three authors performed a title and abstract, and full-text review to identify and label concepts informed by existing findings. A total of 302 articles were categorized into eleven emerging concepts related to competencies: Inclusion, Diversity, Equity, and Accessibility (IDEA) in paramedicine; Social responsiveness, justice, equity and access; Anti-racism; Healthy Professionals; Evidence Informed Practice and Systems; Complex Adaptive Systems; Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. This review identified emerging concepts to inform the development of the 2023 National Occupational Standard for Paramedics (NOSP). These concepts will inform data analysis, development group discussions, and competency identification.