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Identifying Themes for EMS Continued Competency That Are Acceptable and Improve Patient Care
Ashish R Panchal1,2,3, Kayla M Riel1,2, Jacob C Kamholz1,2
1National Registry of Emergency Medical Technicians, Columbus, Ohio.
Prehospital Emergency Care
|June 9, 2026
Summary
Developing an updated Emergency Medical Services (EMS) competency model requires evidence-based, clinician-involved principles. This study prioritized foundational and operational strategies for improved EMS practice and patient care.
Area of Science:
- Emergency Medical Services (EMS)
- Healthcare Education
- Professional Competency
Background:
- Continued competency in Emergency Medical Services (EMS) is inconsistently defined and requires re-evaluation.
- Existing frameworks may not align with current practice, clinician acceptance, or patient care relevance.
Purpose of the Study:
- To derive and prioritize foundational principles for an updated EMS continued competency model.
- To ensure the model is acceptable to EMS clinicians and improves competency and patient care.
Main Methods:
- A four-round, in-person modified Delphi study involving a multidisciplinary panel of EMS subject matter experts.
- Iterative refinement of themes through structured group discussion, Likert-type scale ratings, and consensus-building discussions.
- Consensus defined as at least 75% agreement among 15 participating experts.
Main Results:
- Unanimous consensus was reached on five foundational principles: evidence-based content, active clinician involvement, quality improvement-informed assessment, non-punitive and growth-oriented assessment, and feasibility/scalability.
- Four operational strategies were identified: simulation-based assessment, longitudinal development, microlearning, and technology-enabled delivery.
Conclusions:
- Expert consensus identified key principles for an updated EMS continued competency model.
- The findings offer a structured, evidence-informed framework for designing, evaluating, and implementing EMS competency models across diverse systems.
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