Alan M. Batt, Pierre Poirier, Jeanne Bank, Jennifer Bolster, Ron Bowles, Cheryl Cameron, Elizabeth Donnelly, Becky Donelon, Noël Dunn, Tim Essington, William Johnston, Rene Lapierre, Tyne M. Lunn, Meghan Lysko, Paige Mason, Mary Osinga, Dugg Steary, Ryan Strum, and Walter Tavares on behalf of the NOSP Development Group, Working Groups and CSA Technical Committee.

For publication in Canadian Paramedicine, July 2022

Developing the National Occupational Standard for Paramedics

PAC has partnered with the CSA Group to manage the renewal of the existing National Occupational Competency Profile (NOCP) and incorporate it into a new standard following accredited processes of the Standards Council of Canada – the National Occupational Standard for Paramedics (NOSP). Following on from our earlier update in March, in this article we will provide an update on the development of the NOSP to date.

Development Group (DG)

Ryan Strum, Tyne M. Lunn, Mary Osinga and Dr. Elizabeth Donnelly have joined the Development Group. The DG has reviewed materials for presentation to the TC and appointments to working groups.

Technical Committee (TC)

The Technical Committee met on two occasions since the last update – once in March, and once in April. Additional members have been added to the TC representing Indigenous perspectives in paramedicine, and provinces that were not represented. The next TC meeting is provisionally scheduled for October 2022.

Development process

The development process is collaborative and ensures the inclusion of diverse stakeholders’ and end-users’ views throughout the process. Each step of the six-step development model (1) is conducted in collaboration between the DG and TC. The development of the NOSP is informed by the principles guiding paramedicine in Canada (2), and will be structured according to the paramedic profile roles (3,4).

Step 1.

The DG drafted the purpose, intended uses, terminology, and scope of the Standard, along with identifying potential stakeholders, rightsholders, and end-users who should be consulted as part of the development of the NOSP. This step involved collaboration with the consultant leading the development of the Canadian Organization of Paramedic Regulators (COPR) Paramedic Essential Regulatory Requirements (PERRs) project to ensure the projects were aligned with regards to terminology and other developmental considerations.

The TC provided input and feedback on this step. The NOSP will outline the core activities performed by paramedics, and the core competencies required to enact professional, patient-oriented practice in diverse contexts. It will not consider, or outline competencies related to service leadership, education, research, policy, or other roles that paramedics may fulfil. It will not provide curriculum guidance or career pathway options. These will be outlined in future documents.

Step 2.

The DG identified a number of contexts of paramedic practice in Canada for consideration in the Standard, via a systems thinking approach (5). The TC provided input and feedback on this step. These contexts are now being explored through 15 pan-Canadian working groups – see Table 1.

Table 1. Contexts of practice in Canada

Working Group Lead member(s)
Contexts of practice working groups
Prehospital / Out-of-Hospital Emergency Care Jennifer Doyle, Noël Dunn
Community, Public Health and Primary Care Amber Hultink, Ryan Strum
Emergency Department Sean Teed
Rural, Remote and Isolated Mathieu Grenier
Culturally Proficient Care Tyne M. Lunn
Military Practice Jean Sebastian Morin, William Johnston
Substance Use and Mental Health Dr. Polly Ford Jones, Jennifer Bolster
Critical Care and Interfacility transfer Sean Hackett, Mary Osinga
Industrial Paramedicine Jodi Bender
Palliative and End-of-Life Care Cheryl Cameron
Special Operations Jay Walker, Dugg Steary
Correctional and Remand Practice Sheldon Thunstrom
Focused working groups:
Indigenous Paramedic and Communities Engagement Jeff Gunner
Interprofessional Perspectives Dr. Elizabeth Donnelly
Patient, Caregiver, and Public Engagement Paige Mason, Jeanne Bank

A total of 146 applicants were appointed to 15 working groups. Members were appointed with considerations of inclusion, diversity, equity and accessibility (IDEA), including geographical representation across Canada.

Central to the development of the NOSP is a conscious effort to engage with stakeholders, rightsholders, and end-users with considerations of IDEA. As part of our commitment to this effort, we have established three focused working groups: Indigenous Communities Working Group, Interprofessional Perspectives Working Group, and a Patient, Caregiver, and Public Engagement Working Group.

Indigenous Paramedic and Communities Engagement

The NOSP is being developed with acknowledgement and consideration of the Truth and Reconciliation Commission’s Calls to Action, in particular related to health (#18 to 24), and professional development and training for public servants (#57) [ref]. To this end, Jeff Gunner joined the TC as an Indigenous paramedic service representative to provide a critical strategic perspective. Jeff will also lead the Indigenous Paramedic and Communities Engagement working group, where he will liaise with Indigenous and First Nations paramedics and communities from across Canada.

Patient, Caregiver, and Public Engagement

Paige Mason will lead the development, implementation and evaluation of the patient, caregiver, and public engagement strategy for the NOSP. Patients, caregivers, and members of the public will be engaged and recruited through the development process with considerations of equity, diversity, inclusion, and accessibility, including geographical representation across Canada.

Interprofessional Perspectives

Led By Dr. Elizabeth Donnelly, this working group will solicit input from nurses, physicians, and allied health professionals on their perspectives of paramedic work, competencies, and roles.

Next steps

The DG will support working groups in the conduct of data collection over a several month-long period, expected to complete in October 2022. The DG will then analyse the data and prepare a summary for the TC.

An in-person NOSP event will be held at the Paramedicine Across Canada Expo 2022 from the 7th to 11th September in Saskatoon, SK. Details on the format of this event will be provided closer to the date and will feature on the PACE 2022 website (pac-expo.ca).

Contact the development group

If you wish to contact the DG, please contact us via this form: https://forms.gle/zQUbNodND7LjSQ4t7. We will provide regular updates on the development of the NOSP in Canadian Paramedicine, and via social media.

References

1.       Batt A, Williams B, Rich J, Tavares W. A Six-Step Model for Developing Competency Frameworks in the Healthcare Professions. Frontiers in Medicine. 2021;8:2601.

2.       Tavares W, Allana A, Beaune L, Weiss D, Blanchard I. Principles to Guide the Future of Paramedicine in Canada. Prehospital Emergency Care. 2021 Aug 10;0(0):1–11.

3.       Paramedic Association of Canada. Canadian Paramedic Profile: Paramedic Roles. Ottawa: Paramedic Association of Canada; 2016.

4.       Tavares W, Bowles R, Donelon B. Informing a Canadian paramedic profile: Framing concepts, roles and crosscutting themes. BMC Health Services Research. 2016;16(1):1–16.

5.       Batt AM, Williams B, Brydges M, Leyenaar M, Tavares W. New ways of seeing: supplementing existing competency framework development guidelines with systems thinking. Advances in Health Sciences Education. 2021 May 18;