Restiglian, A; Martin, L; Long, D; Reynolds, L; Walker, T; Meadley, B; Finn, A; Batt, AM; Miles, A; Johnston, T; Shannon, B. National consensus on the capabilities that inform the role of advanced practice paramedics: a Delphi study. Paramedicine. 2025. https://doi.org/10.1177/27536386251360833
Introduction
Advanced Practice Paramedics (APPs) are highly skilled paramedics who operate in diverse clinical settings both within and outside traditional ambulance services. International evidence demonstrates that APPs enhance patient outcomes in areas such as critical and primary care. In Australia, the expansion of APP roles and responsibilities has gained momentum; however, no nationally recognised framework exists to define their expected capabilities. This gap leads to inconsistencies in education, practice, and role clarity. A standardized capability framework is therefore vital to guide the development, implementation, and integration of APP roles within the Australian healthcare system.
Aim
The primary aim of this study was to develop a comprehensive list of APP capabilities tailored to the Australian context through expert consensus.
Methods
A modified Delphi approach was used across four iterative phases to establish consensus. An expert panel of clinical, academic, organisational, and regulatory/governance leaders was identified via the Knowledge Resource Nomination Worksheet. Participants reviewed, rated, and refined proposed APP capabilities derived from international frameworks and relevant literature. Consensus was defined as a minimum of 70% agreement among participants.
Results
Of the experts invited, 43 consented to participate in the Delphi process. A final set of 33 capabilities, achieving 96% overall consensus, was developed. These capabilities spanned four key domains: Clinical Practice (14), Leadership and Management (10), Education (7), and Research (2). Iterative feedback ensured each capability was clear, relevant, and aligned with the Australian healthcare context.
Conclusion
The resulting capability framework provides a robust foundation for standardizing APP roles within Australia, promoting consistency in education, practice, and professional expectations. This framework not only supports the national advancement of APPs but may also serve as a model for international adaptation, contributing to the global development and recognition of advanced practice roles in paramedicine.