Batt Alan M, Lysko Meghan, Bolster Jennifer L, Poirier Pierre, Cassista Derek, Austin Michael, Cameron Cheryl, Donnelly Elizabeth A, Donelon Becky, Dunn Noël, Johnston William, Lanos Chelsea, Lunn Tyne M, Mason Paige, Teed Sean, Vacon Charlene, Tavares Walter
Faculty of Health Sciences, Queen's University, 99 University Avenue, Kingston, ON K7L 3N6, Canada.
Department of Paramedicine, Monash University, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia.
Healthcare (Basel). 2024 May 5;12(9):946. doi: 10.3390/healthcare12090946.
Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when developing a national competency framework for paramedics in Canada.
We used a systems-thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macrosystem, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features.
When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts and is subject to multiple levels of policy, regulatory, and legislative influence.
Using a systems-thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada.
护理人员的实践差异很大，发生在不同的环境中，涉及对一生中各种不同严重程度症状表现的评估和管理。因此，试图定义护理人员的实践具有挑战性且并不完整。这导致了对实践的不准确或不充分描述，最终可能影响教育、评估和护理服务的提供。在本研究中，我们概述了在为加拿大护理人员制定国家能力框架时，为更好地识别、探索和描述专业实践所做的努力。
我们采用系统思维方法来识别加拿大护理人员实践的环境、背景、特征和影响因素。这种方法利用了系统特征在微观系统、中观系统、外部系统、宏观系统、超宏观系统和时间系统层面的作用和影响，从而提供新的见解。我们使用了丰富图片、图表绘制和系统映射等方法来探索这些背景和特征之间的关系。
当我们审视护理人员实践系统时，多个层次变得明显，在这些层次中，我们开始看到在未来任何能力发展工作中都应考虑的特征细节。我们对该系统的探索突出表明，护理人员的实践涉及接受护理的人、护理人员和护理人员本身。它涉及在由其他健康和社会护理专业人员、公共安全人员及其他人组成的同地和分散团队内的协作。实践在不同的地理、文化、社会和技术背景下进行，并受到多个层面的政策、监管和立法影响。
通过系统思维方法，我们绘制了加拿大护理人员实践的详细系统图。该图可用于为制定更具代表性、全面性和当代性的加拿大护理人员国家能力框架的初始阶段提供参考。
