Entrustable professional activities for advanced paramedics: eDelphi analysis of relevant care situations for training of competence

Abstract

Background: As in many medical professions the concept of competence is also relevant for advanced paramedics (NotSan). A way to progressively develop and measure it is pending. Entrustable professional activities (EPA) are proposed as a method of evaluation. The goal of the study was to develop a catalog of relevant operational situations that would form the basis for integration of EPA into training. Method: The EPA catalog was developed in a 2-step process using web-based questionnaires. After the results of an eDelphi survey of practical instructors in emergency medical services were collected, the items were combined in a large cohort with respect to relevance. Subsequently, pertinent factors were identified and scales were formed. Results: After validation of the results of the eDelphi analysis, 5 scales with 22 items resulted. They cover the areas: “treatment of special clinical pictures-NACA IV”, “Communication”, “Incorporation of medical devices into patient treatment”, “Symptom-oriented action” and “Leading symptom pain”. The items account for 59% of the total variance and correspond to a stable factor solution. Conclusion: A catalog of relevant operational situations in emergency medical training has been developed, which is suitable for the further development of EPA. These EPA should be used for training and curriculum development across the board and throughout emergency services and scientifically implemented.