Markers of cognitive skills important for team leaders in emergency medical services: a qualitative interview study

Abstract

Background: Cognitive skills and other non-technical skills are key for emergency medical services (EMS); however, there have been a limited number of their markers identified. This study aims to identify markers of cognitive skills—situation awareness and decision making—important for team leaders in EMS. The focus is on any markers of cognitive skills that are associated with quality and safety at EMS work. Method: In-depth semi-structured interviews were conducted with 20 EMS team leaders (10 EMS physician team leaders and 10 paramedic team leaders) and analysed by the structured approach utilising the known framework of cognitive skill elements. Results: The data analysis revealed a set of 50 markers falling into elements of situation awareness (gathering information, interpreting information, anticipating states), elements of decision making (identifying options, implementing decisions, re-evaluating decisions), and an additional cognitive element (maintaining standards). These markers represented cognitive processes, acts, and communications, therefore, some of them can be observable and others rather unobservable. The identified markers were not too specific, applicable mostly in various challenging situations with patients’ medical problems and in EMS team leaders working in ground ambulances in urban and rural/remote areas. Conclusion: The findings provide a better understanding of EMS team leaders’ cognitive skills, and can aid in the development of assessment and training tools suited particularly to them.