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Identifying effective paramedic leadership skills

02 September 2022
Volume 12 · Issue 3



Paramedics who assume leadership positions rarely receive education and training to prepare them for the change in role. This study examines the experiences and beliefs of paramedic leaders and suggests ways that practitioners looking to move into leadership positions can develop their leadership skills before assuming such a role.


Qualitative, semistructured interviews were conducted with paramedic leaders from the different emergency medical services (EMS) models, including fire department, ambulance district, hospital and private EMS systems from urban, suburban and rural response areas to determine leadership training best practices, based on the leaders' own experiences.


Despite employer and regional variations, all the participants had similar experiences during the transition from frontline clinician to leader. Common themes included a lack of preparatory training, a struggle with moving from peer to boss, issues with learning how to communicate effectively and an ongoing need to perform direct patient care while also fulfilling the tasks of a manager. These issues were a source of considerable stress and self-doubt for many participants.


Leadership training is not typically given to EMS field clinicians looking to assume leadership positions. Paramedic leaders have developed the necessary skills to succeed on their own by learning on the job, developing mentor/mentee relationships, and undergoing training and education in the form of advanced degrees. EMS agencies need to prioritise proactive and meaningful leadership development not only to retain current staff but also to support organisational succession plans.

The purpose of this study was to identify the activities necessary to develop effective leaders within the emergency medical services (EMS) organisations. Leadership development is an important undertaking that influences staff retention, organisational performance and the long-term sustainability of any organisation.

Despite the differences that might exist between individual EMS agencies, there are commonalities between them—staffing shortages, budget constraints, supply chain disruptions and employee wage concerns are found in most of them. Both current and future prehospital leaders will have to confront these matters in a prehospital environment that is ever-increasing in complexity and chaos.

To meet this responsibility, EMS officers must have a firm grasp of their new role to lead and manage their staff effectively. While there are many ways to define both of these concepts, EMS leadership could be defined as the provision of strategic direction (e.g. cultural development and long-term organisational growth) and management as the delivery of short-term operational tactics (e.g. daily staffing and direct patient care). Each potentiates the other and, without at least some ability in both, those aiming to be leaders will not be effective (Kotter, 1990).

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