Competencies and behaviours required for membership and leadership of emergency medical service crews: A qualitative study

The complexity of competencies required for leaders and other members of emergency medical services (EMS) crews has not yet been sufficiently investigated. However, understanding what it means to be a competent leader and a competent other team member, and how each should behave, remains crucial for minimising errors. This study, therefore, explores the competencies and corresponding behaviours associated with both leadership and membership roles in EMS crews. A sample of 17 paramedics was interviewed using the Critical Incident Technique and the Repertory Grid Technique. Thematic analysis of the interview data revealed four overarching competency domains: (1) interpersonal, (2) cognitive, (3) task, and (4) personal. Within these domains, several key competencies, sub-competencies, and behaviours emerged – some shared across both roles, and others specific to either leadership or membership. Notably, leaders were expected to demonstrate coordination, planning, prioritising and critical thinking, whereas other team members were typically responsible for driving an ambulance, actively engaging in emergencies and following the leader's instructions. Clarifying these role-specific competencies and associated behaviours is an essential step towards integrating them into training curricula and educational initiatives aimed at enhancing the quality and safety of EMS work.