Critical analysis of Malaysia’s pre-hospital curriculum: A qualitative study

Background: Malaysia’s prehospital care system, historically led by Assistant Medical Officers, is facing increasing complexity due to emerging trauma patterns, remote operations, and industrial emergencies. While the Advanced Diploma in Emergency Care subspecialisation in Prehospital Care (ADEC-PHC) serves as the national benchmark for training, its alignment with industrial requirements remains underexplored. This study aims to critically assess the congruence between expert expectations and the ADEC-PHC curriculum and to identify training gaps requiring pedagogical reform. Methods: This qualitative, cross-sectional study employed a two-phase methodology: (1) nine semi-structured interviews with purposively sampled experts across government, private, and industrial sectors; and (2) analysis of three official ADEC-PHC curriculum documents. Data were thematically analysed using Braun and Clarke’s six-step framework, with cross-comparison of expert insights and curriculum content. Results: Three thematic domains emerged: (1) clinical preparedness and procedural competency strongly aligned with curriculum; (2) non-technical and administrative competencies, including leadership, communication, and decision-making, largely absent from formal training; and (3) system-level and contextual readiness, including remote care, digital literacy, and medicolegal awareness, insufficiently addressed. Experts called for greater emphasis on critical thinking, reflective practice, and interdisciplinary management. Conclusion: Despite strengths in technical training, the ADEC-PHC curriculum lacks structured development in non-technical and contextual competencies vital for modern prehospital care. These findings offer an empirically grounded framework for curriculum reform aligned with international standards, supporting the evolution of Malaysia’s prehospital care workforce into future-ready, autonomous providers.