Identifying the context-specific roles enacted by community paramedics in Canada

Introduction Community paramedics provide care in a diverse range of settings that address the needs of the communities they serve. Recent developments have resulted in a call for guidance on the education requirements of community paramedics at a national level in Canada. To inform the development of such guidance, we sought to identify the various roles that community paramedics in Canada enact. Methods This was a three-phase study that combined (1) frameworks describing community paramedicine in Canada, (2) a review of community paramedicine literature focused within the Canadian setting, and (3) a review of data reported by a pan-Canadian working group. Elements identified at each phase were extracted and mapped to an existing role description for paramedics in Canada. Elements central or unique to community paramedic practice were iteratively identified and highlighted. Results Community paramedics perform multiple roles that span a broad continuum of the healthcare system. They deliver and support person-centred care through expanded assessment, diagnostic and therapeutic interventions (Clinician). They are situated in and engage with communities in designing programs to meet community needs (Professional). Through their trusted relationships with people receiving care and care partners, they engage in health promotion and education activities (Educator). They coordinate care and help patients navigate the care system (Health and Social Advocate). As members of interprofessional care teams (Team Member), they both accept referrals and refer within these teams, as well as support a range of disposition options. They continually assess and maintain their professional competence and personal wellbeing (Reflective Practitioner). Discussion and conclusion Community paramedics share common roles with other paramedics in Canada, but their enactment of these roles is contextually specific and involves elements that are unique or more prominent. The description of these roles in the community paramedic context will guide future developments in community paramedic education.