Defining Entry-to-Practice Competence in Paramedicine A Scoping Review
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Abstract
Objectives: Paramedics play a key role in unplanned, emergent, and episodic out-of-hospital health care. A comprehensive description of the minimally expected competencies (knowledge, skills, and attributes) necessary to perform the duties of a paramedic is required to build effective education programs and credentialing systems. This scoping review aimed to map and synthesize the literature describing entry-to-practice competence in paramedicine, including professional expectations and approaches used to assess readiness for independent practice.
Methods: A structured search of MEDLINE, EMBASE, Scopus, CINAHL, Google Scholar, and greylit.org was undertaken for literature published between 1996 and 2026. The search included peer-reviewed literature published between 1 January 1996 and 1 January 2026.
Results: The four databases identified 8,231 records. After duplicates were removed, 6,755 records were screened and 99 full-text reports assessed. Twenty studies were identified through database searching and two additional studies through supplementary searching, resulting in 22 included studies. Three domains were identified: desirable non-technical attributes and professionalism, scope of practice, and assessment of competency. Secondary domains were assigned where studies addressed more than one area.
Conclusions: Entry-to-practice paramedic competence is consistently described across three interrelated domains: desirable non-technical attributes and professionalism, scope of practice, and assessment of competency. These findings can inform curriculum design, accreditation, and workplace-based assessment approaches in paramedicine.
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