Identifying effective paramedic leadership skills

Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.