Four dimensions of paramedic practice in Canada: Defining and describing the profession

Ron R Bowles, Catherina van Beek, Gregory S Anderson



This article presents a framework for describing four dimensions of paramedic practice: Practitioners, Practice Setting, Care and Patient Disposition. The framework emerged from a qualitative study conducted to identify potential research directions and opportunities to advance paramedicine and paramedic education at Justice Institute of British Columbia in Canada.


Researchers conducted semi-structured interviews with 17 stakeholders in Canadian paramedicine to explore the current state and emerging expectations of paramedic practice and paramedic education.


The study found no consensus, and little agreement, on what term or terms best describe the profession. Participants agreed that the core of paramedic practice involves an advanced care paramedic responding by ambulance to the patient’s side in an emergency to assess and treat urgent medical and traumatic conditions, then transport the patient to further medical care – most often an emergency physician at an emergency department. However, participants also described paramedics as healthcare providers who are increasingly taking on varied operational roles to improve patient care and address gaps in an evolving and stressed healthcare system. Four dimensions emerged for describing key characteristics of paramedic practice: the Practitioners, Practice Settings, Care and Patient Disposition.


The framework described in this article may be useful for examining and better understanding both traditional and evolving paramedic roles. This, in turn, informs the efforts of paramedic educators, regulators, employers, and professional associations to support practitioners in the field. The article uses the framework to contrast two distinctly different community paramedic programs.


paramedic practice; boundaries of the discipline; paramedicine; EMS; ambulance; professional practice

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