National study of emergency medical services core competencies: a confirmatory factor analysis
PDF

Keywords

allied health personnel
attributes
competence
EMS
paramedic
Saudi Arabia

How to Cite

1.
AlShammari T, Jennings P, Williams B. National study of emergency medical services core competencies: a confirmatory factor analysis. Australasian Journal of Paramedicine [Internet]. 2019Jul.29 [cited 2023Mar.30];160. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/706

Abstract

Introduction
Internationally, the development of emergency medical services (EMS) educational standards from a post-employment to pre-employment model has gained considerable momentum. In Saudi Arabia specifically, the evolution to university-based EMS degrees has proceeded swiftly. However, the fast pace of development has contributed to considerable disparities in educational approaches between university programs. Therefore, the development of an empirically-based core competency framework is of considerable importance. The aim of this paper is to utilise confirmatory factor analysis (CFA) through structural equation modelling to confirm the theoretically developed Saudi ParamEdic Competency Scale (SPECS) model.

Methods
A national cross-sectional study design with purposive sampling technique was utilised with Saudi Red Crescent Authority healthcare providers. The SPECS instrument included 41 core competency items measured on a self-reported Likert scale. The maximum likelihood method was used with all the one factor congeneric and complete CFA models.

Results
In total, 477 EMS healthcare professionals contributed to the study: 444 (93.1%) men and 33 (6.9%) women. Of the participants, 282 (59.1%) were 29–39 years of age and 264 (55.3%) had 5 to 9 years’ experience. A CFA of the SPECS model confirmed five congeneric factors within the adequate fit measurement indices: professionalism, preparedness, communication, clinical, and personal. There was one higher order factor titled ‘paramedic competency’.

Conclusion
The CFA results support the SPECS as a reliable, valid, unidimensional and psychometrically sound model for operationalisation into Saudi university curricula. The confirmed model is made up of 27 items with five factors and an overarching latent higher order construct. The SPECS model represents an empirically developed blueprint for adoption into Saudi Arabian university programs.

https://doi.org/10.33151/ajp.16.706
PDF

References

AlShammari T, Jennings P, Williams B. Evolution of emergency medical services in Saudi Arabia. Journal of Emergency Medicine, Trauma and Acute Care 2017;(1):4.

AlShammari T, Jennings P, Williams B. Emergency medical services core competencies: a scoping review. Health Professions Education 2018;4:245-58.

Caffrey S, Barnes L, Olvera D. Joint Position Statement on degree requirements for paramedics. Prehosp Emerg Care 2018;1-4.

Kutney L, Sloane D, Aiken L. An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality. Health Affairs 2013;32:579-86.

Givati A, Markham C, Street K. The bargaining of professionalism in emergency care practice: NHS paramedics and higher education. Adv Health Sci Educ Theory Pract 2018;23:353-69.

Comrey A, Lee H. A first course in factor analysis. Hillsdale, NJ: Psychology Press; 2013.

AlShammari T, Jennings P, Williams B. Emergency medical services core competencies: a Delphi study. Australasian Journal of Paramedicine 2019;16.

Melnyk B, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 2nd edn. Philadelphia: Lippincott Williams & Wilkins; 2011.

Nunnally J, Bernstein I. Psychometric theory. New York: McGraw-Hill; 1994.

Meyers L, Gamst G, Guarino A. Applied multivariate research: design and implication: CA: Sage Publications, Inc; 2006.

Jöreskog K, Sörbom D. LISREL 8: structural equation modeling with the SIMPLIS command language. Hillsdale, NJ: Scientific Software International; 1993.

Hair J, Anderson R, Tatham R Black W. Multivariate data analyses with readings. 4 edn. Englewood Cliffs, NJ Prentice Hall; 1995.

Schumacker R, Lomax R. A beginner's guide to structural equation modeling. Fourth edn. New York, NY: Psychology Press; 2016.

Tabachnick B, Fidell L. Using multivariate statistics. 6 edn. Harlow, Essex: Allyn & Bacon/Pearson Education; 2014.

Gefen D, Straub D, Boudreau M. Structural equation modeling and regression: guidelines for research practice. Communications of the Association for Information Systems 2000;4(1):7.

Segars A, Grover V. Re-examining perceived ease of use and usefulness: a confirmatory factor analysis. MIS Q 1993;17:517-25.

Kline R. Principles and practice of structural modeling: New York: Guilford Press; 1998.

Hu L, Bentler P. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 1999;6:1-55.

Bentler P. Comparative fit indexes in structural models. Psychol Bull 1990;107:238.

Evans V. Higher-order factor analysis: an introductory primer. Annual meeting of the Southwest Educational Research Association; San Antonio, TX, 1999.

Holmes-Smith P. Structural equation modeling: from the fundamentals to advanced topics. Melbourne: Sreams; 2016.

López S, Peón J, Ordás C. Human resource management as a determining factor in organizational learning. Manag Learn 2006;37:215-39.

Nazim A, Ahmad S. Assessing the unidimensionality, reliability, validity and fitness of influential factors of 8th grade student’s mathematics achievement in Malaysia’. Int J Adv Res 2013;1:1-7.

Awang Z. A handbook on structural equation modeling using AMOS. Malaysia, Universiti Technologi MARA Press; 2012.

Chang Y, Tsai K, Williams B. Development of new core competencies for Taiwanese Emergency Medical Technicians. Adv Med Educ Pract 2018;9:147-58.

Williams B, Onsman A, Brown T. Australian paramedic graduate attributes: a pilot study using exploratory factor analysis. Emerg Med J 2010;27:794-9.

Kilner T. Educating the ambulance technician, paramedic, and clinical supervisor: using factor analysis to inform the curriculum. ibid. 2004;21:379-85.

Council of Ambulance Authorities. Paramedic professional competency standards. Melbourne; 2016. Available at: www.caa.net.au/images/documents/accreditation_resources/Paramedic_Professional_Competency_Standards_V2.2_February_2013_PEPAS.pdf

National Highway Traffic Safety Administration. National EMS Education Standards Washington, DC2009. Available at: www.ems.gov/pdf/811077a.pdf

Health and Care Professions Council. Standards of proficiency for paramedics. London: HCPC; 2014. Available at: www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf

Health Professions Council of South Africa. Core competencies for undergraduate students in clinical associate, dentistry and medical teaching and learning programmes in South Africa Pretoria: HPCSA; 2014. Available at: www.hpcsa.co.za/uploads/editor/UserFiles/downloads/medical_dental/MDB%20Core%20Competencies%20-%20ENGLISH%20-%20FINAL%202014.pdf

Frank J, Snell L, Sherbino J. CanMEDS 2015 physician competency framework series IV Ottawa. Royal College of Physicians and Surgeons of Canada; 2015. Available at: www.royalcollege.ca/rcsite/documents/canmeds/canmeds-full-framework-e.pdf

Alessandro K, Leggio W, AlMubarak H. Muslim mass pilgrimage poses EMS logistical & planning challenges. J Emerg Med Serv 2013;38:52-7.

Nichols P, Horner B, Fyfe K. Understanding and improving communication processes in an increasingly multicultural aged care workforce. J Aging Stud 2015;32:23-31.

Beheri W. Diversity within nursing: effects on nurse-nurse interaction, job satisfaction and turnover. Nurs Adm Q 2009;33:216-26.

Bergs E, Rutten F, Tadros T, Krijnen P, Schipper I. Communication during trauma resuscitation: do we know what is happening? Injury 2005;36:905-11.

Furseth P, Taylor B, Kim S. Impact of interprofessional education among nursing and paramedic students. Nurse Educ 2016;41:75-9.

Johnston T, MacQuarrie A, Rae J. Bridging the gap Reflections on teaching interprofessional communication to undergraduate paramedic and nursing students. Australasian Journal of Paramedicine 2014;11(4).

Ford R, Webb H, Allen-Craig S, et al. A simulated wilderness exercise: the development of relational competence in paramedic students. Journal of Paramedic Practice 2014;6:574-83.