By Dr Paul Simpson, Dr Linda Ross, Dr Robin Pap

Introduction

The Australasian College of Paramedicine (the College) has invested heavily in research, consistent with its commitment to seeing the profession advance in an evidence-informed manner. Central to that commitment has been the funding of an ambitious project aimed at creating an Australasian paramedicine research agenda and associated research priorities.

Why have an agenda?

Research within a discipline can frequently become siloed, with growth and quality being potentially impeded by a lack of collaboration, coordination and cooperation across researchers and industry. (1) This can lead to the duplication of research efforts, inefficiency in resource utilisation, and difficulty securing funding of sufficient magnitude to create ongoing suites of high-quality research.

Research agendas hope to promote concentration of research efforts, assist with prioritisation of grant funding, and enhance collaboration.(2) An agenda doesn’t mean that researchers can only investigate those prioritised items; more so, it serves to foster conversation and stimulate a more strategic, shared approach to paramedicine research.

Research agendas have been created in healthcare disciplines such as nursing,(3) medicine,(4) physiotherapy,(5) and social work. (6) In the paramedicine context, research agendas have been created in several countries, including Canada (7) and the Netherlands. (8) While previously discussed by O’Meara et al (2), this was the inaugural effort to produce a research agenda for the Australian and New Zealand paramedicine context. Although similarities exist across paramedicine jurisdictions, it is the nuanced differences in systems, education, environment, and practice that necessitate the creation of a unique and specific agenda that considers the Australasian context.

How was the agenda created?

Conceived by the Research Advisory Committee in 2021, this ambitious project sought to use what is known as “consensus methodology” to draw in the expertise of diverse paramedicine stakeholders to co-create a research agenda with embedded priorities. The study adopted a two-phase design, commencing with a survey of academics, educators, managers, and clinicians within Australian and New Zealand paramedicine.

This first phase had two aims: First, to gather broad stakeholder input regarding research priorities that would be later used to inform an expert panel’s deliberations; and second, to identify barriers and enablers to paramedicine research in our region. This phase resulted in a publication by Ross et al (9) in the peer-reviewed journal “Paramedicine” – visit https://journals.sagepub.com/doi/full/10.1177/27536386231167590 to read the barriers and enablers paper.

There were responses from 341 stakeholders, creating a rich tapestry of data and providing insights into not just the priorities, but also what is holding paramedicine research back and what we need to move our collective research efforts forward. It also created a provisional list of 109 perceived research priorities.

The second phase used a specific type of consensus approach called a Delphi. From the first phase and via what is known as “purposive sampling”, 63 expert educators, academics, managers, and clinicians engaged in three rounds of online voting to establish a research agenda. They were able to add their own suggestions to the starting list of 109, then collaboratively whittle that down to a final agreed research agenda consisting of 37 items, grouped into six clusters. This phase resulted in peer-reviewed publication by Pap et al (10) in “Paramedicine” – visit https://journals.sagepub.com/doi/full/10.1177/27536386241231666 to read the agenda paper.

What is on the agenda and what are the priorities?

The final research agenda, grouped by cluster, is illustrated in Figure 1. The top 10 ranked agenda items as prioritised by the expert panel are illustrated in Table 1.

Where to from here?

The production of an agenda represents a meaningful and tangible visualisation of research priorities as determined by the profession's experts, but it is not in and of itself an endpoint. We, as a profession, should see it as a beginning, the start of what hopefully might be a new era of enhanced collaboration, cooperation, sharing, and concentration.

Awareness of the agenda within and outside of paramedicine needs to be grown. Simply creating an agenda and publishing it in a journal doesn’t mean it will become widely known and embraced. The agenda has and will continue to be promoted through presentations at key conferences, and through targeted engagement with key stakeholders at the individual and organisational level. The onus is on organisations to recognise the importance of this agenda to the future of paramedicine and to facilitate quality research and pathways. At an individual level, those with a passion for the future of the profession can contribute by discussing, sharing, and engaging with the priority areas.

Funding bodies and schemes, for example the College’s own research grant scheme, should seek to operationalise the agenda by referring to it in the application guidelines and encouraging applicants to demonstrate the connection of their proposed research to the agenda.

An essential next step is to explore each of the agenda items by cluster. The agenda has given us areas of priority, but not the questions within those areas that need to be asked, nor the outcomes that need to be measured to generate meaningful answers. Cluster by cluster, these must be explored via collaboration and further consensus to create suites of rigorous research to answer important questions with actionable outcomes. Collaborations of like-minded researchers and content experts, including paramedics engaged in patient-facing care roles, should be formed to achieve this, and in doing so growing intra and interprofessional connections to assemble appropriately qualified and resourced teams.

Want to learn more about the Australasian paramedicine research agenda?

Visit https://paramedics.org/news/raap-online-publications to download the research agenda brochure. Contact the Chair of the Research Advisory Committee Dr Robin Pap at research.committee@paramedics.org.

Figure 1: Australasian paramedicine research priorities and clusters

Table 1: The top ten research agenda items (including ties) by priority ranking

References

1. Whear R, Thompson-Coon J, Boddy K, et al. Establishing local priorities for a health research agenda. Health Expect 2015; 18: 8–21.
2. O’Meara P, Maguire B, Jennings P, et al. Building an Australasian paramedicine research agenda: a narrative review. Health Res Policy Syst 2015; 13: –5.
3. Chipps EM, Joseph ML, Alexander C, et al. Setting the research agenda for nursing administration and leadership science: a Delphi study. J Nurs Adm 2021; 51: 430–438
4. Mooijaart SP, Nickel CH, Conroy SP, et al. A European research agenda for geriatric emergency medicine: a modified Delphi study. Eur Geriatr Med 2021; 12: 413–422.
5. Rankin G, Rushton A, Olver P, et al. Chartered society of physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique. Physiotherapy 2012; 98: 260–272.
6. Beddoe L, Karvinen-Niinikoski S, Ruch G, et al. Towards an international consensus on a research agenda for social work supervision: report on the first survey of a Delphi study. Br J Soc Work 2016; 46: 1568–1586.
7. Jensen JL, Bigham BL, Blanchard IE, et al. The Canadian National EMS Research Agenda: a mixed methods consensus study. Can J Emerg Med 2013; 15: 73–82.
8. van de Glind I, Berben S, Zeegers F, et al. A national research agenda for pre-hospital emergency medical services in the Netherlands: a Delphi-study. Scand J Trauma, Resusc Emerg Med 2016; 24: –9.
9. Ross L, Reynolds L, Reeves H, et al. Barriers and enablers to paramedicine research in Australasia – A cross-sectional survey. Paramedicine. 2023;20(4):107-116. doi:10.1177/27536386231167590
10. Pap R, Barr N, Hutchison A, et al. Research agenda and priorities for Australian and New Zealand paramedicine: A Delphi consensus study. Paramedicine. 2024;21(3):94-107. doi:10.1177/27536386241231666