Implementing the rural advanced care community paramedics in rural and remote British Columbia: A qualitative study
Bibliographic record
Abstract
Background: Advanced care paramedics (ACPs) are an important component of the interdisciplinary healthcare team, providing care across diverse acute and community settings. ACPs have competencies extending beyond traditional paramedicine roles, offering advanced patient assessment and management, including cardiac monitoring, endotracheal intubation, and intravenous therapies. Rural and remote communities experience complex healthcare challenges, and the new Rural Advanced Care Community Paramedic (RACCP) role is positioned to provide comprehensive and complementary healthcare. Purpose: This research study explores the implementation and integration of RACCPs in five rural and remote communities in British Columbia, Canada. Methods: A two-phase qualitative descriptive study was conducted, with interviews being performed during early implementation (Phase One) and 1–2 years following integration (Phase Two). Thirty-six interviews were conducted with 31 unique participants, spanning five communities. Participants included health system and emergency services representatives, decision-makers, healthcare providers, and community knowledge users. Data were first coded and analysed thematically, then analysed using the Theoretical Domains Framework with the aim of providing more specific insights relating to the barriers and facilitators of implementation and to frame potential recommendations. Findings: The data from this study offers strong support for the RACCP role, noting the potential to address complex healthcare challenges within rural and remote communities. The RACCP role evolved to allow for care to be provided in place, pre-empting admissions to acute care, and providing services to commonly underserved populations. While all participants were strongly positive about the RACCP role, a lack of role clarity, challenges in integrating within existing healthcare services, and policy/regulatory issues were seen as key barriers. Conclusion: New modes of community paramedic practice are emerging, signalling a shift to new and extended acute care community roles. This study provides a comprehensive examination of the integration of these new RACCP roles, providing insights into key barriers and facilitators of implementation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.020 | 0.006 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".