Critical Incident Technique – A useful method for the paramedic researcher’s toolkit

Introduction: Critical Incident Technique (CIT) is a research method that has been used to investigate activities across many fields including psychology, medicine, nursing, counselling, education, learning and marketing. Given this, the method has potential to explore the knowledge and work of paramedics, with capacity to enhance paramedic practice and improve patient outcomes. This paper explores this potential by investigating the use of CIT as a research method for the paramedic and pre-hospital environment.

Methods: A search using the term ‘Critical Incident Technique’ was conducted using the University of Tasmania ‘MegaSearch’ facility. Some 2935 papers were then filtered to include one or more of the terms: ambulance, pre-hospital, paramedic, transport, retrieval, emergency medical service/s, EMS, emergency medical technician/s and EMT. Using these terms, four research articles used CIT as a methodological approach. Searching CINAHL, Scopus and MEDLINE via PubMed individually, contributed one further article. A further search with the same terms was conducted using Google Scholar, which identified an additional seven relevant papers.

Results: Although CIT has been used as a research method since 1954, its use in the examination and study of paramedic practice (prehospital care) was limited and quite new. An analysis of the articles indicated five distinct themes relating to how CIT was used: physical dimensions of job performance (equipment and technology), teamwork and communication (how team members work and communicate), psychological dimensions of work (how paramedics felt about their work), student learning and experience and patient care.

Conclusion: Critical Incident Technique is a research method that has been used effectively to inform various psychological and physical dimensions of paramedic practice. Asking participants about positive or negative, effective or less effective elements of practice encourages open responses that build a picture of optimal practice. Paramedic practice is about caring for those who require prehospital care, and further consideration of the application of CIT in pre-hospital research may increase our understanding of this work to improve service delivery and patient outcomes.