More than lights and sirens : Assessing the impact of a national accreditation scheme from the perspective of change in an evolving profession - Paramedicine

Introduction/Background: This thesis provides an in-depth analysis of the intricate relationship between curriculum design, accreditation processes, and the evolving landscape of paramedicine in Australia, particularly within the context of the National Registration and Accreditation Scheme (NRAS), which was established in 2018. The research explores the impact of the advent of the NRAS on the development and delivery of paramedicine education, examining its influence on both the academic and professional readiness of paramedic graduates. By contextualising the historical evolution of paramedic practice in Australia, this study examines the current status and challenges facing the profession, with a focus on the regulatory and educational frameworks that support it.

Aim: The primary aim of this study is to investigate how paramedicine courses developed under the Australian Paramedicine National Registration and Accreditation Scheme effectively prepare graduates to meet the dynamic and ever-changing demands of their profession. The research aims to identify the strengths and weaknesses within current educational frameworks, providing insights into how these frameworks can be enhanced better to equip paramedic students for the realities of professional practice.

Methods: Employing a multi-modal methodology, this study engages with various data sources, including academic literature, regulatory documents, and interviews with key stakeholders in the paramedicine field. A comparative analysis with international jurisdictions is also conducted to identify potential areas for improvement and innovation within the Australian context. This methodological approach enables a comprehensive examination of the educational, regulatory, and professional frameworks that underpin paramedicine education in Australia, providing a solid foundation for the study’s findings and recommendations.

Findings: The findings suggest that while accreditation processes ensure baseline professional competency, they do not prescribe curriculum content, resulting in varied interpretations and implementation across institutions. This has led to inconsistencies in how key areas—such as primary healthcare, governance, and interprofessional collaboration—are integrated into paramedicine programs. Rather than attributing this solely to a lack of standardisation, the study acknowledges the broader challenge of balancing regulatory flexibility with the need for consistency in graduate preparedness. International comparisons further highlight how structured, but adaptable curriculum frameworks can support both innovation and coherence in education.

Discussion: The discussion synthesises key findings from an analysis of paramedicine curricula, accreditation frameworks, and evolving models of care. It reveals that while Australian paramedicine education programs demonstrate strong alignment with emergency response and acute care, significant gaps persist in primary healthcare, governance, and community-based care. The study highlights inconsistencies in curriculum integration across universities, reflecting the broader challenge of aligning educational standards with accreditation requirements.

A critical finding is that accreditation frameworks, although essential in ensuring professional competency, do not provide prescriptive curriculum guidance, resulting in variability in program design. The RESPIGHT model analysis revealed disparities in how universities integrate primary healthcare and interprofessional collaboration, underscoring concerns about graduate preparedness for expanded roles in healthcare systems. Additionally, international comparisons suggest that paramedicine education in Australia may benefit from adopting structured curriculum frameworks that strike a balance between regulatory oversight and curricular flexibility.

Conclusions and Recommendations: This study concludes that while accreditation provides an essential foundation for ensuring paramedic competence, variability in curriculum design has contributed to inconsistencies in graduate outcomes, particularly in areas aligned with expanded scopes of practice. It recommends the development of structured curriculum frameworks that align with accreditation standards while maintaining flexibility to respond to local and emerging healthcare needs. Enhanced emphasis on primary healthcare, leadership, and collaboration between education providers, industry, and regulatory bodies will be essential to preparing graduates for future practice.

To address these challenges, this study recommends a structured approach to curriculum development, incorporating standardised frameworks that align with accreditation requirements while allowing flexibility for emerging healthcare trends. Strengthening primary healthcare education, embedding governance and leadership training, and fostering stronger collaboration between universities, accreditation bodies, and industry stakeholders are critical steps in ensuring paramedic graduates are well-prepared for contemporary practice.

This work is © 2025 by Anthony Dennis Weber is licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).

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