Paramedics as researchers: A systematic review of paramedic perspectives of engaging in research activity from training to practice

Background: The need for a stronger evidence-base in paramedicine has precipitated a rapid development of pre-hospital research agendas. Paramedics are increasingly involved in research, leading to changes in their role. Yet the integration of research responsibilities has proven to be challenging, resulting in varying attitudes and levels of engagement. Objective: This systematic review aimed to explore paramedics’ views and experiences of research as researchers during training and within practice. Methods: A systematic search was undertaken across 6 databases. Qualitative empirical peer-reviewed articles which discussed paramedic perspectives on engaging with research activity were included. Of 10,594 articles initially identified, 11 were included in the final synthesis following quality appraisal. Data were extracted and subjected to narrative synthesis. Results: Four themes were identified: motivation to engage, moral dilemmas, structural issues within the profession, and reflections on trial involvement. Attitudes towards research, understanding of related concepts, and the drive for patient benefit were interwoven core issues. Conclusion: Research was highly valued when links to patient benefit were obvious, however, this review highlighted some cultural resistance to research, particularly regarding informed consent and changes to standard practice. Paramedic research methods training should provide structured opportunities to explore concerns and emphasize the role of research in developing a high-quality evidence base to underpin safe practice. Currently there is inadequate organisational support for paramedics to engage effectively in research activity, with minimal allocations of time, training, and remuneration. Without properly integrating research activity into the paramedic role, their capacity to engage with research activity is limited.