Disaster Medicine Core Competencies for Emergency Medical Technician Paramedics: A Comparative Analysis with Emergency Physicians

Introduction: In Taiwan, emergency medical technician paramedics (EMTPs) have received disaster management training similar to emergency medicine (EM) residents for the past two decades. However, differences in their roles suggest that their disaster medicine core competencies (DMCCs) may differ. This study aims to identify the DMCCs for EMTPs and compare them with those of EM residents to optimize their performance in disasters. Methods: A modified Delphi method was conducted over three rounds. A 41-item questionnaire, based on the National Standardized All-Hazard Disaster Core Competencies Task Force, was distributed to 21 experts, including 14 senior EMS medical directors and 7 senior EMTPs. Experts rated and ranked the DMCCs, and a consensus was reached after three rounds. A comparative analysis was conducted to highlight the prioritized DMCCs for EMTPs versus EM residents. Results: Twenty DMCCs with high consensus were identified. EMTPs and EM residents shared 12 DMCCs, including mass casualty incidents, mental health, prehospital disaster management, triage, personal protective equipment, identification, notification, activation and information collection, incident management system, decontamination, basic concepts and nomenclature of disaster medicine, disaster exercises, medical response in bioterrorism and biological emergencies, and medical response of chemical emergencies. EMTPs also prioritized 8 additional DMCCs, such as fire and burn mass casualty incidents, safety management, casualty transfer, surge capacity and surge capability, blast injuries, building collapse and medical response, casualty identification and tracking, and tactical medicine, which were not emphasized in EM residency training. Conclusion: The identified DMCCs lay the groundwork for a tailored disaster management curriculum for EMTPs in Taiwan.