Maintaining competency: a qualitative study of clinical supervision and mentorship as a framework for specialist paramedics

Introduction: The aim of this study was to explore the factors influencing the maintenance of clinical competence and the effectiveness of the specialist paramedic in the context of mentorship, from the specialist paramedic’s own perspective. Methods: Semi-structured interviews were conducted with eight specialist paramedics in four regions of one ambulance service. Thematic analysis and coding were used to explore the data and identify emergent themes. Results: The study identified three key themes: appropriate clinical exposure; support and development; and opportunity for reflection. A tailored clinical leadership and mentorship model is required to maintain competency and effectiveness of specialist paramedics. Participants valued a model that delivered support, development and role clarity. Experienced advanced practitioners as mentors and organisational commitment were highlighted as essential components. Conclusions: Mentorship is an essential training requirement in extended roles to maximise efficacy of complex care out of hospital, to maintain clinical competence and as a source of motivation and psychological support.