Methodology for the development of a Canadian national EMS research agenda

Paramedics, educators, EMS managers, medical directors, researchers and other key stakeholders from across Canada will be purposefully recruited to participate in this mixed methods study, which consists of three phases: 1) qualitative interviews with a selection of the study participants, who will be asked about their experience and opinions about the four study objectives, 2) a facilitated roundtable discussion, in which all participants will explore and discuss the study objectives, and 3) an online Delphi consensus survey, in which all participants will be asked to score the importance of each topic discovered during the interviews and roundtable as they relate to the study objectives. Results will be analyzed to determine the level of consensus achieved for each topic.A mixed methods approach will be used to address the four study objectives. We anticipate that the keys to success will be: 1) ensuring a representative sample of EMS stakeholders, 2) fostering an open and collaborative roundtable discussion, and 3) adhering to a predefined approach to measure consensus on each topic. Steps have been taken in the methodology to address each of these a priori concerns.Evidence-based medicine is the "...conscientious, explicit, and judicious use of current best evidence in making decisions..."[1]. The practice of evidence-based medicine combines individual and organizational experience and expertise with the best available evidence to guide clinical care and system design. The challenge for many health disciplines, including emergency medical services (EMS), is the scarcity of research from which best evidence can be derived [2,3].EMS has traditionally focused on emergency response to the sick and injured in the prehospital environment, and inter-facility transport. The last three decades have seen considerable expansion of the scope of practice of EMS personnel and the sophistication of EMS operations. EMS systems and paramedics are now seen as integral parts of th