A European paramedic curriculum for geriatric emergency medicine developed via a modified Delphi technique
A European paramedic curriculum for geriatric emergency medicine developed via a modified Delphi technique
BACKGROUND: Older emergency patients currently account for most European emergency medical service dispatches. Due to demographic changes and increasing comorbidities in advanced age, this number is expected to rise substantially in the coming years. Prehospital professionals require specialised training to provide high-quality care for complex, multimorbid patients. The aim of this study is to define minimum competencies for paramedic education in Europe on the management of emergencies in older adults.
METHODS: A modified electronic Delphi study was performed from January 2023 to November 2024, comprising two appraisal rounds. A narrative literature review was conducted to identify relevant topics and domains in prehospital geriatric emergency medicine, providing the foundation for an interprofessional core group to establish 58 initial learning objectives. Learning objectives were assigned to competence levels based on a revised Bloom's Taxonomy.
RESULTS: In Round 1, 45 of 58 competence-based learning objectives were accepted (77.6%) with average agreement 83.2% [range: 70.8-93.9%]. 13 declined learning objectives were revised, including merging and splitting of learning objectives, adjusting competence levels, and grouping domains. In Round 2, all 12 adapted learning objectives were accepted with average agreement 87.1% [range: 75-100%]. The final curriculum has 57 learning objectives in 12 domains. This consensus was achieved with contributions from Delphi panellists across 27 European countries. The domains include: risk stratification; indicators of serious health problems; altered mental status; clinical assessment; falls; trauma; medication; communication; medical history; frailty; palliative and end-of-life care; positioning and transport; and social, psychological and legal aspects.
CONCLUSIONS: This European curriculum for prehospital geriatric emergency medicine represents a first step towards systematically integrating these geriatric-specific competencies into paramedic education. It can further serve as a foundation for standardised training programs aimed at addressing the complex needs of older emergency patients.
Aged, Allied Health Personnel/education, Clinical Competence, Curriculum, Delphi Technique, Emergency Medical Services, Emergency Medical Technicians/education, Emergency Medicine/education, Europe, Female, Geriatrics/education, Humans, Male, Paramedics
Krohn, Jan-Niklas
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Barrett, Jack
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Heeren, Pieter
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Lim, Stephen
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Moloney, Elizabeth
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Nickel, Christian
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van Oppen, James
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Sandig, Nicolai
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Unlu, Luca
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Singler, Katrin
08e0b9b1-0830-4c2f-b6fb-f801f5c1f13a
12 January 2026
Krohn, Jan-Niklas
d229e308-8983-4644-a661-4faa217db19a
Barrett, Jack
aa853ec1-2196-49ef-909b-287281105775
Heeren, Pieter
33f58996-369a-46c6-8422-e2801913fc08
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Moloney, Elizabeth
80ad82db-b653-4994-a9d3-75330d097595
Nickel, Christian
d1860afb-a9e0-4d6b-bab9-92b58cfd01dd
van Oppen, James
0a1e0979-81f4-46e8-b025-87f42f473e9e
Sandig, Nicolai
b0ffd9ee-83d6-42f9-b881-3f5734dbfd68
Unlu, Luca
71087e4b-b361-43b6-bfbe-9943b7d38abd
Singler, Katrin
08e0b9b1-0830-4c2f-b6fb-f801f5c1f13a
Krohn, Jan-Niklas, Barrett, Jack, Heeren, Pieter, Lim, Stephen, Moloney, Elizabeth, Nickel, Christian, van Oppen, James, Sandig, Nicolai, Unlu, Luca and Singler, Katrin
(2026)
A European paramedic curriculum for geriatric emergency medicine developed via a modified Delphi technique.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 34 (1), [14].
(doi:10.1186/s13049-026-01550-3).
Abstract
BACKGROUND: Older emergency patients currently account for most European emergency medical service dispatches. Due to demographic changes and increasing comorbidities in advanced age, this number is expected to rise substantially in the coming years. Prehospital professionals require specialised training to provide high-quality care for complex, multimorbid patients. The aim of this study is to define minimum competencies for paramedic education in Europe on the management of emergencies in older adults.
METHODS: A modified electronic Delphi study was performed from January 2023 to November 2024, comprising two appraisal rounds. A narrative literature review was conducted to identify relevant topics and domains in prehospital geriatric emergency medicine, providing the foundation for an interprofessional core group to establish 58 initial learning objectives. Learning objectives were assigned to competence levels based on a revised Bloom's Taxonomy.
RESULTS: In Round 1, 45 of 58 competence-based learning objectives were accepted (77.6%) with average agreement 83.2% [range: 70.8-93.9%]. 13 declined learning objectives were revised, including merging and splitting of learning objectives, adjusting competence levels, and grouping domains. In Round 2, all 12 adapted learning objectives were accepted with average agreement 87.1% [range: 75-100%]. The final curriculum has 57 learning objectives in 12 domains. This consensus was achieved with contributions from Delphi panellists across 27 European countries. The domains include: risk stratification; indicators of serious health problems; altered mental status; clinical assessment; falls; trauma; medication; communication; medical history; frailty; palliative and end-of-life care; positioning and transport; and social, psychological and legal aspects.
CONCLUSIONS: This European curriculum for prehospital geriatric emergency medicine represents a first step towards systematically integrating these geriatric-specific competencies into paramedic education. It can further serve as a foundation for standardised training programs aimed at addressing the complex needs of older emergency patients.
Text
s13049-026-01550-3
- Version of Record
More information
Accepted/In Press date: 5 January 2026
Published date: 12 January 2026
Additional Information:
© 2026. The Author(s).
Keywords:
Aged, Allied Health Personnel/education, Clinical Competence, Curriculum, Delphi Technique, Emergency Medical Services, Emergency Medical Technicians/education, Emergency Medicine/education, Europe, Female, Geriatrics/education, Humans, Male, Paramedics
Identifiers
Local EPrints ID: 509622
URI: http://eprints.soton.ac.uk/id/eprint/509622
ISSN: 1757-7241
PURE UUID: 8eed1ca7-fb05-40c4-996e-3776dac51538
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Date deposited: 26 Feb 2026 18:03
Last modified: 07 Mar 2026 03:27
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Contributors
Author:
Jan-Niklas Krohn
Author:
Jack Barrett
Author:
Pieter Heeren
Author:
Elizabeth Moloney
Author:
Christian Nickel
Author:
James van Oppen
Author:
Nicolai Sandig
Author:
Luca Unlu
Author:
Katrin Singler
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