1급 응급구조사의 직무역량과 행동지표 개발

Abstract

응급환자의 증가, 만성질병과 노인인구 증가로 병원 전 단계의 전문 응급처치를 제공해야하는 1급 응급구조사의 역할이 증가하고 있으며, 또한 빠르게 발전하고 있는 응급구조 분야는 응급처치와 이송을 넘어서 환자평가, 의학적 문제확인, 응급처치 제공, 이송결정, 이송기관 결정 및 이송 중 처치가 통합적으로 이루어져야 하는 전문직 과제에 직면하고 있다. 1급 응급구조사의 직무역량과 행동지표는 업무수행을 위한 역할 규명과 필요로 하는 능력을 판단할 수 있는 근거가 됨으로 타 직종과의 관계형성이나 1급 응급구조사의 전문직 발전에 기초자료로 활용될 수 있다. 본 연구의 목적은 1급 응급구조사의 직무역량과 행동지표를 개발하고, 개발된 직무역량과 행동지표의 중요도와 수행정도를 측정하여 그 현장적합성을 파악하기 위함이다. 본 연구는 방법론적 연구로 1급 응급구조사의 직무에 대한 문헌고찰, 현장조사와 인터뷰 자료를 통해 1급 응급구조사 직무내용 276개를 작성하였으며 이를 토대로 직무역량 7개, 세부역량 36개, 행동지표 200개의 예비항목을 작성하였다. 예비항목에 대한 초점집단 9인의 구성타당도 검증과정에서 직무역량 5개, 세부역량 31개, 행동지표 171개의 1급 응급구조사 직무역량과 행동지표(안)이 개발되었다. 이를 전문가 집단 10명에 의한 1, 2차 내용타당도 검증을 거쳐 직무역량 5개, 세부역량 30개, 행동지표 181개의 1급 응급구조사의 직무역량과 행동지표를 개발하였다. 내용타당도 검증을 위하여 내용타당도 지수(CVI)를 이용하였다. 최종 개발된 1급 응급구조사 직무역량 5개, 세부역량 30개, 행동지표 181개를 현장적합성 확인을 위해 현직 1급 응급구조사 200명을 대상으로 중요도와 수행정도의 차이를 확인하였으며 도구의 신뢰도는 Cronbach’s Alpha .81이었다. 본 연구의 결과를 요약하면 다음과 같다. 1. 1급 응급구조사의 직무역량은 ‘평가’, ‘의사결정’, ‘응급처치’, ‘이송’, ‘전문성’ 5개이며 세부역량 30개, 행동지표 181개를 개발하였다. 2. 1급 응급구조사의 직무역량과 행동지표의 현장적합성 검증은 중요도와 수행정도를 평균과 표준편차로 측정하였다. 전체 평균 점수는 4점 만점에 중요도 3.76점, 수행정도 3.49점으로 중요도가 수행정도에 비해 높게 나타났으며 그 차이가 통계적으로 유의미하였다(t=10.51 , p<.001). 3. 1급 응급구조사 직무역량의 중요도는 ‘응급처치’ 3.80점, ‘이송’ 3.80점, ‘의사결정’ 3.75점, ‘전문성’ 3.71점, ‘평가’ 3.61점의 순서이며, 수행정도는 ‘이송’ 3.88점, ‘응급처치’ 3.68점, ‘평가’ 3.47점, ‘의사결정’ 3.42점, ‘전문성’ 3.10점의 순서였다. 즉 ‘3. 응급처치’와 ‘4. 이송’은 중요도와 수행정도가 모두 평균점수에 비해 높은 직무역량이며, ‘1. 평가’, ‘2. 의사결정’, ‘5. 전문성’은 중요도와 수행정도가 평균점수보다 낮아 교육개선과 제도적 보완이 필요한 직무역량이다.;As the demands for professional emergency medical service in pre hospital field and hospital emergency center, paramedics of Korea are being produced since in 1995 and the field of emergency medical service is trying to employ paramedics to assess, do decision making, do treatment and transfer patient. However, there is no job competenecy and behavioral indicators review for Korean paramedics so the purpose of this study is to develop job competency and behavioral indicators for Korean paramedics and apply to the work and enhance the professionality. The purpose of this study is to develop the competencies of paramedics of Korea and the behavioral indicators, and with those as the foundation it is to measure the importance and the performance. This study is methodological research. Through prior consideration of documents and job observation with interview of paramedics, a preliminary draft which consisted of behavioral indicator according to job analysis present paramedics. And there upon a primary expert group discussed to develop the competency and the behavioral indicator for the paramedics. Developed competency and behavioral indicator went through the content validity using Content Validity Index(CVI) which was performed by an expert group consisting of 10 paramedics with over 5 years of practical experience in emergency center and prehospital facility. They performed the examination on the content validity twice by a process which drew the mutual agreement of the expert group. Analysis of the materials used CVI and all the other general characteristics were analyzed with descriptive statistics. Finally, 5 different competencies, 30 subcompetencies and 181 behavioral indicators of paramedics of korea helped measuring the importance of the present paramedic's competency and the performance. The scale's reliability Cronbach's Alpha value was .819. The results of this study are as follow. 1. The competencies of the paramedics are Assessment, Decision Making, Treatment, Transfer and Professionality with total number of 5 competencies, 30 subcompetencies and 181 behavioral indicators are included. 2. The importance of each competency and the performance of the paramedics were measured with Mean and Standard Deviation. The overall average grade of the importance was 3.76 and the average performance was 3.49, showing that the importance degree is higher than the performance. It was a statistically significant difference((t=10.51 , p<.001). 3. The importance and the performance were confirmed by Importance Performance Analysis and the result is as the following. The importance was high but the performance was low. The competencies which were included in a field with necessity for intensive management were 'Assessment', ‘Professionality' and ‘Decision making'. Both the importance and the performance were high and therefore they are considered important. In practical field, they were executed well and the satisfactory competencies were ‘Treatment' and ‘Transfer'. The job competency and behavioral indicators of paramedics, which were developed by this study are considered that they can be used as the effective guides in the practical field, they can confirm the competency in paramedics and they can also be used as basic materials for developing educational program and Human resource management.