Paramedics’ Perceptions of Training and Competence in Structured Documentation in the Finnish KEJO Electronic Patient Care Record

Abstract

Structured electronic patient care records can support consistent documentation, information transfer and secondary data use, but implementation depends on users’ competence and system compatibility with clinical work. Evidence concerning education and competence development for structured documentation in prehospital emergency care remains limited. This secondary analysis examined paramedics’ education and development needs and whether assessments of KEJO training adequacy, timing and documentation competence differed by age, educational background or the electronic patient care record previously used. Data originated from an anonymous cross-sectional web survey conducted in one Finnish wellbeing services county in February–March 2024. Responses from 137 professionals (response rate 30.4%) were examined using descriptive statistics and non-parametric group comparisons, contextualised by previously reported findings and an expanded inductive analysis of free-text responses. Overall, 46.7% considered theoretical instruction sufficient, and the same proportion considered face-to-face training sufficient. Most respondents (83.9%) considered the training-to-implementation interval too long, while 54.7% assessed their documentation competence positively. After Holm adjustment for multiple comparisons, no statistically significant differences were detected across the background groups. Qualitative findings emphasised hands-on practice, authentic cases, simulation, refresher training, concise update materials and timely support. Respondents distinguished educational needs from problems requiring system development. The comparisons provided no evidence of systematic differences between the groups examined. Training should be coordinated with implementation and user-centred system development as a continuous process rather than a single pre-launch event.