From professional competence to coordinated field functioning: a qualitative study of disaster response readiness among members of disaster-deployable emergency medical teams in China

Abstract

Abstract

Disaster response readiness is essential to the effective deployment of emergency medical teams (EMTs). In this study, EMTs refer to multidisciplinary, disaster-deployable medical units supporting health services during major emergencies, outbreaks, and disasters, rather than routine local or regional prehospital EMS, including paramedic- or ambulance-based teams providing day-to-day emergency response, transport, and initial stabilisation. As readiness is commonly framed in terms of competencies, training completion, or deployability, this study explored how EMT members understood disaster response readiness and the core dimensions they associated with it. A qualitative descriptive study was conducted in Sichuan Province, China, with members of three national disaster-deployable emergency medical teams. Data were collected through two sequential phases of semi-structured, face-to-face, in-depth interviews. In Phase 1, 29 EMT members were interviewed. In Phase 2, 9 of these participants took part in supplementary interviews to clarify and deepen issues emerging from the preliminary analysis. Interview data were analysed using thematic analysis, with the two phases interpreted sequentially and then integrated. Participants understood disaster response readiness not as a fixed inventory of competencies, but as an enacted and context-dependent capacity to function effectively in disaster settings. Four interrelated themes were identified: (1) professional competence is an essential foundation, but not readiness itself; (2) readiness requires reorientation from hospital practice to disaster-task functioning; (3) readiness is shown by sustained functioning under pressure, uncertainty, and risk; and (4) readiness is enacted collectively through teams, leadership, and organisational support. Across participant roles, differences lay mainly in emphasis: clinical participants more often highlighted triage, adaptation of care, and functional endurance, whereas leadership, logistical, and administrative participants placed greater emphasis on coordination, operational order, and enabling support systems. From the perspective of members of disaster-deployable EMTs, disaster response readiness is better understood as coordinated field functioning rather than competence possession alone. Readiness is enacted through the interaction of individual capability, disaster-task adaptation, sustained functioning, and team and organisational support. These findings may inform EMT training, drills, readiness assessment, and capability development by encouraging greater attention to how readiness is operationalised in practice. Not applicable.