Research That Drives Better EMS Performance
Sentinel Skills Systems is built upon doctoral research, peer-reviewed scholarship, and ongoing collaboration with EMS leaders dedicated to improving procedural competency and organizational performance.
Evidence-based resources for EMS leaders, medical directors, educators, researchers, and healthcare organizations.

Evidence Before Implementation
Meaningful improvements in emergency medical performance require more than new equipment or additional training sessions. They require a clear understanding of the organizational, educational, and operational factors that influence provider competency over time.
Sentinel Skills Systems was founded on the principle that practical solutions should be grounded in evidence. Every aspect of our competency framework has been informed by doctoral research, current literature, frontline EMS experience, and a commitment to continuous learning.
Research is not simply something we publish. It is the foundation of how we design, evaluate, and continually improve our implementation model.
Featured Publication
Improving Paramedic Airway Competency: Training and System Strategies for Sustaining ETI Skills
Journal of Emergency Medical Services (JEMS)
June 2026
Endotracheal intubation remains one of the most important but least frequently performed procedures in modern EMS. As opportunities for clinical exposure continue to decline, many agencies face increasing variability in provider proficiency despite meeting traditional training requirements.
This article examines why airway competency should be viewed as a system-level leadership responsibility rather than solely an individual provider issue. It presents practical strategies for creating continuous competency through structured skill repetition, operational integration, quality improvement alignment, leadership support, and ongoing performance evaluation.
The concepts presented in this article form an important component of Sentinel’s evidence-based competency framework and continue to guide the development of our implementation model.
Learn About Sentinel’s Airway Readiness Model
Building an Expanding Knowledge Base
Sentinel Skills Systems is committed to contributing to the advancement of EMS through ongoing research, professional publication, and educational scholarship. As additional work is published, this library will continue to grow.
Peer-Reviewed Journal Articles
โข Published articles
โข Articles currently under review
โข Future research publications
Professional Publications
โข Educational articles
โข Industry publications
โข Technical papers
Conference Presentations
โข EMS conferences
โข Leadership presentations
โข Educational seminars
โข Invited speaking engagements
White Papers & Resources
โข Operational guidance
โข Competency frameworks
โข Implementation guides
โข Leadership resources
Future Research Initiatives
โข Pilot program outcome evaluations
โข Competency measurement studies
โข Multi-site research collaborations
โข International comparative studies

The Research Behind Sentinel
Sentinel’s competency framework is grounded in doctoral research examining the organizational, educational, and operational factors affecting paramedic endotracheal intubation performance. Rather than relying solely on traditional continuing education models, this research explored how leadership practices, clinical exposure, skill retention, decision-making, and organizational systems influence procedural competency across EMS agencies. The findings continue to shape Sentinel’s evidence-based implementation model and future research initiatives.

Factors Affecting Paramedics’ Endotracheal Intubation: A Qualitative Case Study of Training, Skills, Decision-Making, and Management
University of Phoenix
Doctor of Management in Organizational Leadership
2026
ProQuest Dissertations & Theses Global
Using a qualitative case study approach, this research examined how EMS educators, emergency physicians, and EMS leaders perceive the organizational and educational factors that influence paramedic endotracheal intubation performance. Six major themes emerged, highlighting the importance of continuous clinical exposure, structured competency development, leadership engagement, quality assurance integration, cognitive workload management, and sustained organizational support. These findings became the conceptual foundation for Sentinel Skills Systems and continue to guide the development of practical, evidence-informed solutions for EMS agencies.
Committed to Continuous Learning

Evidence-Based
Every recommendation is informed by current research, operational experience, and continuous evaluation.

Operationally Relevant
Research should improve real-world EMS performance, not remain confined to academic journals.

Collaborative
We welcome opportunities to work with agencies, universities, researchers, and healthcare organizations.

Forward Looking
As EMS evolves, Sentinel remains committed to expanding the evidence supporting procedural competency and organizational readiness.
Looking Ahead
Improving procedural competency is an ongoing process that benefits from continued investigation and collaboration. Sentinel is actively pursuing additional publications, pilot program evaluations, collaborative research partnerships, and educational initiatives designed to strengthen competency management across EMS systems.
Future areas of interest include:
โข Airway competency systems
โข Skills retention and skill decay
โข Organizational leadership
โข Quality improvement and performance measurement
โข Simulation-based education
โข Clinical competency assessment
โข International EMS collaboration
โข Workforce readiness
Interested in Collaborating?
Sentinel welcomes inquiries from EMS agencies, hospitals, universities, medical directors, researchers, government organizations, and professional associations interested in collaborative research, educational initiatives, competency evaluation, or future publications. Together, we can continue advancing evidence-based approaches that strengthen emergency medical systems and improve patient care.

Research That Informs Practice. Practice That Inspires Better Research.
Sentinel Skills Systems believes meaningful improvements in emergency medical performance begin with evidence, collaboration, and a commitment to continuous competency development.
