Paramedic Educator Reference

Clinical Evidence Hierarchy

Who decides what's "true" in prehospital practice — and how confident should you be in it.

How to read this: These are the sources you check, roughly in order of authority for UK prehospital practice. But "authority" isn't the same as "quality of evidence" — a NICE guideline based on RCTs outweighs a JRCALC recommendation based on expert consensus. Always ask: what is this guidance actually based on?
NICE uses a formal grading system. JRCALC and others are less transparent. When teaching, it matters whether you're citing a Grade A recommendation from RCT evidence or a Grade D from expert opinion — your students should know the difference.
Grade Meaning Basis Teaching note
GRADE system (used in some NICE guidelines): An alternative to letter grades. Produces strong or conditional recommendations with high / moderate / low / very low certainty of evidence. Worth knowing as higher-level students will encounter it.

Before you teach a topic

Tap each item to check it off. This won't save between sessions.

When your knowledge feels rusty

Sequence to follow to get current quickly.

Red flags — things that get educators caught out