Talal AlShammari

Scopus Publications

The Future of Artificial Intelligence in Emergency Medical Services by 2030: An International Consensus Report
Talal AlShammari
Jacep Open, 2026
Objectives: Artificial intelligence (AI) is an application of digital technology with considerable potential to improve quality, safety, and access; however, research on the future of AI in the health-care system and specifically emergency medical services (EMS) remains limited. The aim of this research is to anticipate the possible effects of using this technology on EMS. Methods: A Delphi panel was recruited based on proven international expertise in EMS to contribute to an iterative consensus-based Delphi study design. Data collection was initiated in September 2024 and ended in March 2025. Results: The 3-round study involved 27 expert participants and a 3-member steering group and was concluded at round 3, with 7 items not reaching consensus. The final result included 81 items with expert consensus divided into 6 EMS domains, namely communication, clinical, education, management, operations, and ethics. Conclusion: The forecasted items, although with a limited number of experts, provide an insightful model for an in-depth understanding of the future of AI in EMS and other health care, educational, and associated industries.
Women’s Leadership in Emergency Medical Services: Social and Organizational Influences
Samer Al Haliq, Talal AlShammari
Journal of Nature and Science of Medicine, 2026
Background: While women are increasingly represented in healthcare, their leadership in emergency medical services (EMS) remains limited. In Saudi Arabia, EMS is expanding, but gender disparities persist. Objectives: This study explores social and organizational factors shaping women’s leadership success in the Saudi paramedic profession and their impact on team dynamics and culturally sensitive emergency care delivery. Materials and Methods: A cross-sectional study was conducted among 250 paramedics in Saudi Arabia using a self-administered online survey between April and November 2022. The survey, adapted from Westring et al . (2012), assessed perceived gender bias and leadership support using a validated 14-item, 5-point Likert scale. Participants were required to have at least 2 years of EMS experience. Reliability was confirmed through a pilot study (Cronbach’s α =0.93). Data were analyzed using descriptive statistics, independent samples t -tests, and an appropriate correlation method, with significance set at P < 0.05. Results: Inclusive leadership practices showed high agreement (mean = 3.73, standard deviation = 0.94). Gender (point-biserial r = −0.142, P = 0.047, weak) and education level (Spearman r = −0.141, P = 0.048, weak) were negatively associated with perceived leadership support, whereas years of experience (Pearson r = 0.162, P = 0.023, weak) showed a positive association. Independent-samples t-tests indicated that males reported more favorable perceptions of work-life balance ( t = 2.13, P = 0.036) and organizational policy clarity ( t = 2.45, P = 0.018). Conclusions: Inclusive leadership was valued, but gender and education were linked to lower support perceptions, whereas experience showed a positive association. Males reported more favorable views of work-life balance and policy clarity, highlighting the need for gender-responsive strategies in EMS.
Communication handover barriers among nurses and paramedics in emergency care settings
Samer Al Haliq, Talal AlShammari
BMC Nursing, 2025
BACKGROUND: Clear communication during emergency care handovers is crucial for patient safety, but barriers can compromise the process, increasing risks. The aim of this study is to compare and assess communication handover barriers perceived by nurses and paramedics in emergency care settings. METHODS: A cross-sectional survey was conducted using the modified Nursing Handover Perspectives Questionnaire. A convenience sample was used to recruit nurses and paramedics from multiple prehospital and emergency care settings in the Eastern Province of Saudi Arabia. Data were analyzed with SPSS 29, employing descriptive statistics, independent samples t-tests to compare scores between nurses and paramedics. Pearson correlations were utilized to explore relationships between perceptions and demographic variables. Statistical significance was set at P < 0.05. RESULTS: Out of 250 distributed questionnaires, 219 were completed (87.6% response rate). Most participants were male (75.3%) and held a bachelor's degree (70.8%). Nurses tended to be older compared to paramedics, who were younger. Nurses reported greater awareness regarding the omission of important vital sign measurements during handover (p = 0.006) and greater opportunities to ask questions about things they did not understand (p = 0.049). Paramedics reported experiencing interruptions during handover at a higher rate than nurses (p = 0.036). Nurses also perceived greater benefit in using a structured handover tool like ISBAR for improving communication (p = 0.014) and patient safety (p = 0.019). No significant correlations were found between demographic variables and perceptions of communication handover barriers. CONCLUSIONS: Nurses reported a higher awareness of omitted vital signs during handover, while paramedics experienced more frequent interruptions. Addressing these barriers through targeted training and the use of supportive technologies may improve communication and patient safety in emergency care. Strengthening collaboration between nurses and paramedics, along with reducing interruptions, could support more effective care transitions. This study adds a comparative perspective on handover barriers in emergency settings and identifies areas for potential intervention. The findings contribute to ongoing discussions on enhancing handover practices and highlight the perceived value of structured frameworks and technology-driven solutions for improving communication efficiency and safety.
Empowering women in emergency care: The roles of work-life balance and equal opportunity in navigating success in the paramedic profession
Mohammed Al Jumaan, Samer Al Haliq, Rateb Abuzeid, Mohamed Kandil, Talal AlShammari, Manal Hajjaj, Lutfiah Qawwas, Essa Ojaim Al Bahri
Work, 2025
Background Despite efforts to boost female workforce participation, there remains a shortage of female paramedics relative to Saudi Arabia's female population. Objective This study explores how work-life balance and equal opportunities empower women in the paramedic profession, focusing on their roles in achieving success and overcoming challenges in emergency care settings. Methods Cross-sectional descriptive research was employed using a questionnaire survey conducted among paramedics in Saudi Arabia (n = 250) and a sample of the research (n = 197; response rate: 78.8%). An adapted instrument of the Culture Conducive to Women's Academic Success survey was used to collect data. Using statistical software (SPSS 29), data were coded numerically, and statistical analysis was performed for both descriptive and inferential purposes. In addition, independent samples t-test was used to analyzed data on variables including age, gender, job title, level of education, and years of experience. Results Descriptive statistics revealed high agreement overall, particularly regarding salaries and professional social events. However, there was moderate disagreement about protected time for research. An independent t-test indicated significant gender differences, with female paramedics reporting less favorable experiences in access to opportunities and work-life balance support. Yet, demographic characteristics like age, gender, job title, education level, and experience did not significantly influence success factor scores. Conclusion While female paramedics perceive high equality in career access and work-life balance support, areas for improvement exist, such as research time and reducing stigma around family responsibilities. Policymakers may consider interventions to address gender disparities and enhance female paramedics’ experiences.
Outcomes of COVID-19 During the First Wave in Saudi Arabia: An Observational Study of ICU Cases from a Single Hospital
Saeed A. Alqahtani, Talal M. Alshammari, Eidan M. Alzahrani, Abeer A. Alaohali, Jaber S. Alqahtani, Yahya A. Alzahrani, Ahmad A. Alrawashdeh, Brett Williams, Mohammed A. Aljumaan, Amal H. Alsulaibikh, Mohannad A. Alghamdi, Mohammed A. Almulhim, Shaya Y. Alqahtani, Sarah Al-Ahmadi, Mohammed S. Alshahrani
Journal of Clinical Medicine, 2025
Background/Objectives: Mortality from COVID-19 in intensive care units (ICUs) was not clearly reported in many regions during the first wave. We aimed to assess the characteristics and outcomes of ICU patients with COVID-19 in Saudi Arabia. Methods: This was a secondary data analysis of the Convalescent Plasma Trial. All patients who were recruited from King Fahad Hospital of the University (KFHU) in the Eastern Region of Saudi Arabia between 13 March 2020 and 13 September 2020 were included. Characteristics and outcomes, differences in characteristics and outcomes between Saudi and non-Saudi populations, and predictors of mortality were assessed. Results: The KFHU recruited 185 ICU patients with COVID-19. Of those, 90 (48.6%) were Saudi, and 95 (51.4%) were non-Saudi. The overall mean age was 56.7 years, and 71.9% were males. Compared with Saudis, non-Saudis were younger, with a mean age of 54.4 years, were more likely to be males (81.1%), and had a higher median respiratory rate (28.0 breaths/min vs. 24.0), a lower percentage of blood-oxygen saturation (86.0% vs. 91.0%), and higher median levels of ferritin per µg/L (820 vs. 550). The overall mortality rate was 33.0% (n = 61). The mortality rate in non-Saudis (42.1%) was higher than that in Saudis (23.3%). The variables associated with increased mortality included non-Saudi status (odds ratio [OR] 2.66; 95% CI: 1.05, 6.72), ferritin (OR 1.01; 95% CI: 1.00, 1.02), and intubation (OR 8.55; 95% CI: 2.92, 24.97). Conclusions: Since the mortality rate in non-Saudis was greater than that in Saudis, more efforts should be made to improve social determinants of health across non-Saudis in our region.
Applications and Performance of Machine Learning Algorithms in Emergency Medical Services: A Scoping Review
Ahmad Alrawashdeh, Saeed Alqahtani, Zaid I. Alkhatib, Khalid Kheirallah, Nebras Y. Melhem, Mahmoud Alwidyan, Arwa M. Al-Dekah, Talal Alshammari, Ziad Nehme
Prehospital and Disaster Medicine, 2024
Objective:The aim of this study was to summarize the literature on the applications of machine learning (ML) and their performance in Emergency Medical Services (EMS).Methods:Four relevant electronic databases were searched (from inception through January 2024) for all original studies that employed EMS-guided ML algorithms to enhance the clinical and operational performance of EMS. Two reviewers screened the retrieved studies and extracted relevant data from the included studies. The characteristics of included studies, employed ML algorithms, and their performance were quantitively described across primary domains and subdomains.Results:This review included a total of 164 studies published from 2005 through 2024. Of those, 125 were clinical domain focused and 39 were operational. The characteristics of ML algorithms such as sample size, number and type of input features, and performance varied between and within domains and subdomains of applications. Clinical applications of ML algorithms involved triage or diagnosis classification (n = 62), treatment prediction (n = 12), or clinical outcome prediction (n = 50), mainly for out-of-hospital cardiac arrest/OHCA (n = 62), cardiovascular diseases/CVDs (n = 19), and trauma (n = 24). The performance of these ML algorithms varied, with a median area under the receiver operating characteristic curve (AUC) of 85.6%, accuracy of 88.1%, sensitivity of 86.05%, and specificity of 86.5%. Within the operational studies, the operational task of most ML algorithms was ambulance allocation (n = 21), followed by ambulance detection (n = 5), ambulance deployment (n = 5), route optimization (n = 5), and quality assurance (n = 3). The performance of all operational ML algorithms varied and had a median AUC of 96.1%, accuracy of 90.0%, sensitivity of 94.4%, and specificity of 87.7%. Generally, neural network and ensemble algorithms, to some degree, out-performed other ML algorithms.Conclusion:Triaging and managing different prehospital medical conditions and augmenting ambulance performance can be improved by ML algorithms. Future reports should focus on a specific clinical condition or operational task to improve the precision of the performance metrics of ML models.
What Drives Paramedics to Serve in Rural and Remote Communities?
Samer Al Haliq, Talal AlShammari
Healthcare Switzerland, 2024
In this study, we investigated the motivations of paramedic staff serving in rural and remote communities, given the consistent shortage of healthcare workers in these areas. Using a modified Global Motivation Scale (GMS) questionnaire, we surveyed 450 paramedics in Saudi Arabia, analyzing data from 379 respondents (response rate: 84.2%) with SPSS 29. Chi-square tests explored demographic links to motivation, and ANOVA compared mean scores across groups (p < 0.05). The results showed a moderate overall motivation (M = 3.37, SD = 0.82), with high intrinsic motivation (M = 3.67, SD = 0.96) and relatively high extrinsic motivation, notably in integration (M = 3.48) and identification (M = 3.41). Age and gender significantly influenced motivation (p < 0.05), with individuals aged 24–30 years exhibiting markedly lower motivation. ANOVA confirmed the age, gender, marital status (unmarried), and EMS experience (5–10 years) as significant factors, while the education, job title, and employment site had no significant impact. Scheffe’s post hoc test revealed age-related differences and emphasized the importance of EMS experience. This study suggests that both intrinsic factors and external pressures contribute to the lower motivation in adults in their mid-twenties in rural areas. Experience, particularly in EMS, significantly impacts motivation levels. We recommend tailored interventions that focus on intrinsic motivation and address external pressures to improve retention and care quality.
Electrocardiographic interpretation by emergency medical services professionals in Saudi Arabia: A cross sectional study
Mohammed Abdullah Alalwan, Talal Alshammari, Hassan Alawjan, Hassan Alkhayat, Ahmed Alsaleh, Ibrahim Alamri, Alaa Aldubaikel, Jaber Alqahtani, Ahmad Alrawashdeh, Saeed Alqahtani
Plos One, 2023
BackgroundManagement of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia.MethodsBetween Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed.ResultsDuring the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3rddegree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001).ConclusionWhile the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.
The Perceptions and Expectations of the Clinical Learning Environment in Saudi Arabia: a Multidisciplinary Study
Talal AlShammari, Saeed Alqahtani, Mohammed Jumaan, Rana Alameri, Cameron Gosling, Bronwyn Beovich, Brett Williams, Samer Haliq, Mohamed Kandil
Medical Archives, 2023
Background: The clinical learning environment is a fundamental component of healthcare education. In this setting, students can develop the skills and knowledge necessary to become competent and efficient healthcare practitioners. Due to the importance of clinically based education, it is crucial to have a valid and reliable tool to enable its evaluation. Objective: The aim of this study was to use the Clinical Learning Environment Inventory (CLEI) to examine the perceptions of Saudi undergraduate healthcare students regarding their actual and preferred clinical learning environment and explore the differences between the two viewpoints. Methods: A cross-sectional survey design was utilised with a cohort of Saudi undergraduate healthcare students. Data regarding perceptions of the ‘actual’ and ‘preferred’ clinical learning environments were gathered with the Clinical Learning Environment Inventory tool. Results: A total of 194 students participated and nine healthcare disciplines were represented. The highest mean score for both ‘actual’ and ‘preferred’ clinical learning environment was for the subscale Task Orientation. Significant differences between ‘actual’ and ‘preferred’ environments were demonstrated for Innovation and Individualization, with both subscales scoring higher for the ‘preferred’ environment. All five subscales–Individualization, Innovation, Involvement, Personalization, and Task Orientation–appear to be important aspects contributing to student satisfaction with their clinical learning environment. Conclusion: Saudi healthcare students demonstrate a preference for a clinical learning environment with the utilization of new and interesting experiences, as well as recognition and accommodation of student individuality. Additionally, student satisfaction appears to be multifactorial in origin. Therefore, there may be many avenues available to enhance the clinical experiences of healthcare students, which is vitally important for the optimization of clinical learning opportunities.
Saudi Healthcare Students' Perceptions and Beliefs About Immunizations: a Descriptive, Cross-Sectional Study
Talal Alshammari, Saeed Alqahtani, Mohammed Jumaan, Rana Alameri, Abdulaziz Ghaseb, Bronwyn Beovich, Samer Haliq, Brett Williams
Medical Archives, 2022
Background: Immunization has been one of the most successful public health measures ever undertaken. However, a degree of hesitancy about vaccine use still exists. Healthcare professionals are in a unique position to provide advice and education to the public and may influence the decision to undergo immunization. Objective: The aim of this study was to explore perceptions and beliefs regarding immunizations and immunization-preventable diseases. Methods: A descriptive cross-sectional study was undertaken at the Imam Abdulrahman bin Faisal University, located in Dammam, Saudi Arabia. In the Kingdom of Saudi Arabia, a survey of 564 Saudi undergraduate healthcare students was conducted. 77.8% of participants replied (439). Information was collected regarding perceptions of; severity of immunization-preventable diseases, contracting these diseases, immunization safety, and immunization beliefs. The statistical analysis was performed using the Statistical Package for the Social Sciences (IBM SPSS v25). Non-parametric analyses were utilized. Descriptive data were generated as appropriate, including frequencies, median, and inter-quartile range. Statistical relationships of demographic variables were explored using Kruskal Wallis H-Test and Spearman’s Rank-Order Correlation. A p-value < 0.05 was considered statistically significant. Results: Meningitis was perceived as the most severe disease and COVID-19 as having the highest likelihood of infection. Concern regarding vaccine side effects was most evident for the COVID-19 vaccine. Student year level and profession resulted in statistically significant differences for all three assessed perceptions. Substantial differences were also identified regarding views on immunization belief statements. Conclusion: This study identified considerable heterogeneity in Saudi healthcare students' perceptions and beliefs regarding immunization-preventable diseases and vaccination. Further education is required to produce well-informed and confident healthcare professionals around these issues.
National study of emergency medical services core competencies in Saudi Arabia: An exploratory factor analysis
Talal AlShammari, Paul Jennings, Brett Williams
International Journal of Emergency Services, 2020
Current state of trauma services in Saudi Arabia
Abdullah Alshamrani, Talal Alshammari, Simon Sawyer, Brett Williams
Journal of Emergency Medicine Trauma and Acute Care, 2020
National study of emergency medical services core competencies: A confirmatory factor analysis
Talal AlShammari, Paul Jennings, Brett Williams
Australasian Journal of Paramedicine, 2019
Emergency medical services core competencies: A delphi study
Talal AlShammari, Paul Jennings, Brett Williams
Australasian Journal of Paramedicine, 2019
National study of Saudi Arabian emergency medical services professional profiles: An inferential analysis
Talal AlShammari, Paul Jennings, Brett Williams
Australasian Journal of Paramedicine, 2019
Emergency Medical Services Core Competencies: A Scoping Review
Talal AlShammari, Paul A. Jennings, Brett Williams
Health Professions Education, 2018
Evolution of emergency medical services in Saudi Arabia
Talal AlShammari, Paul Jennings, Brett Williams
Journal of Emergency Medicine Trauma and Acute Care, 2017

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