Over the past two decades, paramedicine research has expanded significantly. While much of this work has been conducted within individual countries, there is now a critical need to foster international collaboration to improve knowledge synthesis and dissemination. This perspective paper draws on the authors’ experience conducting a multi-country study involving Canada, the USA, the UK, and Australia to reflect critically on the structural, methodological, and ethical challenges of international research in paramedicine. Rather than positioning the project as the central focus, it serves as a lens to explore broader issues that impact cross-jurisdictional research, such as differences in ethical review processes, variability in academic and regulatory infrastructures, and the complexity of designing context-sensitive methodologies across systems. These reflections highlight both tensions and opportunities for advancing paramedic research on a global scale. The paper underscores the importance of early engagement with partner organisations, flexible planning when working with operational clinicians, and deliberate strategies to foster mutual understanding within interdisciplinary teams.
Flanagan et al. (2026) studied this question.