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Violence against paramedics is increasing across Canada and internationally, with frontline clinicians experiencing some of the highest rates of workplace violence in healthcare. Addressing this reality requires more than resilience training — it demands leadership, culture change, and system accountability. In this episode of The Inflection Point, we sit down with Mandy Johnston, a frontline paramedic turned system-level leader, to explore the leadership strategies behind the External Violence Against Paramedics (EVAP) program. Mandy shares her journey from the field to leading a provincial initiative focused on: Improving reporting of external violence Building trust with frontline paramedics Translating data into policy, training, and tangible system change Sustaining momentum in emotionally demanding advocacy work This is a practical, evidence-informed conversation about what real culture change looks like in paramedicine — and why leadership behaviour matters more than policy statements alone. What You’ll Learn Why violence against paramedics is a system-level problem How leadership shapes reporting culture and psychological safety The hidden emotional toll of advocacy and change leadership How EVAP moved from awareness to measurable impact What healthcare leaders can learn from paramedicine Episode Timestamps 00:00 Introduction and Initial Thoughts 00:12 Empowerment and Leadership 00:58 Guest Introduction and Initial Reactions 01:58 Challenges and Stress in the Role 02:52 The EVAP Program and Its Impact 09:56 Leadership and Mentorship 14:55 Cultural Change and Reporting 17:24 The EVAP Work Group 34:40 Demonstrating Tangible Change 35:16 Building Trust Through Transparency 35:43 Launching New Policies and Campaigns 36:37 Impact of Training and Reporting 37:17 Leadership and Culture Change 38:08 Personal Stories and Presentation Skills 40:30 Overcoming Challenges in Healthcare 42:49 Sustaining and Expanding EVAP 58:29 Final Thoughts and Call to Action About The Inflection Point The Inflection Point explores paramedicine, emergency medicine, leadership, health quality, and system innovation through expert interviews and frontline insight. Podcast Website: https://theinflectionpoint.podbean.com/ Support the Podcast If you found this episode valuable, please like, subscribe, and share to support conversations around resilience, mental health, and first responders. Disclaimer (Canada / Ontario) This podcast is intended for educational and informational purposes only. The views expressed are those of the participants and do not represent the policies or positions of any employer, paramedic service, regulatory college, base hospital, medical director, or government agency. This content does not constitute medical advice, legal advice, operational direction, or professional instruction. Listeners are responsible for practicing within their legislated scope of practice and in accordance with applicable provincial legislation, regulatory college standards, employer policies, and local Medical Directives. In Ontario, paramedics must follow the directives and oversight of their Base Hospital and Medical Director. Production Notes Edited in Wondershare Filmora 14 and DESCRIPT AI Script, transcription, and voice cleanup with Descript AI Hashtags #Paramedicine #EMS #FirstResponders #WorkplaceViolence #ViolenceAgainstParamedics #HealthcareLeadership #PsychologicalSafety #HealthQuality #PatientSafety #SystemLeadership #CanadianEMS #OntarioParamedics #TheInflectionPoint #HealthcarePodcast #ParamedicPodcast