International Journal of Preventive Medicine (Int J Prev Med)2008-78021512202501064753EN1 Department of Health in Emergencies and Disasters, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan2 Health Management and Economics Research Center, Department of Health in Disasters and Emergencies, Isfahan University of Medical Sciences, Isfahan3 Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences(TUMS), Tehran, Iran, 4 Climate Change and Health Research Center (CCHRC), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran5 Health Management and Economics Research Center, Department of Health in Disasters and Emergencies, Isfahan University of Medical Sciences, Isfahan6 Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America, 7 Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland20250106Background: Climate change poses significant threats to the health and safety of communities worldwide. Extreme weather events can disrupt critical infrastructure and overwhelm emergency medical services (EMS) systems. As the frequency and intensity of these climate‑related disasters continue to increase, it is essential that EMS organizations develop robust strategies to enhance their resilience. One important step in building climate‑resilient EMS systems is the development of comprehensive assessment tools. Developing a comprehensive tool for assessing the resilience of EMS in the face of climate change. Methods: This research employs an applied, mixed‑methods approach to investigate the development and validation of the Emergency Medical Services Resilience Assessment (EMSRA) tool. The study will be executed across four key phases: (a) A scoping review will be conducted to identify the global dimensions and components of EMS systems that demonstrate resilience to the impacts of climate change. (b) A qualitative study, involving semistructured interviews, will be undertaken to explore the specific dimensions and components of EMS resilience within the Iranian context. (c) Based on the findings from the scoping review and qualitative inquiry, assessment items related to EMS resilience in climate change will be extracted and synthesized to develop a pilot version of the EMSRA tool. (d) The pilot EMSRA tool will undergo a rigorous process of quantitative and qualitative validation, including an evaluation of its psychometric properties, to assess the resilience of EMS systems in the face of climate‑related challenges. Conclusions: The development of EMSRA tool will enable the assessment and enhancement of climate change resilience within the national and provincial EMS systems, providing critical data to inform evidence‑based strategies and plans for strengthening EMS against the impacts of severe climate changes.http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2964http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2964/717718805