In the past, patient safety has attracted attention. However, little of it has been focused on the social skills necessary for paramedics. The aim of this article is to both highlight this deficiency, as well as the importance of examining such social skills which are necessary for crews in the emergency medical services. In this review, we present different terms described in the literature, and also the two most prevalent approaches: a non-technical skills approach and a competency approach. The non-technical skills approach has its origin in aviation. Flin et al. (2003) defined non-technical skills as the cognitive and social skills that complement technical skills, and contribute to safe and efficient task performance. The competency approach defines competencies as knowledge, skills, abilities and other characteristics or as a cluster of two or more these attributes (Marrelli, Tondora, & Hoge, 2005). Each competency is composed of behavioural indicators – specific descriptions of effective behaviour (Calhoun et al., 2008). In this article, we discuss the differences and similarities of both approaches and we focus on their critique.