The aim was to investigate professional confidence in the roles of ambulance and medi- cal incident commander (AIC and MIC), and how it influences achievement of perfor- mance indicators at an incident site. A web survey based on theoretical constructs (e.g., social identity, efficacy, accountability) and questions about prehospital emergency care connected to the roles were used (n = 426 Swedish ambulance nurses and emer- gency medical technicians). The results showed that social identity, independence and occupation were moderators for professional confidence. Organizational support, rela- tional trust and independence were moderators for achieving performance indicators. Strengthening group identification and independence as MIC and independence and support for women as AIC together with a stronger organizational support can increase professional confidence and improve performance.