What if distance was always a clinical variable, right alongside heart rate and blood pressure? On this episode of The EMS Educator Podcast, host Hilary Gates and co-host Rob Lawrence sit down with two seasoned leaders in austere and frontier EMS: Tracey Loscar, deputy director of the Mat-Su Borough Department of Emergency Services in Alaska, and TJ Bishop, interim chief administrator for San Juan Island EMS in Washington State. Tracey and TJ dig into why rural systems demand a different training model, one built on closing feedback loops, teaching situational awareness and clinical gestalt, and distinguishing competency from fluency. They describe how they've redesigned field training, onboarding, and scenario-based education around each system's highest-risk, lowest-frequency calls, and why mentorship and cross-agency learning are essential for developing confident, independent-thinking clinicians in resource-limited settings.

Ginger Locke highlights the episode's key points with her "Mindset Minute."

Mentioned in the episode:

"Same Stakes, Fewer Reps: Decision-Making in Low-Volume EMS"

https://www.hmpgloballearningnetwork.com/site/emsworld/feature/same-stakes-fewer-reps-decision-making-low-volume-ems

"EMS in the Ash Zone" https://www.ems1.com/disaster-management/ems-in-the-ash-zone-alaskas-mount-spurr-and-the-volcanic-challenge

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