
Episode #53
Competency vs. Fluency: Building Clinical Judgment in Rural EMS
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 The EMS Educator is published on the first Friday of every month! Be sure to turn on your notifications so you can listen as soon as the episode drops, and like/follow us on your favorite platform. Get your CE at www.prodigyems.com Follow @ProdigyEMS on FB, YouTube, TikTok & IG.

