NOLS' WEMT Program Adapts to Different Learning Styles and Equips Students for Wilderness Emergencies

With more severe weather and natural disaster events emerging comes an increased need for those trained to address the associated medical challenges.

National Outdoor Leadership School (NOLS) is a Wyoming-based nonprofit global wilderness school that offers a one-month Wilderness Emergency Medical Technician (WEMT) course designed to help students build the skills needed to pass the National Registry of Emergency Medical Technicians (NREMT) certification exams and offer top-tier patient care.

The school is noting an increased interest in wilderness medicine. Many of its classes now have a waitlist.

“We have 10 courses going from now until September overlapping every two weeks and we're full at 30 apiece,” notes Jake Wallace, WEMT program manager.  “Just like any other school and nonprofit and everywhere else in the world, we took a dip in the pandemic, but our dip was relatively small comparatively to other places. There's usually always a waitlist within the wilderness EMT program. Folks really want to come here.  Enrollment continues to go up.”

About NOLS' WEMT Program

Taught at the Wyss Wilderness Medicine campus with purpose-built classrooms, student accommodations, and outdoor opportunities for students’ free time – NOLS’ WEMT offers wilderness medicine courses for a variety of skill levels and needs, from initial training for outdoor enthusiasts up to recertifications for outdoor professionals.

The organization notes that the program provides 50 percent classroom education and 50 percent hands-on, real-world experience compared to 90 percent classroom and 10 percent real-world experiences in some traditional programs.

Wilderness medicine is practiced during outdoor recreation, search and rescue, wilderness event support, on expeditions, in remote clinics, and as part of humanitarian relief and disaster response.

It is practiced in the context of delayed access to care and in challenging environments where there is often the need to improvise gear with limited communication and the need for independent decision-making. It often necessitates being with the patient for longer prehospital times.

Those in wilderness EMS need to know more about environmental challenges such as hypothermia, frostbite, heat illness, dehydration, and altitude awareness. It involves keeping oneself, the patient, and teammates protected in adverse environments.

NOLS’ learning environment pairs practical skills application with exam coaching. The organization notes it has a 95 percent national board pass rate for the NREMT compared to 60 to 70 percent by traditional EMT training.

Adapting to Different Styles of Learning

In his years of teaching dozens of courses at NOLS, Wallace notes that the multiple successes happening for students who struggle in traditional EMT classroom settings come about as a result of their ability to take the knowledge that is learned in the 50 percent classroom education/50 percent hands-on style – and apply it immediately.

“They do hands-on clinicals over two weekends at different hospitals within the Wyoming area,” he says.

At NOLS, “You’re in it together with a group, a cohort of about 30 students with that end goal of passing the course and stepping up to take care of other humans,” he adds. “I think NOLS does a really good job of not just giving you the path, but also remembering that we're focusing on people's loved ones – moms and dads and brothers and sisters and partners along the way.”

WEMT provides a highly dynamic learning environment that engages different learning styles.

“It starts from day one with an instructor learning how to be an instructor,” says Wallace. “We go through an instructor training course teaching folks different delivery styles for different learning styles.”

Wallace notes that the program's world-class instructors have backgrounds in outdoor education and medicine and have undergone rigorous instructor training. New instructors are paired with senior instructors who are good at coaching them, which he notes “inherently leads to really excellent coaching for each of the students.”

Honoring different learning styles also comes with experience, Wallace adds. Instructors may note something in a student they had previously seen in another student, leading the instructor to consider different coaching techniques.

“We have seen tons of students over time when we're on a constant basis chatting with instructors in terms of some different learning issues or learning modalities,” Wallace says. “Another really big thing that happens on day one is asking students to be those adult learners and take a little bit of introspection and then communicate with their instructors in terms of their needs – they learn better this way or that way.”

Those who communicate effectively with an instructor can have one-on-one coaching along the way.

“When instructors notice things along the way, they do a pretty darn good job to check in with person A, person B on the struggles they may be having,” Wallace says. “There are more than six or seven exams and practical rubrics and tests along the way that when folks aren't hitting that level, that puts off a little asterisk within our mind to where does this person need more coaching.”

That may potentially lead to pairing that student with someone who may be stronger in hands-on practical skills with someone who's not as strong in hands-on skills and using that as peer support and instructor coaching, Wallace adds.

“The course itself is designed to progressively get harder over those four weeks,” Wallace says. “All of the exams are written in the same style that the NREMT is in terms of questions.”

While not everyone passes the WEMT courses, those that do have a high likelihood of passing the NREMT because they've seen similar questions and styles says Wallace.

“It’s an intense course. It's not easy by any means,” Wallace notes. “Some people walk into it thinking it'll be a breeze. They need to put effort into it and help each other through some of the processes – both the skills and book-based learning – along the way.”

Evaluating Program Standards

According to a study by the NREMT, EMS education program quality predicts national certification.

The study concluded that ‘students graduating from high-performing programs had significantly greater odds of passing the National EMS Certification exam on their first attempt.

‘Even after three attempts, low-performing program graduates did not achieve the first-attempt success rates of high-performing programs.’

According to the organization’s data for the 2023 annual certification report, testing passing rates for the cognitive exam are 69 percent for EMR, 74 percent for EMT, 65 percent for AEMT, and 79 percent for paramedics.

The organization notes a 99 percent passing rate for AEMT and a 98 percent passing rate for paramedics for the psychomotor exam.

Students often come from search and rescue organizations, ski patrols, and EMT agencies.

It has become a prime choice for medical training for organizations such as the National Park Service and branches of the military, partnering with schools and students from Harvard to the U.S. Naval Academy.

Wilderness First Aid Courses

In addition to the extensive courses NOLA offers for EMTs, the organization also offers a variety of wilderness first aid courses, including surface-level awareness information such as some pre-hospital care and emergency medicine patient assessment and then moving up levels that delve deeper into wilderness emergency medicine such as upgrading skills for medical professionals.

“We’re working with doctors, nurses, PAs, EMTs, and paramedics,” says Wallace. “They know the medicine. But how do you apply that same system when you don't have the diagnostic tools or the MRI?”

The courses teach how to turn items such as pieces of someone’s clothing or items found in a wooded area to create splints and bandages to reduce pain and stabilize an injury.

It entails scenarios involving weather extremes, altitudes, and undersea emergency medical responses.

“It’s the same medicine,” Wallace says. “You just have to apply it to the context.”

Wallace says he finds wilderness medicine fascinating.

“I keep coming back to teaching it and working in it as you get to wear so many different hats,” he says. “You're the bone doctor, the spine doctor, the nurse, the PA, the person who's really good at taking care of sunburn. You might be the best friend. You might be like the parents or the partner who's helping change their diaper along the way. You might be with the patient for several days.

“It’s very human, very raw, and very real. Some amazing experiences come from both the courses and then the impact the courses inherently have on someone in their darkest days. Hopefully, our students are stepping up in those realms to continue to do very well for people.”

There’s much to be learned from wilderness emergency medical practice by all emergency medicine providers, Wallace notes.

While it attracts those who love the outdoors, “you might be somewhere remote and you're traveling internationally. It's that excitement of applying the knowledge you already have to an austere setting hopefully to then impact someone when it really matters. 

“A lot of what we do and the benefit is taking people's pain away and supporting them for the long term. There’s some enticing, really cool, creative, dynamic ways to think about medicine and to get outside the typical box of what they would do on a daily basis. Hopefully, it excites them to spark other folks to continue to refine their craft and refine how they do different things in different contexts and different environments.”

Wallace says he notes students completing the course are even more excited in wanting to help. He cherishes the emails and phone calls from those who have passed the course and communicate how they were able to successfully apply their knowledge in specific situations.

Job prospects for traditional EMT graduates typically focus on local EMT companies whereas NOLS WEMT graduates lead trips around the world and work locally like a traditional EMT, the organization notes.

Wallace – who has worked in disaster response with NGOs worldwide – says he believes the future of emergency medicine will require more skills in wilderness-type applications.

“I think where things are going is disaster response is that humanitarian aid, that international response. There are more potential environmental disasters we're seeing within our world,” he says.

Extreme weather events as does living in countries where it may take several days to get to a hospital and the transport can only come through a truck or horse will necessitate more people who are well-trained to take care of humans under a wide variety of circumstances, he adds.