Tracey Loscar

Stress is not the enemy of performance; poorly managed stress is. In EMS, the same physiological responses that derail a scene can derail a classroom, a training day, or a new provider’s development. “Drownproofing” reframes resilience as a trainable skill: the intentional use of stress exposure, cognitive load, and deliberate practice to build competent, confident clinicians.

This session explores how stress physiology shapes performance, why providers freeze under pressure, and how instructors can design learning experiences that strengthen, not shatter, confidence. We’ll examine real-world instructional failures (and successes), from large-scale exercises that collapsed under cognitive overload to small-group methods that produced measurable gains in retention and decision-making.

Drawing on generational research, heuristics, System 1/System 2 thinking, and stress inoculation principles, we’ll examine how providers learn, how they misinterpret information under stress, and how teaching methods must adapt. Participants will learn practical tools to improve communication, reduce “brain friction,” enhance procedural memory, and create training environments where stress becomes an asset rather than a threat.

Resilience isn’t a personality trait; it’s a conditioned response. And with the right approach, you can teach people to function when their heart rate spikes, their vision narrows, and the clock is working against them.

You run two or three calls a week. Your last cardiac arrest was six months ago. Your last pediatric intubation was never. When the critical call comes, you don't have muscle memory to fall back on. You'll have protocols, whatever equipment and training your time and budget allow, and the sinking feeling that you're making decisions with incomplete information and no backup. Welcome to low-volume EMS.

Rural, remote, frontier, and small-town providers face a paradox: they have the same clinical stakes as high-volume urban systems, but without the repetition that builds and maintains competence. You can't practice what you never see. You can't refine skills through volume when there's no volume. And when the big call comes, there's no cavalry. It's just you, your partner, and whatever you can improvise in the back of a truck on a dirt road hours from definitive care.

Fortunately, there are ways to get better at it. We'll examine clinical decision-making in resource deserts: how to think like a detective, when to trust your gut and when to override it, when protocols don't fit your reality and you have to improvise, and how to build clinical reasoning without high call volume.