E-learning concept with man holding a tablet computer

The idea of a watershed is a moment in time when something changes and things will never be the same again.  Your perspective shifts significantly. These are moments that drive us and the world around us, to become different people, with new ideas and motivations. From Ebola, the opioid crisis and active shooter events, Emergency Medical Services (EMS) providers have faced significant events before.  The COVID-19 pandemic, however, is bringing a watershed moment to modern EMS systems like none before.

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EMS systems have always played a vital role in disasters and crisis situations.  There are never-ending requests for assistance in triaging patients and providing emergency medical treatment and transport for ill persons. EMS is heavily relied-on to contribute towards the resolution of the situation at hand, as traditionally, EMS is key to providing for the health and welfare of their communities. Pandemics and crisis situations put immense pressure on EMS agencies, causing change and disruption.  Never before, however, have EMS agencies seen such immense changes to education delivery.

The United Nations Educational, Scientific and Cultural Organization (UNESCO) is tracking the impact of the pandemic on education.  As of March 30th, 2020, they estimate that 87 percent of the world’s student’s- that is 1.5 billion learners-have been affected by school closures (UNESCO, 2020).  As the COVID-19 pandemic leaps around the world, affecting every country in its wake, schools of all types, including EMS learning institutions, have been forced to shut their physical doors and resort to alternative means of education.  EMS is generally reliant on having a pipeline of students ready, trained and willing to fill in the ranks as required. As well, EMS systems rely on education initiatives to up-skill, up-license and broaden the scope of their paramedics and services offered.  However, in the current COVID-19 pandemic, the usual methods of EMS training, instruction and education are suspended, and the education delivery, required to keep the workforce educated and up-to-date, is heavily impeded.

Due to the threat of COVID-19, schools, technical institutions, colleges, and universities are suspending courses or moving to online lectures.  EMS educators and students, who traditionally learn through blended programs of classroom and clinical sessions involving direct patient care, face new concerns about their health, access to their education and their roles in the current pandemic approach to patient care, as they are sent home to learn in a foreign environment, with little or no access to practical education and hands-on experience.  

Sending students home to learn does not need to result in the end of EMS and paramedic learning.  The EMS system relies on students entering the workforce, and also on existing EMS members expanding and deepening their knowledge and scope, therefore it is imperative that EMS education succeeds in this new world order.  In this article, we discuss novel ways in which EMS educators and learners can continue to educate, learn and share education practices, even during an emergency such as the COVID pandemic. We have to be able to think outside the standard EMS teaching-boxes to generate various possible solutions that might help meet the new needs of our EMS learners. Quite simply, when one does not have access to the usual, formal EMS education system, learners and educators must adapt. 

#1 Learning to Adapt

In the present environment, the alternative EMS learning options are vast, and education in emergencies is being mobilized to ensure that EMS students, paramedic educators, and lifelong learners can move to some form of remote learning-whether by printed materials, online learning, or augmented reality approaches.

As our mental model of conventional EMS education is forced to shift, the possibilities become endless. Traditionally, knowledge is seen as an established, objective, authoritative body of facts outside the learner’s experiences or personal preferences, and that the role of the educator is to transmit this knowledge, along with accompanying academic skills and attitudes, to the paramedic mind (Estabrooks, 2006). In this manner, education and instruction are “delivered” and the classroom is “managed” by the educator.  Knowledge transmission may occur if the learner is prepared, engaged and has the necessary background knowledge. It should be remembered that true learning is both a social and a cognitive process, not merely a matter of information transmission (Bandura, 1971). Face-to-face education isn’t successful solely because the lectures are good. Lectures are but one instructional aspect of an overall EMS-education ecosystem specifically designed to support learners with many resources to which to learn from, including the learning that results from the students’ social interaction and practical application of learned skills. As we adapt to new methods of learning and teaching, we might discover learning skills we didn’t know we had previously.

As we all navigate this unprecedented experience together, be patient with yourself and your peers and family.  We are all adjusting to a new situation, and the work will not be perfect. Give yourself permission to relax and recognize that the standards of excellence look different during a crisis and it’s ok to not feel as though you are on top of everything.  Nobody is ever “done’ figuring out how to learn, and in this new remote-learning environment, we all need to figure out how to learn in new ways. Have faith in yourself that you can always increase your capacity for skills and knowledge and have courage in your learning abilities.

#2 Online Learning

E-Learning on the virtual screen. Internet education concept.

Online learning, when courses and education are offered online instead of in a physical classroom, has been studied for decades. Interestingly, research comparing online and traditional course delivery methods has demonstrated the equivalence of student performance in online and conventional learning (Regmi, 2015).  In some instances, online course delivery has been found to be superior to traditional, when it comes to applied learning and may be superior in the process of knowledge transfer. This is comforting knowledge as many EMS learning systems are now relying on online course delivery.

Online learning has never been more important and more widely used than it is today in EMS.  The COVID-19 pandemic has taken face-to-face EMS training out of the equation for now, and successfully making the transition to online learning is important. Success relies on remaining engaged, having the appropriate tools and technology, and exploring new methods of learning outside of the classroom.

#3 Make the Most of Your Learning Experience


Online learning, can be challenging mentally and you may feel it harder to stay engaged with your EMS learnings.  This is an extraordinarily challenging time for everyone. As an EMS learner, you may be feeling stressed, overwhelmed, confused.  It is likely challenging to feel that you can remain engaged as a student of adult lifelong learner. Therefore, it’s important to get yourself in the right frame of mind for learning and studying.

This is an opportune time to understand your own inner motivations, and how you can enhance your situation to help with making the most of your online learning experience:

#4 Appropriate Learning Tools and Technology

Set yourself up for success with online learning by making sure you have the right tools and technology at hand:

Take time now to save time later.  Setting up your workstation properly will help to keep you safe and comfortable while working remotely.  Be proactive to help prevent injuries from occurring and be aware of early signs/symptoms of discomfort. Regular movement throughout the day combined with a safe and comfortable workstation is essential in maintaining good health and preventing potential musculoskeletal issues.

Learning remotely takes some getting used to. How you work with student groups and class projects is also different, and there are best practices for virtual teamwork. The use of interactive websites, web quests, videos and other activities will allow to interact and understand the best way to observe and engage in the online learning environment.

Once you have the right tools at hand, your workstation is comfortable and you’ve observed some best practices, the didactic and theory component of your EMS learning experience can start to happen.

#5 Augmented Reality-Remote Simulation Learning

Paramedics and EMS workers are expert sponges, adept at trailing behind those with experience and observing to learn, and for this reason, a large component of EMS learning involves a practical component.  During this crisis, practical learning sessions, EMS simulation labs and exposure to patients are not possible. As educators and learners, we must look elsewhere to gain exposure to patient presentations. Using Augmented Reality (AR) is one of the best ways an educator can use to engage and up-skill students.  By using AR tools and applications, creating a virtual paramedic experience in the remote learning environment is possible.

Augmented reality technology can help bring students to the virtual frontline.  Some companies such as MedCognition, an award-winning augmented reality medical company, brings the prehospital environment to the virtual classroom in the same consistent and safe manner it has been doing prior to the COVID pandemic.

Students can assess, diagnose and treat a patient case in VR, and practice their all-important critical thinking skills.  Educational institutions that use augmented reality in classrooms already, will have harnessed a completely different learning experience opportunity. For those that hadn’t yet embraced this approach to learning, they can now look to integrate this approach to paramedic education.

AR technology expands the physical world; it adds layers of digital information onto what we can see with the naked eye.  It augments our surroundings by adding patient sounds, presentations, and graphics. AR can provide augmented information for the EMS student during interventional procedures such as stroke and heart attack recognition and management. Virtual reality, on the other hand, creates a completely different environment, an artificial world that replaces the real one and in which we can immerse ourselves.

The benefits of AR in education are increasingly being recognized by researchers on the topic and reports including the following benefits:

 All these benefits are critical to successful patient-EMS interactions on the street, and during this pandemic, are the closest students and learners can get to the real, practical hands-on experience.


The threat of COVID-19 to EMS services and the disruption to education has presented some unique challenges for education.  EMS education providers, students, and EMS lifelong learners are being asked to do extraordinary things regarding course delivery and learning that have not been seen on this scale in the lifetimes of anyone currently involved.  Although this situation is stressful to everyone, when it ends, EMS education will emerge with a new perspective and an opportunity to evaluate how well they were able to implement remote learning, maintain continuity and quality of education and rise to the situation at hand.

Works Cited

Bandura. (1971). Social Learning Theory. General Learning Press.

Estabrooks. (2006). A Guide to Knowledge Translation Theory. The Journal of Continuing Education in the Health Professions, 26, 25-36.

Regmi. (2015). Lifelong learning: Foundational models, underlying assumptions and critiques. International Review of Education, 61, 133-151.

UNESCO. (2020). Latest news on covid-19-facts-impacts-education. Retrieved from https://en.unesco.org/news/covid-19-facts-impacts-education: https://en.unesco.org/news/covid-19-facts-impacts-education

Written by Jennie Helmer, ACP, M.Ed.  Jennie is a Paramedic Practice Leader and the Research Lead with the British Columbia Emergency Health Service. She is a licensed ACP and Paramedic Specialist. She holds a Master’s in Education from the University of British Columbia (Masters in Adult Learning and Global Change) and has a Bachelor of Commerce from Royal Roads University.