EMS Training Blog
Evidence-based EMS education, NREMT prep strategy, and simulation training insights from Dr. Chester "Chet" Shermer, MD, FACEP — emergency physician, EMS medical director, and founder of EMS-MedSim.
The NREMT cognitive exam fails candidates who study the right material the wrong way. It's a computerized adaptive test built to measure clinical decision-making under pressure — not protocol memorization. Here's what actually works.
Chester "Chet" Shermer, MD, FACEP
April 26, 2026
The NREMT cognitive exam is organized around five content domains, and understanding what each one actually measures — not just what it covers — changes how you prepare. Here is a domain-by-domain breakdown from an emergency physician who has trained and evaluated prehospital providers for 25 years.
Chester "Chet" Shermer, MD, FACEP
April 26, 2026
The NREMT cognitive exam is not a standard multiple-choice test. It is a computerized adaptive test that adjusts in real time based on your answers. Understanding how the algorithm works — and what it is actually measuring — is the single most important thing you can do before you sit for the exam.
Chester "Chet" Shermer, MD, FACEP
April 26, 2026
Clinical errors in EMS are underreported and hard to catch in the field. These are the trauma assessment gaps that simulation identifies before a real patient pays the price.
Chester "Chet" Shermer, MD, FACEP
April 30, 2026
A good field training officer changes how a paramedic thinks on scene. Most providers have limited access to one — a fixed field training period, inconsistent preceptor quality, and zero FTO availability outside of scheduled shifts. A Virtual FTO running AI-powered branching simulation delivers the same Socratic challenge method on demand.
Chester "Chet" Shermer, MD, FACEP
May 5, 2026
Simulation-based training outperforms lecture and static protocol review for building clinical decision-making in prehospital providers. A 2025 systematic review of five years of research confirms it. Knowing what to do and executing it under pressure are different cognitive tasks, and lecture trains only one of them.
Chester "Chet" Shermer, MD, FACEP
May 5, 2026
Critical care transport providers work at the highest acuity level in prehospital medicine, often without physician oversight and no hospital backup available. The skills that define CCTP performance — RSI, ventilator management, vasopressor titration — decay between calls and cannot be maintained through ride-along exposure alone.
Chester "Chet" Shermer, MD, FACEP
May 5, 2026
NREMT recertification is due every two years. Most providers choose the continuing education pathway over re-examination, but the NCCP is not a simple credit-collection exercise — it is a structured competency maintenance framework with specific requirements by certification level.
Chester "Chet" Shermer, MD, FACEP
May 5, 2025
Flight paramedics and critical care transport providers manage the highest-acuity patients in prehospital medicine. The calls come infrequently. The specific skills that critical care transport demands — RSI, vasopressor management, vent management, high-acuity pharmacology — are precisely the skills that degrade fastest without regular exposure.
Chester "Chet" Shermer, MD, FACEP
May 5, 2025