This area contains faculty-only resources including session plans, simulation scenarios, debrief tools, and expedition logistics. Access is restricted to OffChartCPD faculty and invited co-facilitators.
Session plans, simulation scenarios, debrief frameworks, pre-reading, logistics, assessment tools, and CPD logging. For OffChartCPD faculty and invited co-facilitators only.
Kyrgyzstan — Jyrgalan Valley · March 2027
Participant group: FACEMs and intensive care paramedics. 9-day expedition with ski touring days alternating with CPD sessions. All session materials below are specific to this expedition's programme structure and participant level.
Two-part session. Part 1 (45 min): individual practice reflection — participants share one area of genuine uncertainty. Part 2 (75 min): facilitated discussion on CRM, HFACS, and authority gradients mapped directly to avalanche decision-making via McCammon's heuristic traps. Discussion questions provided. ACEM: ~2 hrs Educational Activities.
2–3 participant-led cases (~30 min each). Each presenter follows a structured format: clinical narrative → key decision point → honest reflection → what would change. Facilitator names cognitive biases explicitly as they emerge: anchoring, premature closure, availability bias. Open floor critique after each case. ACEM: ~2 hrs Reviewing Performance.
Participant-selected paper presented with a one-page summary or from memory. Facilitator-guided discussion covering study methodology, applicability to remote and austere environments, and clinical take-home. Emphasis on critical appraisal rather than passive listening. ACEM: ~2 hrs Educational Activities.
Group audit of cases from the week — not individual case presentations but a systems-level review. Facilitator guides discussion around recurring themes: system failures, handover and communication breakdowns, documentation, and cognitive error patterns. Includes a structured handover deep-dive: participants recall a poor handover they gave or received and analyse the failure pattern. ACEM: ~2 hrs Measuring Outcomes.
Three participants deliver a 25-minute talk on a clinical topic of genuine personal interest. One rule: clinical application must be demonstrable. Facilitator's role after each talk is to ask the one question the presenter least wants to answer. Deliberately placed mid-week — familiarity with expertise is cognitively lighter when legs are wrecked. ACEM: ~2 hrs Educational Activities.
Part 1 (60–75 min): remaining 2–3 presentations, same format. Part 2 (45 min): verbal expedition scenario set in the group's current terrain — no equipment needed. Walk through: assessment and differential, field treatment priorities, evacuation decision-making, role allocation, and communication plan. Final question loops deliberately back to Evening 1 human factors content. ACEM: ~2 hrs.
Three-part closing session. Part 1 (45 min): structured verbal debrief — each participant answers three questions in turn. Part 2 (45 min): written PDP on paper around three structured questions; participants photograph and upload to their CPD portal. For ACEM participants, this can satisfy the annual PDP requirement. Part 3 (30 min): unscripted closing discussion. Facilitator's only job is to start it and get out of the way. ACEM: ~2 hrs Measuring Outcomes.
Scenarios are designed for FACEM and ICU paramedic level participants in a backcountry ski touring environment. Each includes full facilitator notes, adaptive injects, and a debrief guide focused on human factors. Select 1–2 scenarios per simulation session.
Guide has found an unresponsive skier and made several pre-arrival management errors. Two clinicians reach the scene first; the senior physician is 20 minutes behind. Leadership handover, authority gradient, and correcting a bystander's management without disengagement.
Two simultaneous casualties with competing urgency profiles. Casualty A: probable femoral fracture, haemodynamically borderline. Casualty B: 61-year-old — confused, ataxic, headache at 4,000m, written off as tired all day. One medical kit. One evacuation slot in the next 90 minutes. Who goes first and why.
Day 5. One participant had overnight AMS (LLSS 3), now reportedly resolved. Guide says conditions are perfect and the weather window closes tomorrow. Three participants keen. Two uncertain. One has privately told you they're still worried — but hasn't said anything to the group. Go or no-go, and who decides.
Field handover between two teams at a valley rendezvous. Team A is cold, exhausted, and keen to move. A critical piece of information is omitted. A deterioration is introduced 15 minutes later that makes the missing information suddenly critical. Explores ISOBAR under fatigue and how assumption-making fills gaps.
A person collapses on a ski run. The entire group witnesses it simultaneously. Nobody is assigned a role. Nobody is designated team leader. Everyone is in ski gear. The scenario begins the moment the collapse is observed. Exposes diffusion of responsibility, natural leadership emergence, and the first 90 seconds of an unstructured peer response.
Group split across two rope teams separated by a ridge. Radio comms intermittent with a 20-second delay. Original rendezvous plan no longer valid. One team has a casualty — the other doesn't know. Each subgroup briefed separately with different information. How quickly does a shared mental model fracture when comms break down.
A senior physician is the casualty. The first responder is the paramedic, who is clinically correct throughout. The physician — conscious and lucid — keeps directing their own management, second-guessing interventions, and asking for decisions to be explained before complying. Run this one last. Deliberately uncomfortable.
Session attendance and participation record for all 11 CPD activities (7 evenings + 4 field simulations). 22 CPD hours. ACEM-mapped. Print one copy per participant — collect signatures at close of each session.
All 7 wilderness CRM scenarios in full: facilitator notes, casualty setup, simulated observations, adaptive injects, and structured debrief guides. For facilitator use only — do not share with participants in advance.
Participant profiles, medical declarations summary, known conditions, group dynamics notes, and pre-departure facilitator call agenda.
Full group medical kit contents, drug doses, expiry check dates, and storage notes. Includes emergency protocol cards.
The following are recommended reading for facilitators before the expedition. Familiarity with this material will allow confident facilitation of discussions and debrief of simulation scenarios at FACEM level.
Current evidence-based guidelines for AMS, HACE, and HAPE management. Essential for scenario facilitation.
Diagnostic criteria, field rewarming decisions, and definitive care pathway. Direct relevance to Kyrgyzstan winter conditions.
Structured debrief model used across all simulation sessions. Facilitators should be fluent in this before arrival.
Curated reading list covering CRM principles, cognitive bias, authority gradient, and situational awareness in high-stakes environments.
Generic Resources — these materials are not expedition-specific and can be adapted for any OffChartCPD programme across all activity types and locations.
Full facilitation guide for the Promoting Excellence and Reflective Learning in Simulation (PEARLS) model. Covers healthcare advocacy–inquiry approach, scripted prompts, and timing guidance.
Single-page field card version for use during simulation days. Laminate and carry.
Summary of key cognitive biases relevant to emergency and expedition medicine. For use in human factors sessions and simulation debrief.
Structured post-session review form for facilitators. Captures what went well, what could be improved, and changes for next iteration.
Structured tool for observing and noting individual participation across sessions. Not a formal assessment — for facilitator awareness and personalised feedback.
Non-technical skills (NTS) and technical skills observation framework adapted for expedition medicine contexts. Includes human factors domains mapped to ANTS.
Structured evaluation form covering programme quality, facilitator performance, logistics, and net promoter question. For distribution on final evening.
Reflective evaluation for co-facilitators to complete post-expedition. Feeds into programme quality review and CPD documentation.
Template for participants to document their learning goals, planned CPD activities, and professional development objectives ahead of and following an OffChartCPD expedition.
Structured reflection template for participants to record learning outcomes, insights, and intended practice changes following each CPD session or expedition.
Generic field safety documents for use on all OffChartCPD expeditions. Complete expedition-specific details (contacts, local numbers, insurance) before departure and print copies for all facilitators.
Morning briefing form with circle-the-answer weather conditions, avalanche hazard roses (today and forecast), terrain and objectives, group status, equipment check, and go/no-go decision. For winter and mountain expeditions.
Template for local emergency numbers, OffChartCPD contacts, insurance details, InReach / PLB messaging protocol, evacuation decision framework (red / amber / green), and helicopter LZ preparation. Complete expedition-specific fields before departure.
Pre-populated local emergency numbers, nearest hospitals, recompression chambers, and evacuation routes for all current OffChartCPD destinations: Antarctic Peninsula, NZ Southern Alps, Chilean Andes, North America Heli-Ski, Raja Ampat, Lyngen, Gulmarg, Georgia, and Komodo. Copy the relevant section into your Emergency Comms Protocol before departure.
Generic incident report for all activities. Covers clinical assessment, management timeline, evacuation decision, contributing factors analysis, safety equipment used, and follow-up actions. Includes a diving supplement (DCS symptoms, dive profile, DAN contacts). Required for insurance and post-expedition review.
Generic fillable risk assessment covering hazard identification with likelihood × consequence matrix, participant medical considerations, environmental and logistical hazards, emergency response plan, and sign-off and review log. Complete before each expedition and update if conditions change significantly.
Log your CPD hours as a facilitator. This form submits to OffChartCPD and will be returned to you as a formatted CPD record for your ACEM or ACRRM portfolio. Allow 5–7 days for your certificate to be issued.