Scope of Practice Documents

Scope of Practice defines and describes the unique role, set of skills, and knowledge base for a provider, in other words, what someone with a certain level of training should know and be able to do.

Curriculum refers to the knowledge and skills students are expected to learn, which includes learning standards or learning objectives; the units and lessons taught; the assignments and projects given to students; the books, materials, videos, presentations, and case studies used in a course; and the tests, worksheets, assessments, and other methods used to evaluate student learning.
Contents
Introduction
First aid requirements in a remote setting often differ from the scope of first aiders in a front-country environment. Over time, course content has evolved based on the growing body of medical literature on first aid and wilderness medicine and our experience as practitioners and educators of wilderness medicine. This process has led to a consensus about content and scope of practice (SOP) for wilderness medicine certification within the recreational and professional outdoor industry. For more information about certification, licensure, curriculum, scope of practice, and accreditation and why the WMEC SOP documents provide practical standards for industry-wide medical certifications, view this document.

The Scope of Practice documents are intended to set minimum standards for wilderness medicine certification for the outdoor industry. We recommend the recreational public, outdoor program administrators, and other consumers of wilderness medicine courses refer to these documents and recommendations when choosing an appropriate course and credential level for themselves, their program, or their service. Users may also compare the SOP to an individual school’s course curriculum to ensure the course meets the minimum standards. Because the needs of students and organizations vary by location, population, and experience, some educational institutions may choose to exceed the minimum standards. End users should compare the curriculum from different wilderness medicine schools before making a final decision on whose curriculum best suits their needs. While schools that teach wilderness medicine are not legally bound to conform to the minimum standards, they have a professional obligation to consider them. Failing to follow an industry standard may dilute the quality and value of a certification, compromise the care of wilderness participants, and leave the wilderness medicine provider, outdoor program or organization, and graduates open to a lawsuit.

While delivery strategies and detailed curriculum are left to the discretion of the course provider, we recommend that instructors who teach wilderness medicine are skilled educators and medical providers who utilize hands-on skill practice, case studies, and realistic simulations as the prominent delivery style for their courses. Detailed information on the topics, including signs, symptoms, and pathophysiology can be found in the first aid and wilderness medicine literature. Neither the WMEC nor any approving parties are legally responsible for a loss arising from the use or misuse of any WMEC documents. Outdoor programs may benefit from working with a medical advisor to identify any predisposing terrain, environmental, and clinical conditions that may contribute to program-related accidents, injuries, and illnesses and suggest risk management strategies designed to prevent them. For more information on medical advisors, standing orders, and protocols view this document.

Course Format 
Courses may be taught in a standard or hybrid format. We do not recommend courses that are taught entirely online (e.g. synchronous, asynchronous, or a combination of each). The WMEC believes that the in-person hours of all wilderness medicine courses are an essential element of each training. For more information about in-person versus online only, view this document. 
​
CPR & AED Certification
We recommend that all graduates be certified in adult and child CPR and AED use based on the American Heart Association (AHA) or International Liaison Committee on Resuscitation (ILCOR) guidelines and their skills practiced and verified through in-person training; depending on the school, formal certification may or may not be included in some courses. 

Treatment & Evacuation
We recommend treatment guidelines and evacuation parameters based on injuries and illness. Due to the dynamic nature of the wilderness environment and the variables unique to each situation, some treatments may not be available and a prompt evacuation may not be a viable option. In the SOP documents, we provide a generic recommendation to assess the need and urgency of the evacuation. In general, we recommend an urgent evacuation for all potentially life-threatening problems. However, we understand that in some cases, the associated risk may be too high to attempt an evacuation, or an evacuation is not possible. Graduates may not have the training or experience to conduct a risk/benefit analysis that accurately weighs the risks to all parties involved in the treatment and evacuation of a patient; this is especially true for WFA and WAFA graduates. When possible, graduates should consult medical and rescue professionals before initiating an evacuation. 
Interpreting the SOPs
In order to figure out which course—WFA, WAFA, or WFR—best meets your needs, it’s first necessary to understand the underlying pedagogy. There are three basic steps to assessing and treating an injury or illness:
  1. Gather relevant information about what’s wrong.
  2. Accurately evaluate the patient information and identify the problem(s).
  3. Treat the problem(s).
​
Medical personnel must evacuate patients to definitive care if they cannot treat their injury or illness in the field. The urgency of the evacuation will depend on the potential consequences if the problem remains untreated; these can range from minor cosmetic damage to permanent disability or death.

Regardless of the course type, a graduate’s ability to prevent, assess, and treat a patient’s injuries or illness relies on:
  • their understanding of normal anatomy and physiology,
  • their grasp of the problem’s pathophysiology,
  • the amount of time spent analyzing case studies,
  • the treatment procedures they have learned,
  • their ability to improvise, and
  • the amount of time they spend learning and practicing hands-on patient assessment under the direct supervision of a qualified instructor.
​
Each SOP identifies the:
  • required core topics and skills. The depth of anatomy, physiology, and pathophysiology varies with the individual school’s curriculum and the allotted instruction time.
  • elective topics and skills that typically require additional in-person class time to teach the skill; the actual amount of extra time is left up to the individual school but should be greater than the minimum number of class hours or fit into the allocated flex time.
  • total number of in-person class hours required to teach and master the core topics and skills in a standard course with minimal or no precourse work; this is a minimum number—at their discretion, a school may add additional hours. Also included is a breakdown of the minimum hours required for simulations and skill labs.
  • total number of in-person class hours required to teach and master the core skills in a hybrid course; foundational information is presented and assessed online before the practical session; this is a minimum number—at their discretion, a school may add additional hours. Also included is a breakdown of the minimum hours required for simulations and skill labs.
  • amount of flex time built into each course; providers may use flex time to add topics, skills, or depth to the course curriculum without adding extra time to the course.

The core topics and skills and the electives in the WFR SOP provide the baseline for the WFA and WAFA SOP documents. Wilderness medicine schools may—and frequently do—add regional or ancillary topics and skills to WFA and WAFA courses based on the needs of an individual sponsor or student group; the “extra” content tends to reflect the terrain, environment, or seasons the students work or the activities they lead or teach. If the time necessary to teach the additional topics exceeds the course flex time, the school increases the course class time proportionally.
​Delivery strategies also vary between schools as do course materials. Potential students and sponsors should carefully evaluate their needs and research each school’s curriculum, including hours and delivery strategies, before choosing a course or school. Keep in mind that the depth of anatomy, physiology, and pathophysiology varies between each course type, between individual schools, and sometimes between courses taught by the same school.

Because of the vast amount of knowledge necessary to perform well in a field situation, we encourage each wilderness medicine school to provide their students with a field manual that outlines the signs, symptoms, and treatment of the problems presented during their course.
​
To receive certification, students must demonstrate a basic understanding and mastery of core topics and practical skills via in-person skill training and simulations.
Course Descriptions
Wilderness First Aid (WFA) courses are introductory courses that focus on general concepts and basic treatment skills for people on half or full-day trips, those traveling with reliable cell or satellite phone service, and where outside assistance is typically available within a few hours. WFA graduates are often employed as assistant trip leaders in college outdoor programs and residential camps or as guides or instructors in low-risk activities and environments.

Wilderness Advanced First Aid (WAFA) courses provide comprehensive training and basic treatment skills for people on half-, full-, or short multi-day trips, those traveling with reliable cell or satellite phone service, and where outside assistance may be delayed for numerous hours. WAFA graduates are often employed as trip leaders in college outdoor programs and residential camps or as guides or instructors in low- to moderate-risk activities and environments.

Wilderness First Responder (WFR) courses provide the ideal training for people who travel in remote locations, in challenging weather, with limited equipment, unreliable communication, and limited or no access to outside assistance. As a result, WFR graduates often care for patients for prolonged periods and may need to make independent decisions regarding the need for and urgency of evacuation and required additional resources. WFR certification is the outdoor industry's standard for guides, instructors, and other outdoor professionals.
Click here to download a pdf file that summarizes the minimum in-class hours, core topics and skills, regional & ancillary topics and skills, and elective topics and skills for WFA, WAFA, & WFR courses.​
The WFA, WAFA, & WFR SOPs
Click on a file to download a pdf copy of a current WFA, WAFA, or WFR SOP document.
WFA SOP
revised 3-2022
WAFA SOP
revised 3-2022
WFR SOP
revised 3-2022
The draft WFA, WAFA, and WFR SOPs are open for public until June 1, 2023. 
​Please visit the Blog & Comments page for details.