Last updated: June 29, 2021

Course Writing Policies

This applies to all our course and exam manuscripts as well as other printed medical products for sale.


Pacific Medical Training course manuscripts are files that meet our accreditation requirements and follow a certain format to allow quick transcription to our online course. Courses are drafted as two separate files: reading materials and examination.

Manuscript by subject matter expert

The subject matter expert is a chosen expert in the field of learning material. They must find the best citations which are related to this course and create the first draft of learning materials. They will provide the first manuscript.

If you are adding a significant amount of material, provide your CV to Will and you will be added to the faculty section. You will also need to sign a conflict of interest form stating that you are not taking money from drug companies to maliciously write courses promoting those companies.

Learning objectives

Each course reading material section shall have learning objectives. These must be measurable objectives related to that material. Here is an example:

Learning objective: The participant will demonstrate knowledge about the change in emphasis from airway and ventilation to compressions and perfusion by selecting the correct responses in a multiple choice examination.


Writing style

Modern typesetting dictates there is one space after the period and other punctuation.

Units of measure are noted in common units followed by SI units. Include a space between the number and unit name. See also

Drugs are referenced by their generic names. See also;jsessionid=6B3817FCC1E6E5C454D6DD05DCD8AB58?sequence=1

We follow the style guidelines of the latest edition of AMA Manual of Style and The Chicago Manual of Style.


For ranges we use punctuation per APA. Example: 5 cm–6 cm. That is an en-dash, not a hyphen, on macOS use Option--.

A good way to make a note is to use an uppercase “NOTE” with a colon. Example:

NOTE: Do not try this at home.

Definitions can be introduced by writing the term and then an em-dash. On macOS use Option-Shift--. Example:

Hand — the part of the body most people use primarily for interacting with phones

Be careful with “a 54-year-old patient”. Here 54-year-old is a compound adjective and should have hyphens.

Word case


Course sections should be titled like “SECTION 3: Respect patients’ privacy”. Use smaller headings hierarchically to organize content further.


All content in the course should be left-aligned, including images. Below the image, include a description and usage credits/rights. We only use images with creative commons or public domain permissive licensing, or that are created in-house. If sourcing is not shown for an image then we assume we do not have the right to use it.

Note: attribution is not required for ECG strips, these are not copyrightable.

Other formatting

Writers use bold and italic type as necessary to make emphasis or draw attention. Our goal is to help people learn.

Writers should not manually edit the font, font size, or color unless specifically directed to do so in this document.

Works cited

Each course section includes a works cited section (“Heading 2” format). This lists each citation inside the course text, in order of appearance. Each section’s citations start numbering at number 1. Use the “numbered list” styling for this list and do not use “references” or other built-in citation features. Abbreviate journal names according to Index Medicus. List the first three authors, followed by “et al” if there are more than three. Examples of correct referencing forms are as follows:

Journal Article: Raftery KA, Smith-Coggins R, Chen AHM. Gender-associated differences in emergency department pain management. Ann Emerg Med. 1995;26:414-421.

Book: Huddy J. Emergency Department Design: A Practical Guide to Planning for the Future. Dallas, TX: American College of Emergency Physicians; 2002.

Book Chapter: Mengert TJ, Eisenberg MS. Prehospital and emergency medicine thrombolytic therapy. In: Tintinalli JE, Ruiz E, Krome RL, eds. Emergency Medicine: A Comprehensive Study Guide. 4th ed. New York NY: McGraw-Hill; 1996:337-343.

Electronic resources: King MW. Carbohydrate Nomenclature. The Medical Biochemistry Page. Updated April 2, 2020. Accessed June 3, 2020.

In the course text, make citations in superscript like this1. Or multiple citations like this2,3 or this4–7. If a reference applies to an entire section of the course then use the citation for the first paragraph of the section. Do not add citations to heading names.

Course examinations

Manuscript by subject matter expert

The subject matter expert is a chosen expert in the field of learning material. They will provide the first manuscript in any format.


All examination questions are to be organized into sections that match the learning material sections. Students that get a question wrong will see that question and the section on their post-exam report and they will search for the answer.

Multiple choice structure

All exam questions are multiple-choice with one correct answer, “All of the above” and “None of the above” answers are not acceptable. Indicate your correct answer with bold and list it first. The correct response must clearly stand out as the one that experts in the field would recognize as the best answer. Wrong answers should represent unsafe practices or commonly held misconceptions and should be plausible. See also

All examination questions are multiple choice problems. There are two sentence structures that may be used for these questions. The first uses a question mark in the question and each answer does not have periods. The second uses a partial sentence in the question and each answer has a period at the end. In each case, the answers begin with a capitalized letter.

All questions must have 4 or 5 answer alternatives.


Each incorrect answer will include an explanation of why that answer is wrong. This explanation will not explicitly provide the correct answer. Writers must make complete sentences, with periods, in the remediation text.


Following are examples of each examination question format following all styling rules:

  1. What is the complementary color of red?

    1. Green
    2. Blue

      1. Blue is also a primary color, primary colors may not be complements of each other.
    3. Black

      1. Black is the absence of color, so it cannot be a complementary color.
    4. Anti-red

      1. This is not the name of a color.
  2. The first rule of Fight Club is

    1. You do not talk about Fight Club.
    2. Always wear a belt.

      1. Wearing a belt is neither necessary nor recommended.
    3. Each fight is recorded.

      1. Your privacy is respected – we do not record fights.
    4. You can only attend once.

      1. This is not one of our rules.

Versioning process

Each of our courses completes a thorough review process by many parties inside and outside the company. We track each revision of each published document through a review and versioning process.

In each document and exam manuscript, the first top-level heading is “Version history” and a reverse-chronological-order list follows like so:

While you are making any changes to a document, note your progress under Changes not yet published. When we are ready to publish, Will will create the official print version, secure signatures of any reviewers and set the publication date for that version.

Adherence to AMA standards

  1. Pacific Medical Training’s (PMT) course writing policies address the following steps:
    • Conduct an educational needs assessment
    • PMT Identifies the target audience relative to the identified educational needs in accordance with Appendix F of the Commission on Accreditation for Pre-Hospital Continuing Education Accreditation Handbook.
  2. PMT identifies overall goal(s) to meet identified educational need(s).

  3. PMT writes objectives based on the identified goals. These objectives must be specific and define a short-range goal that describes what the participant will be able to do upon completing the educational activity. Objectives must begin with a verb that describes an observable action that may be evaluated at the end of the activity. “Understand” does not describe an observable action; “list,” “describe,” or “explain” do.

  4. PMT identifies qualifications for authors or instructors who will write or otherwise deliver the content that addresses the goals and objectives for the target audience. PMT identifies the format that will best address the goals and objectives (e.g., lecture, discussion, Q and A, laboratory, etc.). PMT develops lesson content and a bibliographic list of references on which the content is based, (Appendix H, Style Sheet). PMT lists complete reference information for all materials used to prepare the activity and uses an activity format that allows participants to relate specific content to each reference. PMT considers thorough research an indispensable element of sound educational design. References at a minimum must support the current National EMS Education Standards. Best practices include articles from peer reviewed journals, standard textbooks, and information from the internet. PMT, at its sole discretion, may require applicants to provide additional content and references appropriate to the topic.

  5. PMT selects qualified authors and/or faculty for the activity. PMT requires faculty and authors to complete and sign a conflict of-interest statement that is displayed at the beginning of the materials for each activity.

  6. PMT develops test items based on the lesson objectives that will assess the participants’ mastery of the objectives in accordance with Appendix G, Item Writing Standards of the Commission on Accreditation for Pre-Hospital Continuing Education Accreditation Handbook.

  7. PMT develops an evaluation instrument that uses a five-point Likert scale to solicit participants’ opinions about the activity, instructor, lesson format, syllabus, AV, and the activity as a whole. PMT provides a list of basic evaluation items, Appendix N, Standard Evaluation Items. Additional items may be added.

  8. PMT provides participants a mechanism for asking and receiving answers to questions regarding lesson content and test items within a maximum of five days.

  9. PMT develops a mechanism that ensures that participants complete all content including videos, slide presentations, case studies and other delivery platforms before the user is allowed to access the summative post-test. Applications for accreditation that do not employ “gating” of the content in this manner will not be considered.

  10. PMT ensures activity content conforms to the current National EMS Education Standards at a minimum (see above for exceptions).

    • Note: PMT requires that each activity undergo a comprehensive review at least every three years. Conduct an ongoing review of an activity, via continuous quality improvement, to make adjustments to activity content based on changing guidelines and protocols and participant and faculty feedback. The medical director must review each revised activity and affirm that the revised content is medically accurate and consistent with the standard of care for emergency medicine.
  11. PMT summarizes the participants’ responses to the test items and to the evaluation instrument to pinpoint strengths and weaknesses in the activity and document plans for quality improvement.

Med talk

All courses should include several (at least 5) links to a discussion on Med Talk as appropriate. It should be indented from the content around it and look like this:

Join the discussion: Have you ever administered heparin? What is the difference between unfractionated and low-molecular-weight heparin, and what are examples of clinical applications? Discuss on Med Talk.

First login to LMS admin and then visit Med Talk, create a new topic for the discussion. See our ACLS courses for how to make the actual link to the Med Talk site.