personnel at the U.S. Army’s Medical Research Institute of Chemical Defense [USAMRICD] collaborated with simulation industry in developing high-end manikins that simulate a human seizure and the cholinergic crisis caused by severe nerve agent exposure. These manikins have totally replaced non-human primates for the training of medical personnel. Also, medical personnel from USAMRICD collaborated in developing sulfur mustard blisters than can be placed on manikins or human actors to simulate mustard agent exposure. Moving beyond training, Madigan Army Medical Center and the National Center for Telehealth and Technology [T2] are exploring simulation to improve evidence-based behavioral health treatments for PTSD. With the University of Southern California’s Institute for Creative Technologies, they piloted simulation to improve ecological validity of cognitive assessments for active duty soldiers at Joint Base Lewis-McChord. T2 now uses simulation to deliver interactive PTSD psychoeducation. In summary, simulation has become one of the most effective modalities to train cognitive, psychomotor and communication skills among medical teams. Scenarios with authentic noises, visual cues and other sensory stimulators, even smells and “feel,” are replacing sterile labs, sometimes-boring lectures and “there-I-was” stories. Synthetic environments train rote skills and critical thinking and yield more predictable outcomes, improved patient safety and quality of care. Serious gaming offers iterative learning in learner-centric environments, to engage tech-savvy volunteer soldiers. Of course, academics are still important, but the ability to synthesize academic information approaches reality through simulation. As we learned from Captain Sullenberger’s water landing on the Hudson, his training in the aircraft simulator and years of experience saved many lives that day. Simulation can do that for the military medical community as we care for our patients, whether care is given on the battlefield, in the air during evacuation, or at a brick-and-mortar medical facility. If the outcome of a simulation is not good, we reset the simulator and try again. Our medics and providers need standard, effective, repeatable training, tailored to learner needs, for yet more capable and confident caregivers, so we can protect and care for our warfighters and their families. The Army has developed, validated or provided significant monetary support for many of the medical simulators available today, either as working prototypes or in use by civilian hospitals and emergency medical services. Improvements in simulation technology have been impressive, but we must keep our eyes on the ball, seek the resources necessary, and close the gap between what we have and what we need. Our medical personnel and our patients deserve no less.
implemented into training conducted at both forward locations and at the AMEDDC&S’ Academy of Health Sciences. The proposed Medical Skills Reset Program is designed to take advantage of the vast resources of the Army Medical Department for maintaining a skilled enlisted force. AMEDDC&S representatives will be working with the stakeholders such as the combatant commands, Forces Command, Army National Guard and the Army Reserve to determine the professional standards of trained and ready medical soldiers. Relevant, engaging and effective training will be implemented and executed through close coordination with medical education departments of installation medical, veterinary and dental activities. Distributed learning products will continue to be available to units to maintain competency in deployment related medical skills while in a garrison environment. Currently, there are more than 280 Army Training Requirements and Resources System courses available through distributed learning technology. Q: How has the U.S. Army medical community addressed the growing numbers of soldiers who are medically unfit for deployment? A: MEDCOM has addressed the issue of medically not ready soldiers through several initiatives: •
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Q: What will be the primary focus of training of the medical caregiver as troops begin to come home from deployment? A: As the Army transitions to a garrison-based, expeditionary force, the challenge will be to keep the skills of the battle-proven medical soldiers current and sharp. Various methods of instruction will be employed to ensure a well-trained, competent and ready medical force. The 315 programs of instruction currently offered at the U.S. Army Medical Department Center and School [AMEDDC&S] are continually updated using the latest science, technology, innovations and lessons learned from the field. Medical simulations for both collective and individual skills will continue to be improved and 20 | M2VA 16.3
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Increasing the number of providers and support staff to ensure adequate resourcing to meet established timelines and ensure appropriate individual attention Flexing capacity through virtual capabilities like the implementation of telehealth assets and VTC capabilities Improving information systems to improve efficiencies and enhancements to eProfile and eMEB Improving and standardizing staff training to provide a more efficient and better informed workforce Creating a consolidated, centrally-managed program with detailed and prescriptive directions to subordinate organizations Automating the Army system for the creation of physical profiles for soldiers with medical limitations and mandated that all physical profiles be created in an electronic database [eProfile]. This allows visibility of both temporary and permanent profiles on all soldiers by eliminating the pocket profile, and provides transparency for providers and commanders in real time. Automating the system for identification of soldiers with evidence of a permanent medical condition and no medical or administrative board outcome in MEDPROS. These soldiers will automatically be moved into the ‘not ready’ population. Once a board finds a soldier fit for duty, they will automatically be moved into the ‘ready’ numbers. This process identifies soldiers as not ready if they have not been boarded and forces adjudication by a medical or administrative board. Developing an Individual Medical Readiness Leaders Course which: assists leaders to ensure soldiers are medically ready; gives leaders an understanding of medical profiles, individual readiness and unit medical readiness; and familiarizes leaders with the medical readiness classifications and available reports for monitoring unit medical readiness and profiles. O www.M2VA-kmi.com