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  • Research and Realism Enhance Readiness: Highly Realistic Training for IDC Students

    SAN DIEGO – Imagine you’ve just graduated from a school that taught you how to be an independent medical provider. Now imagine you have a critically injured patient whose life is in your hands. If that weren’t stressful enough, you have to treat them in the middle of a warzone with bullets flying, the air filled with smoke and screams. 

    How confident would you be in your ability to provide life-saving care? Would you be confident if you’d never been in a situation like this? Would training in a realistic, operational environment help you be better prepared?

    In 2013, a team of researchers from the Naval Health Research Center (NHRC) launched a study to answer those questions. They wanted to learn if Independent Duty Corpsmen (IDCs), enlisted personnel trained to provide advanced medical care independent of a physician, would have increased confidence in their ability to provide care in an operational setting if simulated battlefield scenarios were part of their training. 

    The team worked with leadership at the Surface Warfare Medical Institute’s (SWMI) Independent Duty Corpsman School in San Diego to develop and implement the training. The scenarios were developed with the expertise of IDC school instructors and required students to correctly assess and treat specific medical problems such as uncontrolled bleeding, respiratory distress, and blast wounds.

    Live actors (some of them combat-injured veterans) played the role of trauma patients, adding elements of realism. Actors interacted with the students during scenarios, yelling, screaming, and even resisting treatment. Some actors wore cut suits that allowed participants to practice hands-on medical care (controlling bleeding, inserting chest tubes). The overall goal was to test the IDC students’ ability to use their trauma combat casualty care (TCCC) skills while managing single and mass casualty situations. 

    Another dose of reality came from the location. The training took place at a television and film studio in San Diego, using pyrotechnics and sets designed to replicate real places IDCs would encounter after graduation including a ship, a village in a combat zone, and a flight deck.

    The project ran from February 2013 through December 2014, with the simulation incorporated as part of the students’ final exercise for their trauma unit. NHRC researchers measured satisfaction with the simulated training, career intentions, and general, occupational, and task-specific self-efficacy using pretest and posttest surveys from a sample consisting of 290 male and female service members enrolled in IDC School.

    “It was important for us to know if the corpsmen were satisfied with the training and with specific elements of the training as this information could lead to modifications in the future,” said Dr. Stephanie Booth-Kewley, research psychologist at NHRC.

    According to Booth-Kewley, the team hypothesized that IDC students would express high levels of satisfaction with the training, significant increases in their self-efficacy, and increases in perceived readiness and career intentions.

    “All of our expectations were confirmed, except career intentions did not change,” said Booth-Kewley. “This isn’t surprising given that most of the corpsmen in this sample had been in the Navy for a fairly long time, with an average tenure of nine years.”

    One of the findings was that the increase in task-specific self-efficacy was particularly large.

    “Our finding on task-specific self-efficacy is not surprising,” said Booth-Kewley. “The training focused on improving the students’ hands-on trauma skills and it was hoped that the training would allow students to both perfect and gain confidence in performing those skills in battlefield conditions.”

    According to Master Chief Hospital Corpsman Brad Kowitz, IDC School program director, the simulated training helps students improve confidence in their skills by reducing the initial stress that comes when treating a trauma patient for the first time.

    “The best part of the training is taking students away from the classroom, placing them in a very realistic environment, and watching them evolve during the two days they’re out there,” said Kowitz. “On the first day, they are overwhelmed and distracted by all the external stimulation in the simulated training environment. At the end of the training, they are more confident, more relaxed, and more focused on treating their patients. They are transformed.”

    With NHRC’s initial study complete, the training has become a routine part of IDC School training, a successful transition of research into practice.

    As the Navy transitions away from live tissue training, highly realistic training holds promise as an effective way to prepare Navy medical personnel to be mission ready and deliver high-quality care in a variety of operational settings, on land and at sea.

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