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Survey of Current Simulation Based Training in the US Military Health System.

Adam Bacik¹, Joseph O Lopreiato², Harry B Burke²

¹Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Silver Spring, MD 20910, USA.

Military Medicine

|August 20, 2024

Summary

Medical simulation in the Military Health System (MHS) primarily focuses on medic and nursing skills for combat casualty care. Larger MHS programs offer more advanced provider and General Medical Officer training, identifying potential gaps in comprehensive skill coverage.

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Area of Science:

Medical Education
Military Medicine
Simulation Technology

Background:

Simulation-based medical training is effective in civilian settings, but its utilization in the U.S. Military Health System (MHS) is not well-defined.
Assessing current simulation practices in the MHS is crucial for aligning training with the needs of modern warfighters.
Understanding simulation methodologies and skills taught is vital for future curriculum development and resource allocation within the MHS.

Purpose of the Study:

To survey MHS simulation programs to determine the prevalence of skills taught.
To identify the types of learners served by MHS simulation programs.
To ascertain the most common simulation methodologies employed across the MHS.

Main Methods:

A cross-sectional survey was distributed to 93 MHS medical simulation program directors.
The survey included 82 critical wartime skills based on U.S. Army, Navy, and Air Force medical guidelines.
Respondents reported learner types, skills trained, and simulation modalities (mannequins, standardized patients, VR/AR, etc.).

Main Results:

80% (75/93) of MHS simulation programs completed the survey.
The most commonly taught skills were medic and nursing skills, with medics/corpsmen (95%) and nurses (87%) being the most frequent learners.
Training predominantly focused on point-of-injury combat casualty care, addressing common battlefield fatalities.

Conclusions:

MHS simulation training is heavily concentrated on medic and nursing skills essential for combat casualty care.
While medic and nursing skill training is widespread, medium and small programs are less likely to offer advanced provider and General Medical Officer (GMO) training compared to larger programs.
Over 50% of skills in nursing, advanced provider, and GMO categories are not covered by 80% of relevant sites, indicating potential training gaps.