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Medical Direction Needs Analysis: Codifying a Medical Directors Course to Meet the Demands of Modern Combat Care
Joshua Lowe1,2, Eric Kretz1, Emily Raetz1,2
1Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, United States.
Military Medicine
|May 31, 2025
Summary
Emergency medicine physician training variability impacts medical director readiness for large-scale combat operations (LSCO). Standardized training is crucial for improving military medical outcomes.
Area of Science:
- Military Medicine
- Emergency Medical Services
- Trauma Systems
Background:
- Prehospital Medical Directors are vital in military medicine, especially during Large-Scale Combat Operations (LSCO).
- Current Emergency Medicine (EM) physician training for Emergency Medical Services (EMS) is inconsistent.
- This variability impacts their ability to manage and direct medical operations in high-intensity scenarios.
Purpose of the Study:
- To explore the impact of current EMS training variability among EM physicians on their medical direction capabilities in LSCO.
- To identify training needs and leverage technology for military medical operations.
Main Methods:
- A cross-sectional study using an online survey distributed to active-duty EM physicians.
- Survey evaluated training, experience, and comfort levels in medical direction.
- Data collected from January to September 2024; analyzed using descriptive statistics and t-tests/ANOVA.
Main Results:
- 139 EM physicians responded, revealing significant EMS training variability.
- Physicians with supplementary "crash course" training reported higher comfort in critical tasks like teaching medics, establishing protocols, and guiding resuscitations.
- Physicians without supplementary training showed lowest self-perceived proficiency, especially for LSCO.
Conclusions:
- A critical gap exists in EM physician preparedness for LSCO medical direction due to inconsistent EMS training.
- Standardized, comprehensive training incorporating Tactical Combat Casualty Care and technology is needed.
- Addressing training disparities will enhance military medical team readiness and effectiveness.
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