Crawl, Walk Fast, Run Hard: Military-Civilian Partnership Training at the Army Trauma Training Course Improves...

The Army Trauma Training Course (ATTC) has held the responsibility of training deploying U.S. Army Forward Resuscitative and Surgical Detachments (FRSDs) since September 2001. The program of instruction (POI) consists of didactics and skill stations (Crawl), a mass casualty (MASCAL) situational training exercise (STX) (Walk), and clinical integration into an urban Level I trauma center (Run). Over the program's 25-year existence, there has been no report on the subjective assessment of the rotator's perceived effectiveness of the program as a whole. We hypothesized that a post-course survey would evaluate the POI at the ATTC and that ATTC graduates would subjectively describe improved operational readiness.

Post-course surveys were delivered electronically to rotating FRSDs as a graduation requirement. Survey questions were developed on a 5-point Likert scale, and descriptive statistics were calculated.

Survey data were analyzed from 25 courses (October 2021 through December 2023), including 485 FRSD members. There were 41 general surgeons, 19 orthopedic surgeons, 48 emergency medicine physicians, 51 CRNAs, 53 critical care nurses, 48 emergency room nurses, 7 other nurses, 57 LPNs, 82 combat medics, 50 surgical technicians, 6 physician assistants, and 23 medical service corps officers. The post-course survey response rate was 441/485 (90.9%), with nearly all respondents answering the entire survey. Among respondents, 402/440 (91.4%) respondents agreed that the MASCAL STX better prepared them to manage a MASCAL scenario; 410/441 (93.0%) respondents agreed that clinical rotations were useful for FRSD team development; 401/440 (90.9%) respondents agreed that their experience at ATTC made them more confident in performing their Individual Critical Task List (ICTL) skills in the deployed setting; 402/424 (94.8%) respondents agreed that their experience at ATTC made them more knowledgeable of the Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs); 398/425 (93.6%) respondents agreed their experience at ATTC contributed favorably to their operational readiness; and 437/441 (99.1%) respondents indicated they would recommend the course to another deploying FRSD.

POI at the ATTC subjectively improves FRSD collective and individual preparedness for deployed combat casualty care. Further studies are needed to evaluate the objective effectiveness of the training platform.