A Novel Training Method for Prolonged Care: Scenario-Based Simulation for Military Medical Practitioners

Prolonged Casualty Care (PCC) is a critical skill for all military medical practitioners responsible for managing trauma patients for extended periods in austere environments. Aligned with the Joint Trauma System (JTS) PCC Guidelines, this article introduces a novel training method developed for the Combat Casualty Care Course (C4) PCC Lane. The C4 is an 8-day course hosted by the Defense Medical Readiness Training Institute (DMRTI), a division of the Defense Health Agency (DHA), at Camp Bullis, TX, and serves to provide training to Army, Navy, Air Force, Coast Guard, and foreign national medical officers in the conduct of medical operations in a simulated combat environment. Having identified the requirement to expose students to PCC, constraints such as time, staffing, and materials, coupled with the need to ensure minimal interference with already established training objectives created challenges for integrating PCC training events. The approach described herein uses scenario-based simulations with moulaged mannequins, deliberate inaccuracies, and structured debriefs to enhance the critical thinking and hands-on skills of participants. Designed for a heterogeneous audience, from combat medics to physicians, this scalable model adapts to diverse training venues and provider expertise levels. By integrating realistic patient scenarios and go/no-go checklists, it ensures providers address key PCC tasks while identifying and correcting clinical discrepancies within time constraints.