Military Medical Training -- Younger Learners Demanding  More 

HTE correspondent Marty Kauchak gained one subject matter expert’s insights on the benefits and challenges of the US Navy’s use of learning technology in its medical training and education programs.      

Military services around the globe have compelling reasons to invest in learning technologies for their training and education programs. From one perspective – the US Defense Department’s – aside from the persistent clouds of budget uncertainties remaining over the Pentagon’s budget through the next several fiscal years, the services’ ranks are being filled with tech-savvy and proficient recruits and officers. One glimpse of this reality can be gleaned from the services’ medical and other healthcare branches and corps. Indeed, as LCDR Kazmer Meszaros, NC, the assistant director for Navy Medicine Modeling and Simulation Training at Navy Medicine Education and Training Command, matter-of-factly observed, “In this day of ever increasing technology, educators will have to adapt to keep their learners engaged. Gone are the days of instructor-led Power Point lectures. Our younger learners demand more. Thankfully, technological advances such as augmented reality are being developed to meet this need.” The Nurse Corps officer offered other insights of interest to the broader healthcare learning community.

One Community “Snapshot”   

Meszaros strengthened the case for investing in learning technology when he focused on a Navy Hospital Corps School student preparing for tomorrow’s class on cardiac anatomy. In his example, using a tablet device, the student scans over a 2-D picture of a patient’s chest. “As the camera brings the image in to focus a digital 3-D image of the heart appears showing its location within the chest in relation to other structures. As the student moves the tablet around the 3-D image, the heart chambers and valves come into view,” he explained and continued, “As the heart proceeds through the cardiac cycle, the student not only hears the familiar ‘lub-dub’ but also sees the chambers fill and valves open and close as blood is pumped out to the body tissues. Tell me, given the choice between a Power Point lecture and this type of instructional supplement which would you choose?

The subject matter expert asserted that as technologies are already being utilized in medical education programs and as the technology improves, their use will only increase in the future. “The challenge will be to determine how to insert these learning technologies into existing curriculum,” he emphasized.

It is therefore no surprise that on any given day, the education and training of Navy medical personnel is enhanced through medical simulation. Meszaros observed that when most people hear the term “medical simulation” visions of plastic manikins come to mind. However, manikin-based training is only a small part of the many training technologies being used throughout Navy Medicine. “For example, simulation centers at some of the Navy’s larger Medical Treatment Facilities utilize ultrasound simulation trainers that incorporate imaging from over 1,000 actual patient cases with real pathologies to provide realistic hands-on training experiences. This technology enables physicians and other healthcare professionals to improve their ability to scan and recognize real-patient pathology in a risk-free setting,” the subject matter expert added.

In this era of increased joint training among the services and with non-US DoD organizations as part of the “whole of government” training and operation construct, Meszaros was asked about any challenges to completing seamless virtual training among these entities. The service subject matter expert pointed out a challenge with the Navy’s current state of manikin-based simulation training is the inability to continue the training scenario through multiple levels of care across the treatment continuum and offered as one example – a scenario starting with a Marine receiving a gunshot wound on the battlefield somewhere in the Pacific theater. “A Hospital Corpsman begins providing Tactical Combat Care on a high-fidelity manikin.

After inserting an airway and applying a tourniquet, the patient is transported to a Navy Role II facility for further resuscitation and stabilization then transported via Army helicopter to an Air Force Role III facility for ongoing care. Moving the manikin through all of these multi-service levels of care, while maintaining continuity of the scenario, is logistically challenging.” LCDR Meszaros said it was important to find a solution as this team-based training has been shown to improve patient outcomes and offered “One way to overcome these challenges is through standardization of high-fidelity manikins that use a common software across the services. In this case, the manikin doesn’t actually move but the ongoing physiologic response to interventions is passed to the high-fidelity manikin at the next level of care, and the training scenario is allowed to proceed in a more realistic fashion.”

Meszaros was also asked to highlight learning technology trends and developments his service’s medical personnel may see in the next 18 months.

In one instance, “Exciting technology currently exists to comprehensively understand and train warfighters for the stress they will experience during combat. In this context the warfighter is the learning audience,” the Nurse Corps officer said and continued, “Technology exists that comprises a realistic combat experience represented in a virtual reality environment. This virtual environment is designed to provoke physical and emotional stress and will frequently portray a situation reported by veterans with PTSD [post-traumatic stress disorder] to have been a contributing factor in their PTSD.” After playing out the virtual event a “virtual mentor” helps explain, with the use of dynamic, high resolution animation, how the brain and body react to stress. “In conjunction with explaining the physiology of stress, the mentor also presents physical, social and cognitive exercises, utilizing Cognitive Behavioral Therapy techniques the warfighter can engage in to assist in preparation for upcoming combat experiences,” he added.

Asked to help the training & simulation industry community better respond to his service’s requirements, LCDR Meszaros replied, “My recommendation to the training and simulation industry would be to research the service-specific needs for medical training. For the Navy, a high-fidelity manikin able to withstand water exposure would be useful for shipboard mass casualty drills.”

TAGS: US Navy, PTSD, Navy Medicine Education and Training Command